I treat all equines, horses, ponies, donkeys, mules regardless of their size, performance demands etc, etc. From million pound racehorse, to olympic team horse to family hack, pet or companion. Although their dental needs differ, they all recieve the same standard of care and attention.
I will discuss with you your horses management and care regime, diet, performance demands, preivious dental history and any problems you may feel your horse has which may be ,directly...or indirectly, dental related.
Whilst Ihave the highest regard for safety (for you, your horse and myself) i do not regard the use of sedation as a substitute for horsemanship. By this i mean that I see sedation (chemical restraint) as an "Instrument" to be considered where necessary as any other to enable specific procedures to be enacted efficiently and thoroughly and safely.
I get many calls from owners who ask as part of their initial enquiry "do you want him / her sedated because my vet / last dentist always has him sedated"? Over the years I have come to learn that many Vets sedate horses even for simple or routine dental treatments simply because "THEY CAN" i.e. only a veterinary surgeon can prescribe and administer sedative drugs. Many of them are not skilled enough in equine communication and simply take the "easy option"of chemical restraint. The same is also true to say of some non veterinary Equine Dental Practitioners lack the same communication skills and prefer some horses to be sedated for treatment. The unfortunate outcome of this option is that the horse never actually learns that the whole procedure doesnt have to be as traumatic as anticipated. In addition, there is an added cost burden to the procedure and sadly I have found that this can deter some owners from being as actively "Proactive" as they ought...e.g. they dont have their horses checked as often as they should.
Also, many practitioners learn their skills only on sedated animals. (As an instructer i fully appreciate the virtues of such policies), however, I very soon realised that I needed to improve my horsemanship skills to enable me to work the way i wanted to. As well as being very fortunate to have travelled and trained with an excellent mentor who specialised in working with un-sedated horses, I studied several "natural horsemanship" metodologies and I incorporate many of the principles that I have learned into my practices when treating horses. I have adapted my techniques and chosen the specific equipment I use to enable me to work the way that I do (and you will see that tthe way I work is very different from most) in order to treat the vast majority of horses requiring uncomplicated, or routine treatment without the use of sedative drugs.
I spend the time it takes to evaluate every horse''s reaction to what is happening and wont even attempt to start any treatment untill I''m sure that the animal is appreciative and understanding of what is being asked. Over many years, I have established a solid reputation for being able to work with the most nervous and "naughty" (the owners words...not mine) horses and ponies who have previously been sedated for Dental encounters.
Having sad that, I will not hesitate to include the use of sedation as part of a treatment plan for more complicated procedures and treatments. These procedures will involve consultation with, (for the administration of sedatives and or other drugs and possibly other diagnostic methods, e.g. x-rays) your Vet. Occasionally referal to a Veterinary Surgeon who specialises in such procedures is necessary too. Proceedures requireing the involvement of sedative and analgesig drugs include the extraction of wolf teeth, periodontal treatments, including diastema and other restorative treatments and in certain instances where large amounts of use of high speed power equipment is required and work on insicors is necessary.
Having discussed your horse with you, I will usually enter his stable alone. I have learned that most horses and particularly ponies, feel much less threatened this way. When two people enter a horses personal space, his claustraphobic instincts kick in to a higher level imediately. I will always ask the horse to come to me (he must move his feet when i do not move) and I prefer him to make first contact. when I feel fromhim that he feels easy with me in his presence, I will then put on the head collar or halter and agin, only when I feel that he is comfortable I will begin the examination.
Firstly I look the horse or pony all over. I assess confirmation and in particular look for symetry in the head. Then I will start a hands on examinaton. All the time i am getting a feel for the way the horse is accepting my presence and this will tell me how he is going to respond to further requests from me. I will ask him, in a calm but assertive manner to do very simple tasks and the way he responds will indicate the ammount of respect he has for me (how he rates me as a leader) and if I have his respect....I will have a higher chance to gain his trust. All the time I am with your horse, I am never prepared to take more than he / she is prepared to give.
I will begin by palpating (feeling) several areas which are known to exhibit discomfort caused by dental problems. This is a way of asking the horse "where does it hurt?". He cant tell me vocally, but his reaction to my touch tells me lots. You cannot identify a problem without knowing the symptoms.
The first area I palpate is the area around the "jaw joint" (Temporomandibular joint). This is a very common area of pain and tension created from a host of dental problems. Particularly in older horses, this joint becomes very worn (from years of almost constant movement, e.g. chewing for upto 18hrs per day) and is an area prone to osteoarthritis. The degree of soreness in this area will give me an indication of how far the horse will allow me to open his mouth with the dental speculum (gag) and for how long he can tollerate it being kept open.....I dont keep it open for more than 3 minutes at at time regardless. Simply knowing this will make the whole experience far more tollerable for him and easier for me. Whilst feeling in this area I will encourage the horse to chew (by touching his hard palate) and listen and feel for any abnormal noise or movement from the joint.
