Dentistry for your horse

[minesadouble]

Overseas qualifications are not recognised as qualifications by DEFRA and therefore they are legally only allowed to carry out Category 1 procedures (manual rasping, minimal corrections only), and are on the same legal basis as completely unqualified 'dentists' (and not allowed to use the term EDT either). The only people allowed to perform Category 2 procedures (power tools, larger corrections) are vets or EDTs who have passed an exam ratified by DEFRA and are qualified with BAEDT/BEVA or WWAED. Category 3 procedures (anything involving significant extractions, pathology, diagnosis or treatment) are strictly for vets only.

He can claim all he likes that it is just a money making scheme, lots of unqualified 'dentists' do. It's a pretty common argument. I mean I could claim that requiring me to go to vet school for 5 years in order to do vet stuff is 'just a money making scheme'. If I'd qualified as a vet overseas I would equally have to sit further exams here in order to work in the UK. However at the end of the day DEFRA have agreed a way for non-vets to carry out some procedures in a horse's mouth in such a way that they don't contravene the Veterinary Surgeons Act, but have limited it to those with qualifications that they have checked, approved and ratified. Currently these are only the qualifications offered n the UK by the BAEDT/BEVA and the WWAED. Essentially their game, their rules. If you want to play, you play by their rules or you're playing illegally. There has to be some way to regulate and quality control this field.

This is a guide to the legal framework, and to who can do what in a horse's mouth:

https://www.beva.org.uk/Portals/0/Documents/ResourcesForVets/1current-regulations-on-equine-dental-procedures-final.pdf

Thanks for clearing that up!
So WWAED is a recognized qualification in the UK even if they are not on the BAEDT list?
I do feel that it's a bit of a minefield and regulations need tightening up.
When someone asks for a recommendation on the local equine FB page I positively cringe at some of the names mentioned!

 

[minesadouble]

Not read all the replies but a number of people have warned me that EDT's not using sedation can miss sharp areas right at the back. So this time I used a vet with sedation, having used an EDT without sedation for years. She was happy that the back was no different to the front - ie due a rasp, but not horrendous. So for the next routine appt I'll go back to my EDT. Mainly because Lottie found the needle much more traumatic than the dentistry. But I think I will always alternate from now on - and at least check the back under sedation every so often. And if I ever had concerns.

Definitely a good point.

We used to have a horse who the Vet said would always need sedation as his jaw was so 'small and tight' that he would find the gag really uncomfortable and they wouldn't be able to do a their job properly without it.

 

[Tiddlypom]

Thanks, gamebird, that’s really helpful.

Just to clear up one thing, please.

A fully qualified BAEDT EDT who has been correctly registered for a numbers of years but who has now let their registration lapse (apparently because of ‘politics’) - are they contravening professional guidelines by continuing to perform category 2 procedures? As I see it they are still qualified but are no longer accredited to their professional body?

 

[Fransurrey]

I have two that both have the vet as they're done at same time as jabs. One sedated, one not, but he would be if he needed more than a basic rasp. He hasn't so far. The vets at my practice have all done the training, though (I forget the name of the certification, but it's not basic).

 

[The Fuzzy Furry]

Thanks, gamebird, that’s really helpful.

Just to clear up one thing, please.

A fully qualified BAEDT EDT who has been correctly registered for a numbers of years but who has now let their registration lapse (apparently because of ‘politics’) - are they contravening professional guidelines by continuing to perform category 2 procedures? As I see it they are still qualified but are no longer accredited to their professional body?

I would expect that they would no longer have any insurance liability for anything carried out above basic level and hope that they ARE notifying clients before attending.

My preferred practice vet let his BAEDT lapse earlier this year, but this was down to him not being able to fulfil the CPD requirements in a timely manner as he was off long term through injury. He's pretty hectic still, last time we spoke he said he would re-visit it next year.
That said, that's not what you asked TP!

 

[Puzzled]

I use a vet who is a dental specialist…..does no other work! Believe me the difference is incredible. I’m not saying if the horses mouth is fairly straightforward an EDT or standard vet won’t do a good job but the difference in using a specialist is amazing.
I have the teeth of over 30 horses a year checked on the yard to give an idea.

