Ask the Professional - Interview – Equine Performance Dentistry
Today we’re talking with Dr Paul Owens BSc, BVSc, PhD, MRCVS MANCVS (Eq.D) from HorseVetDentist (www.horsevetdentist.com.au) about Equine Performance Dentistry on how dressage horses can benefit from dental assessments and dental treatments. Paul is a Veterinarian who hails from the UK but is now based in Australia although he makes regular lecture trips back to the UK for work. Find out more about Dr Owen's work at: www.horsevetdentist.com.auwww.horsevetdentist.com.au
We took advantage of his time while treating each end of the performance horse spectrum today to pick his brain – today we had a young 4yo warmblood gelding getting checked out before starting his riding career, and a 15yo advanced level mare imported from Germany 4 years ago who has had some health issues since.
What is your advice on how young a horse should be to get their first dental checked?
After a mare has foaled, we always advise that a veterinarian carry out a general mare and foal check within 24-48hours of foaling. This check will ensure that the mare has no complications post-foaling and that the foal has received adequate colostrum and is in good general health. This is also a great opportunity to check for congenital dental/facial defects in the foal, that may affect it's long term health and welfare. Such things as Parrot mouth, Wry Nose and Monkey Mouth. Early diagnosis is the key to set up treatment plans.
What kind of changes take place in a horse’s mouth over the first few years?
Very few people are aware of the massive changes that take place in the growing horse in the first five years of life, so this is an excellent question to address.
During this time-frame, the average horse or pony will shed (lose) 24 deciduous (milk) teeth and erupt between 36-44 permanent adult teeth! That is an awful lot of change happening in such a short time.
Just like in young children where overcrowding and crooked teeth can be a common feature, so too do we see abnormalities in eruption of teeth in equids.
A foal is born with 12 cheek teeth – staggering fact! In addition, by six months of age they have a full set of deciduous incisors and can even be born with the four incisors already erupted.
One can now see how important it is to have your horse's examined at least every six months in the first five years of life. This can alert the veterinarian to any dental issues early that can then be addressed easily.
I often tell my clients that investing in veterinary dental care for the growing horse through thorough dental checks, will set their horse up for life and this will mean a healthy horse which is a happy horse!
What are some of the most common dental problems you’d find in Dressage Horses? Anything riders should look out for?
There are no specific dental problems that I see with horses used for different disciplines. I see horse that are engaged in eventing, dressage, pleasure, cutting and reining. The key message is making sure that a dental abnormality is detected and then appropriately treated. This involves a very detailed examination which I will describe later. Having said that, there are a number of issues that Dressage riders may notice that can be dental related. These include an abnormal head carriage, leaning to one side, head tossing, chewing excessively on the bit.
I advise riders to try and assess at what point their horse appears to behave differently – is it when they request a change in transition, when contact is made, resistance to the left or right? This can sometimes help when carrying out the dental examination.
Another good idea that should be routine for all riders, is to assess the lips at the commissure (corner of the mouth where the bit goes) after a ride and see if there are any signs of trauma, abrasion from ill-fitting bits or more severe trauma with cuts or splits at the commissure. This may be bit-related, rider ability or dental pain causing the horse to avoid the discomfort and hence "grab" the bit.
What’s involved (or should be) in a Dental Assessment?
Before examining the horse, I like to get a detailed history from the owner / rider that includes eating habits (dropping food/slow eater/fast eater/balling food –gulping/ any health issues, including colic episodes); how does the horse behave under saddle - head tossing/leaning/head tilting/resistance on a particular rein?
The head of the horse is a very complex area and there is a close association between dental structures and other areas of the head. For this reason, a dental examination should start by looking at the external structures of the head. This can be carried out by palpating the muscle, bone and joints. Looking for any lumps or bumps that should not be present and any discharges from the nose and eyes that may alert the veterinarian to potential abnormalities.
When one looks inside the mouth the requirements for a complete and detailed examination are simple. The best way to think about this is when we go to the dentist ourselves – the human dentist uses a high powered light, a mirror to check each tooth and a probe to touch any area of a tooth that looks abnormal.
If your dental provider is not carrying out this type of detailed examination, then unfortunately your horse is not getting their teeth checked properly. To carry out such an examination does require sedation to allow for a stress-free and pleasant experience for your horse.
After sedating the horse and carrying out my external examination, I flush their mouth out with water and mild antiseptic wash (as used by human dentists). I examine the front teeth (incisors) and then place a speculum to open their mouth.
Working systematically, I check every single tooth in the horse’s mouth. This examination relies on using a dental mirror to look at every single surface of every single tooth. Areas of concern are checked further with a dental probe and special dental camera (laparascope) that allows for really fine detail of the area in question.
All findings are then recorded on a dental chart for future reference.
By carrying out a thorough dental examination in this way, I can be confident that any abnormalities have been properly identified and a treatment plan can then be put in place.
