There is a standard of care in equine dentistry and it includes sedation, a full mouth speculum and power tools. Some might consider the above statement controversial. But the simple fact is that power dentistry with sedation produces a better result than hand floating without sedation. We are all committed to our horses—to their health and well being. Power floating reflects this commitment in that it reflects the highest quality of equine dental care.

Power dentistry, a full mouth speculum and sedation represents the standard of care for some very basic reasons.

Visualization. A dental exam should include a full mouth speculum to properly visualize a horse’s mouth. There is no way 1) to gain full visualization of the entire dental arcade and soft tissues without a speculum or 2) to perform a complete and adequate dental treatment, especially of the lower dental arcades without a speculum. There is no way to properly gain access to the lingual (tongue) side of the dental arcades and the lower caudal molars without a speculum.

Muscle Relaxation. A horse has large and strong muscles associated with the head, jaw, and neck. Additionally, a horse has a Temporomandibular Joint (TMJ) that is sensitive to pressure and disruption. In order minimize the risk to a horse’s TMJ and to allow the large muscles of the head, jaw and neck to properly relax, sedation should be used as part of a dental exam and treatment.

All dental work represents some risk to horses’ TMJ mechanisms. This risk is due to the indirect pressure the full mouth speculum puts on the TMJ (a normal speculum puts direct pressure). Because the speculum must be used for proper visualization, care should be taken to minimize its effect on the TMJ. The speculum should not be forced or opened wider than necessary. A horse’s jaw muscles should be relaxed as much as possible–to allow the speculum to open a horse’s mouth without producing excessive pressure on the TMJ. Sedation allows the muscles related to the TMJ to relax and reduces the pressure a full mouth speculum places on the TMJ.

Disruption of the TMJ mechanism is a serious problem. The risk of TMJ distruption related to dental work should not be ignored. TMJ pain can cause a horse to go off feed or colic; it can cause disruption to body balance and mechanics resulting in lameness. Responsible dental care minimizes the risk of TMJ disruption.

On a more general level, muscle relaxation is again important for visualization of the entire dental arcade. Sedation is not a reflection of a horse being well or poorly behaved. It is a reflection of the mechanics of a horse’s head, jaw and neck. For a thorough exam to be performed, it is important that the horse relax the muscles in these areas. Sedation allows these muscles to relax and for a dentist to adequately access and visualize a horse’s mouth.

Time. A dental exam should last only as long as absolutely necessary. As mentioned above, a full mouth speculum puts indirect pressure on a horse’s TMJ. Because of this pressure and the risk to the TMJ, a goal of any dental exam and treatment should be to do the best job possible while only taking the time necessary. Power dentistry quite simply takes less time than hand floating. Therefore the risk of TMJ disruption is reduced over hand floating.

In the hands of a skilled and knowledgeable professional, power dentistry allows for a better and safer job in less time than is possible with hand floating. This is especially true in the areas of sport horse dentistry and geriatric horse dentistry, and in horses with congenital or traumatic pathologies.

A few other key points about modern equine dentistry:

• The sedation required is safe, transient, and causes minimal to no side effects. When one compares the risk of sedation versus the benefit gained from its use in dentistry, it is clear that its use is indicated.

• Dental examinations/treatments should occur at least once a year, or as recommended by your veterinarian.

• DO NOT wait until there is a problem to think of dentistry! Horses have an AMAZING tolerance for pain. I literally have had scars on my hands from sharp teeth after examining shiny, fat and well performing horses. You wouldn’t have known it from the horses’ behavior, but their mouths held thick scars and barbed wire for teeth.

• Dental exams and treatment should begin early! Waiting until the horse has a bit in his/her mouth or is in training is waiting too long. Consult with your veterinarian about your individual horse.

NPR has a nice update on Barbaro. Barbaro had the cast supporting his repaired leg removed a few days back. Barbaro is doing well though his life is still threatened by laminitis. NPR interviewed Dr. Dean Richardson, chief of surgery and professor of equine surgery at the University of Pennsylvania School of Veterinary Medicine. Click the below link to go to the NPR site and listen to the interview.