 

[Hackback]

I had my physio over yesterday and was discussing this issue with her. She tells me that it isn't illegal for an EDT to knock out wolf teeth without vet supervision because they only have rudimentary roots. Other teeth, with roots, do require proper vet supervision. She also believes that it is beneficial to use a vet with specialist dental knowledge and use sedation in order to access the teeth right at the back. This is because she couldn't get the older horse to 'grind' his teeth easily and she queried hooks on the back teeth. Food for thought. I think I might get the vet in to do a check now..

 

[anguscat]

Use a vet who’s full-time working on teeth and sedation.

 

[TPO]

I had my physio over yesterday and was discussing this issue with her. She tells me that it isn't illegal for an EDT to knock out wolf teeth without vet supervision because they only have rudimentary roots. Other teeth, with roots, do require proper vet supervision. She also believes that it is beneficial to use a vet with specialist dental knowledge and use sedation in order to access the teeth right at the back. This is because she couldn't get the older horse to 'grind' his teeth easily and she queried hooks on the back teeth. Food for thought. I think I might get the vet in to do a check now..

Your physio is wrong on both counts. Only vets can extract Wolf teeth and they can have substantial roots.

 

[Tiddlypom]

When my mare was waiting for the appointment to have her grade 3/3+ infundibular caries filled in, I was very disappointed to be advised by a first opinion vet not to bother, and to save my money

Horses used to have to ‘just cope’ with dental decay until recent advances in equine dentistry, so I might just as well let her teeth crumble and fall out like in the old days, apparently.

ETA It was fascinating watching the procedure for the fillings. Vet dentist kept stopping to check his progress with the camera probe, so I could see it on the monitor screen. Very precise work to drill out the decay leaving as much healthy tooth behind as possible, and then fill in the cavities. All still good 18 months on.

 

[Chippers1]

I have always used an EDT for Buzz and have a really lovely one who understands that Buzz needs a little extra time and patience for his teeth but always gets them done. Last time though, due to yard move, I decided to join on with the vet who was booked out for others to do a few of the horses' teeth and it was such a mistake she lost her patience with Buzz, and he was getting quite stressed about it (with me like 'he's not normally like this!' and he's not, she could see his teeth are done regularly!) so she was rolling her eyes to her assistant. She also lost the end of her drill in Buzz's mouth then lost the screw in his bedding - complaining about straw beds - and didn't have a spare so had to finish with one side not fully done

I had explained multiple times that he just needs a bit of time and patience and a few breaks and he is absolutely fine but she didn't listen. He can be a little dangerous to inject (bargy, he had an incident with a vet when very young so is quite scared of needles, he's vaccinated in his chest) so I really try and not go down the sedation route but I was so upset with how she'd treated him. I'm not saying at all that all vets are the same, and she's not from the practice I use, but I will definitely be sticking with my EDT after that.

 

[Arzada]

I have always used an EDT for Buzz and have a really lovely one who understands that Buzz needs a little extra time and patience for his teeth but always gets them done. Last time though, due to yard move, I decided to join on with the vet who was booked out for others to do a few of the horses' teeth and it was such a mistake she lost her patience with Buzz, and he was getting quite stressed about it (with me like 'he's not normally like this!' and he's not, she could see his teeth are done regularly!) so she was rolling her eyes to her assistant. She also lost the end of her drill in Buzz's mouth then lost the screw in his bedding - complaining about straw beds - and didn't have a spare so had to finish with one side not fully done

I had explained multiple times that he just needs a bit of time and patience and a few breaks and he is absolutely fine but she didn't listen. He can be a little dangerous to inject (bargy, he had an incident with a vet when very young so is quite scared of needles, he's vaccinated in his chest) so I really try and not go down the sedation route but I was so upset with how she'd treated him. I'm not saying at all that all vets are the same, and she's not from the practice I use, but I will definitely be sticking with my EDT after that.

That was a hard lesson to learn. Presumably you're asking the EDT to come soonish to complete the unfinished vet job. And at the same time restore Buzz's faith in dentistry.

