Old Fashioned Float Versus Power Tools . . . Hold Your Horses!
Imagine how a horse or pony feels when their teeth are as jagged as the Alps. Or they have a hook on the very front or back of their molars, like a huge thorn that pierces their gum each time they close their mouths. Or they have an abscessed tooth. What happens to them in terms of their dental health impacts on their entire beings, most noticeably in terms of their musculoskeletal structures, attitudes, temperaments and way of going under saddle and in harness.
Competent and regular dental care plays a vital role in the Equissential equation for Happy Horsekeeping. This means a semi-annual or annual check up, starting as yearlings and sometimes younger. They may seem like mere babies, but a good look in the mouth at a few months of age can be beneficial for future exams, both for the experience factor (make it a gentle one!) and to see how a particular mouth develops. Between the ages of two and five they experience major changes in approximately 36 teeth. Younger horses need wolf teeth removed and edges smoothed. For parrot mouths and other malocclusions where contact between lower and upper teeth is faulty, this is the perfect time for corrective dentistry to commence.
Most of us are familiar with the equine dentist, that female or male who rolls up to the barn with a truck or trunk full of tools. Heavy stainless steel bucket with disinfectant for the floats, speculum, all sorts of nifty paraphernalia . . .
It's tempting to ask them to make a muscle to see those impressive biceps BULGE, and we wonder if they are challenged a lot to arm-wrestling - because we'd put money on them. We are familiar with the rasping sounds as they work to reduce razor sharp edges, waves, and to round everything off so that the teeth don't sharpen up again almost overnight.
Guess what is fast becoming the latest trend in equine dentistry? Power tools. That's right. Plug them in and turn them on.
What does this mean to our
Heavy sedation. Not just enough to result in a positive experience. Heavy sedation: as in la-la land. Total head restraint and the aftershock of drugs wearing off, as well as body aches and pains. When too much is done to correct problems found in the mouth from malocclusion and a variety of other dental dysfunctions, the impact reverberates from head to tail. The stress and strain on tendons and ligaments when dental anatomy undergoes radical adjustment can be very painful. When drugs wear off, your Dobbin will experience discomfort and pain. This is a serious situation requiring immediate attention and follow-up care by an expert.
Now, sometimes a little sedation can be a very good thing for a horse about to have its teeth floated. Some horses have been handled poorly, especially around the head. Others simply do not cope well with speculum and all that activity taking place in the mouth cavity, no matter how gentle the technician may be.
In fact, about 20 % of the total body weight of a horse resides in its head and neck. A horse with a speculum strapped on turns into a formidable weapon. The first time you have a horse floated, it may pay to play it safe and call in a vet for mild sedation. When any equine wants nothing to do with dental care, both dentist and helper may get flung around the stall as if they were confetti. It's dangerous to all concerned, and some professionally administered sedation would relax the creature so that he can get his teeth properly and safely floated.
In this case, the amount of sedative required is minor, just enough to quiet the horse or pony. It wears off in an hour or so. It does not open the corral gate to consequential problems. Sedation used in this way helps reduce the risk of injury to the animal and its attending humans in the event that resistance erupts into full-scale rebellion complete with head thrashing.
The scenario with power tools, however, may be a completely different ball game. The horses or ponies must be totally sedated, just about knocked out on their feet. Moreover, their heads are restrained somehow to prevent sudden movements while the equine dentist plugs in and turns on the juice. The attending vet monitors the horse's state, maintaining the level of sedation required until the job is done.
Power tools for floating teeth?
No thanks! In autumn 1999 I had just arrived at a classy facility to perform Bowen on two equine clients. The atmosphere when I first entered the barn was charged and electric; the whine of power tools sounded as if someone were rebuilding the whole structure. The horses looked half-dead on their feet. Then I saw a dentist who had worked on my horse once many years before, without drugs, without even the benefit of a speculum. He had treated my horse gently and with great honor. That dentist taught me about the importance of dental anatomy in terms of proper bit fit. It was a wonderful experience for my horse and me. I was shocked to see him wielding power tools. The racket alone was enough to wake a coma victim. It was very disturbing.
