By Rachel Boyce, DVM
(Published in The Illinois Horse Network News, November 2010)
In recent years, the debate over whether non-veterinarians (commonly called “lay-dentists”) should be allowed to float horses’ teeth has become more and more heated. Unfortunately, in this debate veterinarians are sometimes portrayed as the “bad guys” – pushing for more regulation, limiting horse owner’s choices and protecting their turf. In reality, veterinarians genuinely want what’s best and safest for their patients. Most veterinarians actually support the right of properly educated dental technicians to practice, as long as they are under the direct supervision of a veterinarian. What the veterinary community does not support is unlicensed, unregulated, self-professed “horse dentists” potentially causing real harm to the horses we have dedicated our lives to protecting and caring for. Many who are in favor of allowing lay dentists to float teeth assert that horse owners should have the choice to employ anyone they choose to provide services for their horses. While this may be true, I believe owners can only make good choices when they are aware of the facts and implications.
Lay dentists are frequently compared by their supporters to human dentists, chiropractors or other healthcare service providers but this comparison is a gross misrepresentation. Human dentists and dental hygienists, chiropractors, massage therapists and even hairdressers are licensed practitioners that must provide proof of completion of education requirements at accredited institutions, complete required ongoing continuing education courses and show that they have not been convicted of wrongdoing (either personal or professional) in civil or criminal court in order to maintain their license and operate a business. If one of these practitioners causes harm to a client or patient or fails to provide the services contracted for, the affected customer has legal recourse against them both through the state licensing boards as well as through civil or criminal court. In contrast, lay dentists are not regulated in any way. They are not required to obtain any level of education, earn a degree, become licensed, carry liability insurance or be accountable in any way. In fact, ANYBODY can call themselves a horse dentist. Your neighbor down the street can go online and buy some tools tonight and get right to work floating teeth tomorrow!
Another argument made for allowing lay dentists to practice is that they know more about horse teeth and dentistry than most veterinarians. This assertion is unequivocally false. Even the best equine dental technician education programs provide instruction only in the technique of “floating teeth” and the most rudimentary oral anatomy. Only veterinary schools provide four years of post-graduate education that includes the anatomy and physiology of the whole horse, diseases and infections associated with the mouth, pharynx and GI tract, pharmacology of the sedatives used to sedate patients and proper use of drugs such as antimicrobials and pain medications. Veterinary students also receive instruction and hands-on training in techniques such as routine dental equilibration (“floating”), tooth extractions and management of intra-oral diseases. Although we continue to learn throughout our professional careers, graduate veterinarians have received all the education they need to adequately care for the mouths and teeth of their patients.
Some contend that they prefer to use lay dentists because they are cheaper than veterinarians. This statement is often simply untrue. However, even if it is somewhat more expensive to have a veterinarian work on your horse’s teeth, remember the adage that you get what you pay for. Veterinarians have invested large amounts of time and money in their education in order to provide the best care. They make a substantial investment in equipment to provide that care. They continue to invest time and money in Continuing Education courses throughout their careers to make sure that they stay current with new research and techniques. They pay to keep their licenses active. They pay for liability insurance so that if a mistake or accident should occur horse owners can receive compensation for their losses. In contrast, the lay dentist’s only substantial investment is in the purchase of his equipment. Many have no formal education or training and since they have no degree, credentials or license there is no Continuing Education available to them. Many do not even carry liability insurance.
Lastly, horse owners must realize that even well-educated, experienced lay dentists cannot legally administer tranquilizers or sedatives to horses under any circumstances. If you choose to hire a lay dentist to work on your horse’s teeth and he administers these drugs he is breaking the law. Even in states that allow lay dentists to practice they must work with a veterinarian to administer and monitor sedation of the horses.
As a veterinarian who has dedicated her personal and professional life to the enjoyment and care of horses, it saddens me to see veterinarians vilified as greedy, uncaring or unqualified to provide basic care to their patients. Nothing gives me more pleasure than to provide dental care to a thin, unthrifty, geriatric horse and watch him blossom into good health or to float teeth on a young equine athlete and then see him in the ribbons at the next show, happy and willing to do his job. It also makes me angry to examine horses “treated” by lay dentists with teeth ground away until they look like “cue balls”, unable to function normally and grind feed, or horses with damaged or broken teeth due to poor technique or faulty, outdated equipment. Sometimes I can’t even tell that the lay dentist did anything at all. At best, these owners have wasted their money and at worst, the health and well-being of their horses has been severely compromised. After considering all the implications and arguments, I sincerely hope that when you choose a practitioner to care for your horse’s teeth, you choose a veterinarian.