Did the vet charge her full price?

 

[Chippers1]

That was a hard lesson to learn. Presumably you're asking the EDT to come soonish to complete the unfinished vet job. And at the same time restore Buzz's faith in dentistry.

Did the vet charge her full price?

Yes his teeth were finished off not long after and he was well behaved again

And yes charged full price!

 

[Gamebird]

I had my physio over yesterday and was discussing this issue with her. She tells me that it isn't illegal for an EDT to knock out wolf teeth without vet supervision because they only have rudimentary roots. Other teeth, with roots, do require proper vet supervision.

Your physio is completely wrong on that I'm afraid. This is the legislative guidance which emphasises 'direct and continuous veterinary supervision'. Category 2 procedures are limited to vets and qualified EDTs only (and as previously discussed this does not include those with foreign qualifications). Also worth noting that some wolf teeth fall into category 3 (vets only):

However, it is important to note that currently category 2 procedures are still acts of veterinary surgery until any future exemption order or legislative reform. This has important ramifications since according to the category 2 list “the removal of erupted, non-displaced wolf teeth in the upper or lower jaw must be under direct and continuous veterinary supervision” i.e. the veterinary surgeon must be present to supervise the entire procedure. Failure to do so may result in serious consequences for all parties concerned. Furthermore, removal of any non-erupted or displaced (“blind/unerrupted/oblique”) wolf teeth remain as a category 3 procedure, since incision into vital tissue to expose the tooth is clearly an act of invasive surgery. Should a non-veterinarian carry out a category 3 procedure (which is not legal), even if under the direction of or assisting a veterinary surgeon (and this includes the veterinary surgeon incising over the non-erupted tooth) then the veterinary surgeon, EDT and owner of the horse are ALL liable for potential prosecution or disciplinary action, should unforeseen complications occur.

 

[Gamebird]

Thanks for clearing that up!
So WWAED is a recognized qualification in the UK even if they are not on the BAEDT list?

That is correct. The evolution of EDT status in the UK has been slightly political, to say the least! It would be impossible to get all UK EDTs on the same page (in fact one or two members of the profession are well known for their ability to start an argument in an empty room, so a consensus on anything is pretty unlikely!), so for the moment there are two organisations that EDTs can be registered with. The WWAED exam has been ratified by DEFRA, so those qualified via this route are also allowed to perform Cat 2 procedures. There aren't all that many qualified via this route.

The list can be found here:

WWAED Category 2 List - The WorldWide Association of Equine Dentistry

The WWAED have been approved by DEFRA and the RCVS to run Equine Dentistry Category 2 Examinations, alongside the British Equine Veterinary Association (BEVA). Current Members that have passed the Category 2 Exam Gary Khakhian Essex Nat Heal Kent Chris Warren Sussex Duncan Gipson Sussex Fraser...

wwaed.org.uk

 

[Gamebird]

Thanks, gamebird, that’s really helpful.

Just to clear up one thing, please.

A fully qualified BAEDT EDT who has been correctly registered for a numbers of years but who has now let their registration lapse (apparently because of ‘politics’) - are they contravening professional guidelines by continuing to perform category 2 procedures? As I see it they are still qualified but are no longer accredited to their professional body?

This one has been much discussed in the profession, but the consensus seems to be that they are OK. They have demonstrated their fitness to practice by passing the exam and maintaining registration, at least initially. They would need to have current insurance. It does make life tricky though, as if they are not on the list it is virtually impossible for anyone to check their credentials! For example in our veterinary practice we will only sedate horses for qualified EDTs. Our receptionists check when booking the appointment that the particular EDT is on the BAEDT/BEVA or WWAED list. If they are qualified but not on the list how can they check?

 

[SEL]

Vet with sedation for all 3. I used to have an EDT but the Appy without sedation uses the gag as a battering ram and I like my head intact. The EDT kept insisting on going on until I literally said no - we get the vet & sedate her. I'm not sure whether her pssm means it's uncomfortable but sedation makes it quick and safe.