Click here to listen to the interview.

Over the weekend, I saw an emergency resulting from an all-too-common practice: A boarding facility that allows the immediate “integration,” if you will, of a new horse into the barn’s larger horse population. Fast-forward from one to four weeks and other horses are becoming ill. At the emergency call, I evaluated a recently weaned filly, ~7 mo of age, whom had a lump under the jaw. A Strangles infection is feared. The barn had introduced a couple of young, “off the track” Thoroughbreds only two weeks back.

“The Lump” strikes fear into the hearts of barn owners and managers everywhere–and immediate action is taken. But by the time the lump appears, or other signs are manifest, it is often too late to control a potential influenza, rhinopneumonitis, or strangles outbreak. The time to have acted was on the introduction of new horses to the barn. We’ll see over the coming days if we’re dealing with a Strangles infection and if the infection spreads. Hopefully, it’s just a false alarm.

In either case, though, the lesson is the same: isolate new horses (for at least a two week period) before their introduction into another horse population. This lesson is especially true in the case of an unknown or incomplete vaccination record. The consequences of failing to isolate new horses are severe. There is 1) the impact on the health and well being of the barn’s horse population; 2) the high cost of intensive and prolonged veterinary care; 3) the financial harm from disruption of a horse boarding business; 4) the damage to the barn’s reputation; 5) the potential liability from failing to take “basic” measures to protect horses under your care.

There are other lessons here as well. Barn owners should require a complete vaccination history from all boarders prior to accepting a horse into their barn. This history should include a current Strangles and Flu/Rhino vaccination. If these vaccinations are not current, they should be required PRIOR to the horse being allowed onto the premises. The same vaccination requirements also hold for horses that are showing or otherwise being introduced to a larger horse population.

Dr. Aimee Eggleston

Question: “I was considering purchasing a 2-year-old Peruvian Paso filly. She was beautiful, well gaited and had a nice temperament. When I got home and looked at her photos I noticed that she had what I have learned are known as “coon-feet.” Her rear pasterns were on the long side and the angles did not match the slope of her hooves. I did not purchase her because of this, but I am seeing more and more gaited horses with this conformation fault. I am wondering if I over-reacted? Should this be a deal breaker when purchasing a horse? Are varying degrees of it acceptable? Will it lead to other soundness issues later on?”

The term “coon footed” refers to the fact that there is a broken forward axis at the coronary band. A line drawn from the fetlock down to the toe should be straight. In other words, the slope of the hoof wall is steeper than the pastern. This conformation is often associated with long, sloping pasterns tending towards the horizontal, that breaks the angulation between pastern and hoof. This conformation is usually seen in the hind feet, especially in post-legged horses.

In Peruvian Pasos and in Paso Finos and some other breeds, this conformation isn’t uncommon–because these horses may have weak suspensory ligaments that allow the fetlock to drop. Indeed, Paso Finos, Peruvian Pasos, and Paso Fino crosses are the breeds that are more commonly afflicted with degenerative suspensory ligament desmitis (DSLD). DSLD can cause very significant and frustrating chronic lameness and will often give the foot a “coon” like appearance. Even if this particular Peruvian Paso shows no evidence of DSLD, the “coon footed” conformation will put stress on the back of the fetlock–perhaps setting the horse up for future lameness/injury in the area.

Agility sports would not be indicated for a horse with a “coon footed” conformation. Low speed endeavors like pleasure and maybe equitation may be within the horse’s abilities. I don’t think it is necessarily an automatic “deal breaker” if a horse has this conformation. It is imperative, though, that a thorough pre-purchase examination be undertaken–to help illuminate the possibility of DSLD. The exam findings should be considered closely in the context of your intended use of the horse.

Dr. Aimee Eggleston

Ron, a client of mine, recently sent me a video about a farrier and his amazing dog Skidboot. Skidboot’s abilities are remarkable and the story of companionship between farrier and dog is moving.