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State laws vary over whether veterinary dental technicians can perform routine care.
Should equine dental technicians be allowed to float teeth, sedate an animal or perform extractions on horses with direct supervision from veterinarians?
According to a revised 2009 position paper by the American Assn. of Equine Practitioners, “The practice of equine dentistry is an integral branch of equine veterinary medicine.
“This discipline encompasses all aspects of diagnosis, treatment and prophylaxis of any and all equine dental conditions and diseases that affect the oral cavity, mandible and maxilla, teeth and associated structures. As such, it falls within the purview of veterinary medicine.”
Accordingly, the AAEP recommends that veterinarians perform such care and supervise it when administered by equine dental technicians.
Kimberly May, assistant director of the department of professional and public affairs for the American Veterinary Medical Assn., says the AVMA agrees with the AAEP’s stance.
Dr. May, DVM, MS, Dipl. ACVS, says veterinarians have the training in anatomy and physiology, as well as pharmacology, that is necessary to treat horses. Though most equine dental technicians are trained, performing dentistry on a horse without a licensed veterinarian’s supervision can be risky.
Consistently Inconsistent
Laws pertaining to equine dental care vary among states.
An amendment is pending in Oklahoma to change a law that makes practicing dentistry without a veterinary license a felony.
In Texas, only veterinarians can perform dental procedures. It is punishable for lay dentists to do so, but it’s not a felony.
Dental technicians must have a veterinarian on-site in Arizona, Alabama, California and South Carolina.
Minnesota requires equine dentists to be certified.
In Arizona and Virginia, dentistry can be performed under the indirect supervision of a veterinarian, says equine dental technician Christine Griffin. “More horses can be treated each day, and that’s good all the way around.”
All other states have some laws on the books that permit dentistry as “animal husbandry.”
Difference of Opinion
Not all veterinarians agree.
“We need to revamp some of the state practice acts in this country,” says Tom Allen, DVM, of Patterson, Mo. “The way some of the acts read, anything that affects the life of animals is veterinary medicine. If you feed and water your animal, you are providing for its nutrition and therefore, practicing veterinary medicine without a license.”
Dr. Allen has devoted his practice to equine dentistry since he was introduced to it 14 years ago, after practicing for more than 20 years.
“Veterinarians have not had good instruction in equine dentistry,” he says. “I graduated from veterinary school in 1973 and we did not have much dental training.”
As of about a year ago, Allen says, out of 28 U.S. veterinary schools, only four offer equine dentistry electives. Dentistry courses are not required for licensure in any state, though laws say dentistry can be performed by a licensed veterinarian.
“By far the most common misconception among horse owners is that all veterinarians are competent in equine dentistry,” Allen says.
“Increasingly, some are. It was only after Dale Jeffrey began resurrecting the study of this field in the 1980s did a few veterinarians take notice. Mr. Jeffrey had the audacity to help horses live better, longer lives by breaking the law and performing equine dentistry after finding that veterinarians were not willing or able to do so.
“The veterinarians took him to court in Nebraska and won, and he relocated to Idaho with his Academy of Equine Dentistry, which is now thriving.
“There are plenty of non-veterinarians who are well trained to service this aspect of horse health,” he says. “These dentists picked up the ball we dropped and ran with it.
“Now, the veterinary profession has taken the cue from the non-vets,” Allen says. “And the American Assn. of Equine Practitioners is offering excellent continuing education seminars on equine dentistry lately.
“It is very difficult for me to believe, that many vets who are objecting about this are concerned about the safety of the horse more than their loss of market share in equine dentistry. Keep in mind that many vets do in fact utilize the services of the non-vets
Opt for Teamwork
James Anthony, DVM, an associate professor of veterinary dentistry at The Western College of Veterinary Medicine at the University of Saskatchewan, says the best of both worlds would be that equine dental technicians perform their work and veterinarians are on hand to sedate the animal.
“Veterinarians don’t want to spend their days performing routine treatments,” he says. “They want to use their talents and training in diagnosis and treatment.”
Dr. Anthony likens the relationship between a veterinarian and dental technician to that of a human dentist and dental hygienist. “They both need to work together,” he says. “There is a place for equine lay dentists,” Anthony says. “I am all for them, as long as we have some checks and balances for quality control.”
He would like to see strict guidelines developed–much like the AAEP’s dentistry guidelines.
“Lay dentists need the credibility of having a veterinarian guiding them,” Anthony says. “They need certification on medical and surgical procedures. They need to recognize their limitations.
“There is no substitute for a good, yearly oral exam of the head, mouth and teeth. And the resulting oral pathology will let veterinarians recognize the proper treatment.”
Allen says lay dentists sometimes start their professions after taking a two-weekend course.
“That’s too short a time period to learn everything that veterinary students take years to study,” he says. “Proper education and certified courses should be available to dental technicians. A little bit of knowledge is a dangerous thing.”
Another reason to use a veterinarian: diagnostic equipment.
“Digital radiography is underused,” Allen says. “With the development of better equipment, X-rays more often identify needed procedures.”
Legislative Lobbying
Teri McKee, an equine dental technician in San Antonio, Fla., helped equine dental techs in her home state gain legal ground and the right to practice.
“It took three years,” she says. “We called on legislators in Tallahassee and spoke before the state Senate to let them know that the laws were not fair.”
McKee belongs to the International Assn. of Equine Dentists, as well as the Florida-National Assn. of Equine Dentists, which holds CE classes in Ocala, Florida’s horse country.
“There are fewer than 100 large-animal vets and 800,000 registered horses in the entire state of Florida,” McKee says. “Without equine dental techs, each veterinarian would have to do nothing else but teeth on 20 horses a day for 20 years and they’d never get to all the animals who need them.
“It is unacceptable to let that happen to animals.”
McKee concedes there are “good and bad equine dental techs, just as there are good and bad veterinarians.” She asserts that a good reputation for caring for animals is sterling in both professions.
“Equine dental technicians want the same things veterinarians do,” McKee says, “to keep animals safe and heathy.”
McKee was a veterinary technician with a degree in animal science for 14 years before pursuing her interest in equine dentistry. On everything but routine floats, she works with veterinarian oversight.
She says the Florida law also was changed so that ranchers and their day-labor cowboys could legally castrate and inoculate without having a veterinarian on site.
McKee’s vet tech background gives her an advantage over lay dentists who “maybe took a class or two and bought a bucket of floats,” she said. Before she works on a horse’s mouth, she evaluates its feet, hair and body for nutritional issues or other problems. She has noticed bowed tendons, eye injuries, founder and more and often recommends that owners consult their veterinarians right away.
“I’m in this to help animals,” she says.
Stamp of Approval
Christine Griffin, an equine dental technician in Ramona, Calif., made a career change at 48 because she couldn’t find a dentist to solve her horses’ dental problems.
Griffin is certified by the International Assn. of Equine Dentistry. She is one of three practitioners in San Diego County who has passed the association’s rigorous standardized testing. She works with Lisa Grim, DVM, of Encinitas, Calif.
“I can see both sides of the controversy,” Griffin says. “Associations like the AAEP and AVMA want to protect horses as much as dental technicians do.” For years, floating and extractions were performing by blacksmiths, she says. Unlike other mammals—dogs, cats, humans—a horse’s teeth erupt constantly.
“One law for both types of animals—companion and livestock—is not acceptable,” Griffin says. “We need to change the laws. We need to require a level of education and testing for all who perform equine dentistry—veterinarians and dental technicians alike.”
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