A well known non UK Equine dentist who I'm never sure can practice in this country was on my old yard once and stuck his hand in M's mouth. Announced he desperately needed his teeth doing and was missing a tooth. Given he'd only been done 3 months earlier by a highly qualified EDT I smiled, nodded and said thank you. I asked the vet to take a look when she was next out & he was being sedated for a leg trim. Not even a sharp point, let alone a missing tooth.

 

[FieldOrnaments]

EDT and always sedated personally, i just don't think it's a pleasant experience for the horse if not sedated/fully aware as you cannot explain to them what is happening and why as a dentist would with a human patient. Though our vets have always just prescribed sedation for us to give and have not been present themselves. Is this also illegal?

 

[AShetlandBitMeOnce]

Well, consider me educated, I will now be having the vet out once a year or so to check on the EDT's work.
I trust her and have no sign of issue with his mouth, but better safe than sorry and all that.
I trusted the farrier too until I didn't...
ditto saddle fitter.

 

[LEC]

No matter how still a good horse it isn't as still as a sedated horse with their head resting on a support.

My horse had really bad diastema and infected periodontal pockets. He was 11 when the vet found them. I'd had the horse since age 2 and used the EDT since then at 6-9mth intervals (intervals were advised by EDT).


Those used to be my exact words on here ans my reasoning.

My EDT who was very good picked up similar issue and then we had specialist dental vet to sort. Now I just use the vet and knock them out as much more reliable and you can get a better job done. I don’t doubt EDT but as they can’t sedate…. Then I pay for the vet.

 

[JenJ]

This thread has been so much more informative than I could have even hoped for! Thank you to everyone who has contributed so far.

I have been convinced to go the specialist vet + sedation route for mine next time. If anyone has any particular recommendations for someone that covers NW Surrey, please shout!

 

[xxcharlottexx]

Always used to use EDT but horse got progressively worse and throw his head up so required sedation. He still does this with sedation at times so just all round easier for vet to do with jabs. He's now 25 and vet thinks he's probably got arthritis in his jaw so finds the gag uncomfortable. Even with cute beforehand I think he just anticipates something to hurt and he often relaxes into it once they're into the swing of it but he'll always make it a bit tricky for them to look at the start.

 

[Tiddlypom]

Had my vet dentist back yesterday for the routine 6 monthly floats of my two.

He’s completely rescued the 18yo IDx from the dreadful imbalance left by the non vet EDT with her wave and shear mouth and sharp points. He’s been working in stages for the last 18months since he took her on, and she is so much happier in her mouth. She can eat properly again.

Even sedated and fairly immobile with her head resting on the chin rest she puts up a fair struggle by crossing her jaw and wiggling her tongue, so it took the best part of an hour of steady work, including a sedation top up. She also needs her upper 102/103 incisors burring due to the previous extraction of 402/403.

It’s good to know that there’s still hope for the older horse once a decent professional takes over. He couldn’t be too drastic and correct everything at once, it needs to be done over a period of time, but she was much more comfortable from the off.




The other mare took half the time to float!

 

[Fieldlife]

Same here; poacher turned game keeper re sedation and EDTs.

I was firmly in EDT camp and recommended him lots.

Due to circumstances with a new horse a "normal" equine vet was used and they found massive issues with my horse. They referred to the Equine Dental Clinic, who'd done an extraction on another horse previously, who had to do remedial works and now, thankfully, do the routine 6mth visits for all three of my horses.

I wouldn't have listened to me any time before February 2023, I'd have sworn blind that EDTs were better and that sedation wasn't needed for a good look.

I hope some people can learn from my mistakes and not need to go it for themselves. But I know if I'd read this, or Tiddlypom's posts, pre Feb 2023 I'd have been "not my EDT, he's great & better than vets plus sedation isn't needed". I was 100% wrong and found out the hard (& expensive way) and worst of all my poor horse suffered.

Do you now use a specialist vet dentist? As I had the opposite experience, as in I decide one year both horses in early teens, stables settled teeth. I had vet do teeth as part of a package with jabs. Had gag, all seemed ok. I think dentist was at yard anyway less than 4 months later, and I was having a contact issue. He put gag on and showed me that teeth at back were digging into cheek significant and causing an abscess. Not long enough gap for them to have grown that much. Vet clearly hadnt rasped right to the back of the mouth. I havent used a vet again.