Now, in the interest of learning more about something new, I started asking questions. I quizzed reputable equine dentists on the subject of power tools. I even asked horse owners why they thought their horses needed to be worked on that way. The answers may shed some light. They will certainly provoke thought and possibly even controversy.
Q: Is there an advantage in using power tools?
Professional proponents say that power tools are easier on the horse. Some owners also blithely parrot, "My (vet, dentist, other) says that power tools will be easier on my horse."
From the opponent side, some of the replies from experts in the field are unquotable. Distilled into polite terms, it boils down to this: power tools do NOT do a better job. They are simply easier on the person wielding them. If the equine dentist is not fit, they will have a hard time doing a full daily schedule of manual floats. Time-wise, if the dentist is fit and experienced, power tools take the same time as manual floating.
Q: If the dentist is fit . . . ?
Fitness is absolutely important. Here's a guide: look at your equine dentist's shoulders and arms, their overall condition. You won't see a pudding muscle or soft gut on any of the experienced manual floaters. They come in all sizes and shapes, and they'll be rock solid, to boot. The forearm reminds you of Popeye, which means many hours and more likelihood that they have honed their skills and developed the finely tuned control required.
When my horse's dentist, Debbie Stroup, started to make the transition from surgical nurse to equine dentist, she was lean and wiry. During her apprenticeship with Ken Pankow, she got a lot fitter. I would bet the bank on her in an arm-wrestling contest against anyone, male or female, except another old-fashioned manual float dentist - especially Pankow!
Q: So, what is the point, really, of using power tools?
Because the equine dental schools include power tools in their teaching curriculum, along with the tried and true manual technique. (huh?)
Handing a novice dental technician a power tool is like handing a 6-year-old human a skill saw instead of building blocks. Be ready to dial 911.
In every profession and endeavor, there is a period of skill building that cannot be replaced. Some horsemen use the term "mileage." After you take an equine dental school course, you are expected to spend a fair amount of time in the field working with a reputable role model - someone skilled and expert enough to show a newcomer the ropes, to be there to help correct technique before problems crop up with the horse.
But if the person is not familiar with the horse's mouth, is not totally at home in there with the manual floats, how on earth can they be trusted to wield power tools?
The power tools make so much noise, you won't hear your dentist say, OOPS, but the horse will feel it. This is a living creature, and the dentist is working on living tissue. The potential for great harm is unbelievable.
Q: So why arm dentists with power tools?
"Well, it boils down to several things, and I'm not going to win any popularity contests when I say that greed and laziness might be the top two," states Gail Emerson. Her extensive equine dental practice, based in Delaware, keeps her busy. She believes in the importance of teamwork where horses are concerned and works in conjunction with vets and horse owners on a daily basis.
"Don't get me wrong, I own power tools," she adds. "I use them maybe once or twice a year. Power tools are not the basis for my practice. They are there for the odd occasion. I use the time tested, old-fashioned floats. And you know something, you have to be fit to do equine dentistry. It's demanding and it's tough on your body."
That is where this whole issue gets very interesting. Emerson isn't just concerned with the mouth of the horse. She looks at the entire perspective, the big picture: e.g. not just saddle fit - bridle and bit fit, too, correct balance and riding, shoeing, deworming, and nutrition. She has a fair amount of knowledge and, like many of the dentists queried, warms up to her favorite topic, horses. It is also obvious that she loves these animals.
"Power tools have been around since Hitler was in power," Emerson explains. "Actually it may have been the best set ever made, and a film about the tools and their maker, Dr. Becker, is available. And I own power tools, yes, but I'm not into power. Say I'm called to work on a parrot-mouthed horse that's severe. I'll do some work now, come back in 3 months and do more, come back in 3 months - it's my choice. It depends on a lot of factors, such as the horse's well-being and also the type of clients. If the horse needs mild sedating, okay, but I don't want the horses falling over dead drunk. Or say there's a huge overbite hook - maybe power equipment is easier but NOT better for the horse. Manually, I'll take a little off, as much as is safe for the horse and that won't be so much that the pulp cavity is exposed, and come back in a couple months and take off more. Maybe again in a couple months to take off more, then check back in six months."