*Watch Dr Owens perform a Veterinary Dental Assessment and hear his advice on videos below:
Dental Assessment Part 1 - https://www.youtube.com/watch?v=7uzEhaaxBAY
Dental Assessment Part 2 - https://www.youtube.com/watch?v=7KGJ2qVhygc
Today my young horse had a wolf tooth on one side that was obviously going to cause discomfort once a bit had been placed in his mouth and you performed a simple procedure to extract it - Under what circumstances would a horse need an extraction – and what possible side effects could there be?
The most common dental extraction is the removal of wolf teeth. We usually remove these as they can pose problems with bit placement in the riding horse. Although wolf teeth are relatively uncomplicated to remove, the area must still be numbed using local anaesthetic as it is painful to remove a tooth any other way.
Other instances where teeth may need to be removed include
1) Retained or loose caps - these are deciduous / baby teeth that have not shed properly.
2) Fractured teeth
3) Teeth that have a tooth-root (peri-apical) abscess
4) Teeth that have irreversible periodontal disease that has caused gum and bone recession
5) Teeth that have pulp exposure – where the blood and nerve supply are open and food and bacteria can get trapped and work their way down the root canal leading to eventual death of the tooth.
In each of these cases, it is paramount that the offending tooth is extracted by veterinarians with training in equine dentistry. Tooth extraction is no different to any another surgical procedure and requires careful planning with pain relief, nerve blocks, x-rays in some cases, antibiotics and other medications.
If this is carried out it will minimise the complications that can arise. These include, fracture of the tooth at the root as it is being extracted, injury to the bone socket, infection and damage to other teeth.
Is there any known link between dental issues and Stomach Ulcers?
Actually, there is good evidence that links dental pain with Equine Gastric Ulceration Syndrome (GUS) in horses. Dental pain can affect the way a horse chews (masticates) which in turn can affect the saliva production which is an important buffer in the stomach. Chronic long-standing pain that is associated with dental disease, can be a trigger factor for the development of gastric ulcers. A veterinarian with dental training can advise you about this.
What kind of improvements have been made in equine dental science over the years?
The biggest advancements in veterinary dental science has been our understanding of the anatomy and physiology of the teeth and surrounding structures. We now know so much more about periodontal disease, the position of the nerve and blood supply inside teeth, the emergence of peripheral carriers and even new work on root canal therapy in horses. It must be stressed that these advancements are being led by veterinary research scientists throughout the world.
How regularly should a horse’s teeth be checked by a Dental Vet?
The gold standard for check-ups is as follows:
1) The first five years of life : every six months. There is a huge amount of change during this time period with horses shedding 24 deciduous teeth and erupting up to 44 permanent teeth. By caring out twice yearly dental checks, it is possible to address abnormalities with dental eruption during this time period. Teeth can become impacted (like our own Wisdom teeth) and teeth can be forced to erupt into the mouth in a crooked manor which can lead to all sorts of problems down the line.
I always tell my clients that by investing in twice yearly dental checks in the first five years of your horse / pony's life, you can set them up for a healthy and happy future.
2) Horse from five years to twenty years : every twelve months. Often horse at this age will only require an annual check-up if they have been maintained properly in their younger years. Of course, this has to be on an individual case basis. I often find performance horses, particularly dressage riders, like to maintain their dental checks every six months to ensure that the mouth remains a pain-free area for the horse under saddle.
3) Senior horses 20 years plus : every six months. Interestingly, older horses can often require the same regularity of dental care as young horses. Senior horses start wearing out their teeth.
My older mare today has some old scarring on the inside of her mouth from lack of dental care prior to purchasing her – she’s had regular dental care now for several years – but does the scaring or trauma ever heal once it’s happened or will the skin callous and always remain?
Scaring does indeed occur when the cheek is constantly exposed to sharp points that damage the cheek tissue. When on-going damage occurs to the cheek, the body lays down thickened tissue and this is called hyperkeratosis. Thankfully, the scar tissue is not painful but it will remain in some circumstances.
Are there any dental problems that really can’t be fixed that a buyer should consider when purchasing a horse?
This is both an excellent question and a very difficult one to answer. When purchasing a horse, I would advise a purchaser to request that the veterinarian carry out a thorough oral examination at the time of the pre-purchase examination. This does require sedation and additional time and the vendor may be reluctant for this to happen.
Some horses may have fractured teeth that are very costly to have removed if they are complicated fractures. Other horses may have sinus infections caused by tooth root abscesses and they can be difficult to treat. Neoplasia, or cancers in the mouth and around teeth, are less common, but sadly do occur. Most dental problems are fixable, but treatments may be very costly, require multiple surgeries and could prevent the horse from being ridden.
Where can we find more information?
This is a very exciting time in equine veterinary dentistry. There is much research being carried out into several different problems and new avenues for treatment are being pursued.
We have come a long way in the last 15-20 years and horse owners now have the possibility of seeking help from veterinarians with high skills in dentistry. The organisation Equine Dental Vets was started here in Australia and now has veterinary members from all over the world. This is a great resource for people wanting help and advice. Follow the link www.equinedentalvets.com
Happy horse riding and never forget ..... "A Happy Horse is a Healthy Horse"
Find out more about Dr Owen's work at: www.horsevetdentist.com.au