I use an EDT who is a horseman, compete and owns horses competing to a high level. Does the teeth of a lot of international competitors, and seems very well thought of. Seems to do a very good job, but I am not a teeth expert.

 

[TPO]

Do you now use a specialist vet dentist? As I had the opposite experience, as in I decide one year both horses in early teens, stables settled teeth. I had vet do teeth as part of a package with jabs. Had gag, all seemed ok. I think dentist was at yard anyway less than 4 months later, and I was having a contact issue. He put gag on and showed me that teeth at back were digging into cheek significant and causing an abscess. Not long enough gap for them to have grown that much. Vet clearly hadnt rasped right to the back of the mouth. I havent used a vet again.

I use an EDT who is a horseman, compete and owns horses competing to a high level. Does the teeth of a lot of international competitors, and seems very well thought of. Seems to do a very good job, but I am not a teeth expert.

Yes, I use the Equine Dental Clinic. They are all vets who specialise in dentistry and only do dental work.

I thought about the/my EDT what you do about yours, but here I am 9 years later with a horse who had bad diastema and infected periodontal pockets that had been missed for years despite regular 6 (or 9, depending on his advice) monthly appointments.

 

[spotty_pony2]

I always used to have an EDT religiously twice per year but then I learnt taking off too much can actually be just as bad as not taking enough off. I think younger horses and horses with problems need doing twice yearly but our three are all older and fine so I now use the Vet, two have light sedation and one doesn’t. Vet is always very good at explaining and showing me what they can see.

 

[Fieldlife]

Yes, I use the Equine Dental Clinic. They are all vets who specialise in dentistry and only do dental work.

I thought about the/my EDT what you do about yours, but here I am 9 years later with a horse who had bad diastema and infected periodontal pockets that had been missed for years despite regular 6 (or 9, depending on his advice) monthly appointments.

Tricky isnt it.

I can see no disadvantages in getting my horse checked out by an vet dentist next time, and getting a view on the work of my EDT.

Though google isnt bringing up any vets that only do teeth in Surrey.

I found the Equine Dental Clinic but they are not close. I have messaged to see if they come my way on other visits, and if I can tag along.

I did think would be more dentist only vets in Surrey, but google not finding them.

 

[Fieldlife]

I always used to have an EDT religiously twice per year but then I learnt taking off too much can actually be just as bad as not taking enough off. I think younger horses and horses with problems need doing twice yearly but our three are all older and fine so I now use the Vet, two have light sedation and one doesn’t. Vet is always very good at explaining and showing me what they can see.

I certainly heard a horror story about a very well thought of EDT Oxfordshire way, that took a bit too much off every visit, and over time significantly aged a number of horses.

 

[The Fuzzy Furry]

Tricky isnt it.

I can see no disadvantages in getting my horse checked out by an vet dentist next time, and getting a view on the work of my EDT.

Though google isnt bringing up any vets that only do teeth in Surrey.

I found the Equine Dental Clinic but they are not close. I have messaged to see if they come my way on other visits, and if I can tag along.

I did think would be more dentist only vets in Surrey, but google not finding them.

I use a vet from a group practice in Surrey who has further quals in dentistry, in my humble opinion, he's damned good.
Since the practice went from private to corporate ownership 2 years ago, its become marmite, but all my pre booked appts are with this one vet.

 

[Fieldlife]

I use a vet from a group practice in Surrey who has further quals in dentistry, in my humble opinion, he's damned good.
Since the practice went from private to corporate ownership 2 years ago, its become marmite, but all my pre booked appts are with this one vet.

Could you PM me who. My current Surrey based practice (still independent) have a vet that specialises in teeth. But dont know how good he is / how much of his work is teeth. Or if he is a normal vet with an extra teeth qualification.

If I am going to get a vet to do next routine rasp, and give a second opinion on my horse's teeth, ideally I would like a vet that mainly does only teeth.