The overall condition and fitness of the horse is also very important. If a horse is fit and a dentist does too much, you may have problems, especially if there is consequential trauma to the balance of the temporomandibular joint (TMJ). In humans as well as horses, TMJ dysfunction means more than clicking in the jaw joint and grinding of molars; it can mean serious compromise of the smooth functioning of the entire musculoskeletal system.
Skinny doesn't necessarily mean bad teeth. A fat horse can need dental work. Wavy mouths aren't that big a deal, but hooks are a huge problem and very common. Hooks prevent food from going down the mouth and into the esophagus to continue the digestive process. When the back hooks are taken off, horses show dramatic improvement right away. Problems arise, however, when a dentist overdoes a horse's mouth and takes too much off incisors and molars, period.
It's easier to monitor manual floating than power tools because it's easier to take off a little at a time and check. With a power tool, you can reduce the working surfaces of the teeth to nothing in a New York minute. Oops, and then what does the horse do? There is at least one documented case of a horse dying as a result of power tool floating, and experts offer their serious doubts that this is an isolated incident. In other words, how many other horses have suffered tremendous pain and discomfort and stopped eating completely? This won't show up in blood work or other diagnostic tests. Who would make the connection between a power tool float and possible loss of soundness and free movement or even life a month or more after the fact?
"I'm into horses as living things and we have to be very careful what we do with them," Emerson says. "All that matters is the horse. I don't like to do excessive dentistry, and if the horse is managed properly this doesn't come up very often. Power tool floats can result in excessive dentistry, and horses can die. This happens more than we hear about. It's important to listen to the voice of the horse and the voice of common sense. In most cases, I'll do what I can with manual floats in one session, and then arrange to come back in a couple months. I'll do what's necessary and no more."
Here's a case history that illustrates the choices faced by every equine dental technician. About a month or so ago, Emerson is called in to work on a 20 year old horse. He has a heart murmur. He's thin, his teeth are terrible, he has lots of problems. He needs sedation and float work. Please keep in mind that Emerson emphatically states that she would never use power tools on a geriatric.
Emerson describes her call: "Let's bring this horse into a good situation and bring the vet here and I'll do what's necessary and no more. Owner agrees. Vet comes out, sedates the horse, I take care of the teeth. I feel like the horse's savior. He needed aggressive deworming, his sheath cleaned, etc. The vet's there to take care of that and leave antibiotics for periodontal disease and Banamine® to ease aches and pains. You can't just throw this horse out in a paddock. He needed some intensive care. He had all his teeth, but they were an absolute nightmare. I got a call recently from the owner who reported that the horse is doing great, and he's getting fat.
"Nothing beats the touch of a human hand, and nothing ever will," Emerson adds. "With the teeth you have to be so careful. They are alive. My biggest fear is to kill the teeth. My biggest concerns about power tools are: 1) you have to sedate the heck out of the horse, really blast them, and 2) it takes years for a horse's teeth to get that bad, and when we alter that all at once, it compromises tendons, ligaments and muscles. They end up hurting in so many ways.
"I'm in favor of sedation to do a thorough job on a horse's teeth, but in most cases we're talking mild sedation," she emphasizes. "I'm against power tools. I have it all, and I use it in very limited situations. I'd rather do the job manually, a little at a time, when it's possible to come back in a few months. It's easier on the horse."
Hmmm, easier on the horse.
If your horse has been getting competent and regular dental care, and appears to be in great health, then why change to power tools? One thing you might want to know: power tool dentistry costs big bucks, like $250 on up, and more like $400 at the moment, per horse. That's a pretty steep price to choose to pay for something that may not be especially beneficial to your horse's health and well-being.
You know your horse better than anyone. His greatest good is up to you.
For more information:
Gail Emerson 302-892-9215
Debbie Stroup 703-444-1868
Ken Pankow 540-675-3815
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