Next i will feel and check the poll and cervical vertebrae area. If there are any deviations or rotation of the atlas or axis (1st and 2nd cervical vertebrae) there is a very high likelihood of dental problems caused by the horse having to tilt his head whilst chewing, thus favouring chewing on one side of his mouth more than the other. This can cause problems with both molars and incisors. Any soreness around this area will tell me where the horse feels most comfortable holding his head during treatment....higher, lower or off to one side or other.
Whilst i am not able to offer proper diagnosis or treatment advice for chiropractic problems, I have trained with vets and non- vets who specialise in such and can recognise certain problems in and around the head and neck which would warrant further investigation by a suitably qualified practitioner and my extensive dental training has shown me the strong "two way" links between dental and chiropractic problems.
After this I will check the muscles used in the mastication (chewing) process. I will assess them for symmetry, e.g. is one larger or more developed than the other, therefore working more than the other, indicating a problem in one area of the mouth. These muscles are on the forehead, (the temporalis...close the mouth), the cheeks (the masseter providing the sideways grinding stroke) on the side of the face and the buccinator (helps to keep food central in the mouth whilst it being chewed) between the jawbones. By feeling them I can tell if they are sore etc. If there is soreness there, I often massage the area to provide relief and the horse becomes much more tolerant of the whole treatment process (lessening the need for sedatives or other restraint).
I will then gently press the cheeks against the outer edges of the upper teeth and also apply pressure at the parts where the bridle noseband and the bit would press when a contact is taken. Again this is all the time asking things of the horse in order to formulate a treatment plan which works best for him / her. The horses are the patients.....you are the client.
Other pre-treatment checks include moving the jaw from side to side to assess the range of movement and to listen for any "squeeky" teeth (loose teeth will sound like this when in contact with another tooth during chewing) and also any high points along the rows of teeth will give a distinct sound. I will check the horses breath (we really are a weird lot us EDT''s...ha ha) as this is an indicator of periodontal disease, fractured or decayed teeth, or, as in younger horses, loose deciduous teeth which may need removing. I will examine the lips, the canine teeth, if present, and examine and feel the bars for signs of bit trauma or "bone spurs"(spints).
Next I will examine the Incisors. I look for loose caps (remnants of baby or deciduous teeth), gingivitis or periodontal disease and general signs of correct wear. I will check the "bite" or alignment of these teeth, as many malocclusion''s here lead to problems with the molars or grinding teeth.
It is also the incisors which are used to ESTIMATE the horse''s age.
Whilst examining these teeth, I will check for Lampas. This is a very common, harmless condition which is present in the mouth of many young horses and ponies which are "cutting" their permanent incisors. Its is a localised swelling and inflammation of the hard palate behind the upper incisors. The degree of lampas, if present, will dictate which type of tooth plate it is best for me to use on my speculum or "gag" to minimise irritation or discomfort for the horse during treatment.
At this stage I will introduce the horse to the "gag" or speculum. This part of the proceedings is probably one of the most important in terms of determining how the whole treatment will go and how the horse will react and respond. If the horse is taught what the gag is and how it works and how he can control how it is used, there should be no problem with him accepting it. My speculum is specially designed to open very quietly and at very small increments to only as much as is comfortable for the horse.....his needs and comfort levels are paramount here. If he''s comfortable and happy with the use of the gag and knows how it works, he wont fight it or resist it .
When the horse is comfortable with wearing the speculum I will examine the inside of the mouth. I will feel around and check visually using a head light. Its strange, but when you do this for a living you develop a "third eye".....at the end of your fingertips. I check and look for ANY abnormality in the teeth, tongue, gums and other structures and tissue in the oral cavity. At the same time am gauging the horses reaction to having my hand in its mouth which will also give me an idea of how it will cope with any treatment and I can plan such treatment,noting which areas of his mouth are the most uncomfortable and where should I place the instrument first. I always start in the most uncomfortable areas FIRST so that, in the event that complete treatment is intollerable to the horse in one session, at least the most painfull area has been treated and the horse wil know what I am doing....and Why.
At this stage, if the horse is comfortable and I feel it is safe to do so, I will encourage you to look in your horses mouth and to feel around so that you can see the problems and get a feel of what discomfort he is experiencing. Untill you actually feel the severity of points of sharpened enamel and your fingers get cut by them that you can appreciate why the treatment is necessary. When someone tells you that "his teeth are sharp", you dont fully appreciate just HOW sharp and what these "little razor blades" can do to your horses cheek linings and tongue. The whole process will then become self explanitory.
Many dental problems in horses are not treated sufficiently, or not at all, simply because they are not identified correctly in the first or initial examination. This is where the training, experience, knowledge and skill of the practitioner comes to the fore. It is essential to FULLY identify ALL problems correctly as mistreatment, or incorrect evaluation of one problem will create another. In some cases, this may leave a horse worse of than before.
I beleive in educating owners as much as possible and there are many ways to assist in this. One of the most interesting and visual ways of achieving this, in addition to the many diagrams and other visual aids I carry is via the use of horse skulls, which I take with with me. I have prepared and sectioned some of these, to show how a variety of problems occur and are resolved or avoided. The skulls are excellent teaching aids, as a problem can be much more fully explained with such real life samples. I can demonstrate the whole chewing cycle, highlight any bitting problems from certain bits and generally give you a better insight to oral anatomy.
If the treatment required is identified as being what I would term "Routine", e.g. it can be carried out there and then, using an array of hand operated instruments, I will start. Again I work on my own, thus maximising the available space in the stable and so that the horse and I can concentrate on each other and maximise communication.
Sometimes I may prefer to move the horse outside, or to another area, e.g. a menage or paddock etc so that his available space is increased should I feel that he needs to know its there. (understanding Claustrophobia). There is no time limit allocated to each patient and my attitude is that it "takes the time it takes" to carry out the treatment effectively with the highest regard for the feelings and comfort level of the horse. This is the only way to gain effective comunication. I have been very lucky to have worked and trained with a great mentor and friend, Mr Bert Lambert ACEqDt, from Idaho who specialised in working with nervous horses in a variety of "non conventional" locations and scenarios, where the luxuries and comforts of the modern stable facilities were not available.
When carring out the treatment I will keep contact with the horse via his lead rope tucked in my belt and attatched to his headcollar, which is removed and fastened loosely around the neck.
As mentioned above, I will treat the worst area first and he / she will be given lots of breaks where the speculum is closed and he / she will be rewarded for every little try they make in cooperation. Doing things this way helps me to be able to treat the vast majority of "UNTREATABLE" horses, or those that have previously always been sedated for dental treatment. Occasionally, I may require an owner to assist by reasuring the horse, eg placing a hand somewhere on him / her, but ,on the whole ,the experience from start to finish is conducted on a "one on one" basis. FORCE is not an aviailable option, as anyone who truely understands horses will tell you, that never works.
Whilst I possess a vast array of power dental instruments and specialised equipment to cover a host of different situations, I carry out the vast majority of routine treatments using hand held tungsten carbide headed floats (rasps).
A "ROUTINE" treatment involves:
Removing ALL the sharp enamel points from ALL the molars and pre molars
Reducing the height of all EXCESSIVE transverse ridges where necessary (note; this does not mean making the occlusal surface flat or smooth, as is so often interpreted)
Ensuring all molar & pre-molar crown heights are even and maintaining or adjusting as necessary the occlusal angles of all the molar and pre-molars. This is essentially what is involved in "Balancing" the mouth.
Shaping the rostral portions of all the first pre molars (termed "bitseating") as is appropriate to the individual horse.
Removal of tartar or calculus accumulations from all teeth where necessary.
General dental hygiene proceedures, e.g. the removal of impacted food debree which can be removed adequately with dental picks and simple water & bacteriacide flushing. (Assessement of any peridontal problems will be made for possible further treatment requiring more specialised methods)
Simple or minor corrections to Inscisors and Canine teeth.
These above proceedures do not cause any pain or adverse discomfort to the horse and when carried out with skill, dexterity and sympathy for the animal and they can be well tollerated by the vast majority of horses and ponies.
Upon examination, it may be apparent that other, more advanced, specialised treatment will be required. This may include the removal of wolf teeth, peridontal proceedures, more extensive balancing of molar/ pre-molar arcades or individual teeth, restorative treatment (fillings etc), further Incisor occlusion correction , etc, etc. I am suitably trained, qualified, equipped skilled and experienced to carry out a vast array of advanced equine Dental proceedures.
However, as such proceedures invariably involve the use of specialist instrumentation (power opperated burrs etc), consultation with a Veterinary Surgeon will be required as the use of sedatives and further diagnostic proceedures , e.g. x-rays, are often involved in such cases.
Rest assured, your horses welfare and best interests are ALWAYS the primary concern here and, in the event that any treatment identified is beyond my limitations I will do my utmost to ensure that such treatment is carried out by the most suitably competant provider.
Due to my extensive knowledge of the profession and of other individual practitioners'' specialist skills, I will also endevour to obtain the best value for money service for you in such cases and refer you to the most competant provider of the best treatment.