First Step in Floating: a Thorough Oral Exam
By Don Jergler For Veterinary Practice News
Posted: November 14, 2013, 2:15 p.m. EDT
Jack Easley, DVM, MS, Dipl. ABVP, owner of Equine Veterinary Practice LLC in Shelbyville, Ky., takes a stern view of skipping steps and getting right down to running a float in a horse’s mouth to address equine dental problems.
Dr. Easley and other authorities on the practice of floating say a common problem is that some dentists are not doing a thorough examination first, and in their books that’s a huge mistake.
"The most important thing about dentistry is not the floating. It’s the oral exam,” said Easley, who recommends a complete oral exam at least once a year.
Easley, who has been practicing dentistry on horses for more than 30 years, said too many dentists start to grind away on teeth before a thorough exam.
Easley likes to follow several steps before he gets to a point where he feels the need to float a horse’s teeth.
Most horses must be sedated, and once that’s done Easley picks up his mouth speculum, a good headlight and then he rinses out the mouth and conducts a thorough visual examination as he palpates inside the mouth, all the while closely looking at structures.
Following an exam, further diagnostics may be necessary using the tools of the trade, such as X-rays, probes, picks dental mirrors or an oral endoscope, Easley said.
Equine Oral History
In fact, even before he starts an examination, Easley takes a thorough history and notes any complaints regarding bitting issues, eating problems, weight gain, swelling, nasal discharge.
With a thorough history taken down, and a visual and tactile exam complete, "Then you can decide whether they need floating or not,” Easley said.
Hammering home his point, Easley said it’s essential to determine what problems need addressing before going in a horse’s mouth with a float.
"People start rattling floats around in a horse mouth before they do an oral exam and they think they’ve done something,” he said. "You don’t know what you want to float on unless you do a good oral exam.”
Twenty years ago the field of equine dentistry had poor equipment, low-quality floats, inferior blades and tools without ample power, hesaid. Now the tools are far superior, and the drugs used to sedate horses enable dentists to do much more.
Therein lies the problem: because they can do more, many dentists feel the need to do more, Easley said.
"They tend to over-float,” he said. "I think more horses today are over-floated than under-floated.”
If you figure a horse has a 4-inch tooth and you plan for about 1/8th of an inch of wear per year, the horse has about 32 years with those teeth. A few too many floating sessions, and that horse’s teeth can ware out in 16 years, Easley said.
Equine Oral Examinations
Examinations are also top priority for Carrie Neiderman, VMD, owner of Complete Equine Dental Maintenance, a mobile veterinary practice in Houston.
Neiderman believes dental exams should start when a horse is a foal to make sure it wasn’t born with any jaw-length discrepancies, such as uneven lengths of the maxilla and mandible, which would warrant early intervention.
If a foal is normal at this point, the next full dental exam should be done at 1½ to 2 years of age, when a horse typically begins training, and dental exams should continue after every six months until a horse is 5 years old with a full set of permanent teeth, Neiderman said.
"These exams will allow early detection and correction of any problems relating to the loss of the deciduous teeth,” she said.
After age 5, she suggests annual exams.
Neiderman prescribes the following for various scenarios:
* Sharp enamel points: Are routinely filed off (floated)
* Tall teeth: Conservatively, slowly reduced over a period of months
* Hooks, ramps, waves: Conservatively reduced over a period of time
* Periodontal pockets: Should be cleaned and radiographically evaluated, depending upon the severity
* Fractured teeth: Must be radiographically evaluated and extracted
* Loose teeth: Must be radiographically evaluated and extracted
Horses' Mouths are Not the Same
All horses’ mouths are not the same. That’s the point Edward T. Earley, DVM, FAVD/Eq., with Laurel Highland Veterinary Clinic in Williamsport, Pa., wants to drive home.
"When performing dental procedures, pay attention to individual variables with each horse and try to determine what is normal for that horse,” Dr. Earley said. "All horses—and mouths—are not the same. There may be differences within the same horse when comparing right to left or maxillary teeth to mandibular teeth.
"Do not start with a preconceived idea of what all teeth should look like and then grind/shape asymmetrical normal healthy teeth to a symmetrical balanced portrayal of perceived normal,” he said.
"The main goal in equine dentistry is to develop a treatment plan for each individual horse that will allow for a working occlusion that will not remove excessive tooth structure. With aggressive grinding, normal peripheral cementum and transverse ridges may be removed, which could alter the strength and function of the tooth.”
Like Easley and Neiderman, Earley is emphatic about the need to first conduct a comprehensive examination.
Using the acronym COHAT—for comprehensive oral health assessment and treatment—Earley said the process will enable dentists to thoroughly evaluate all structures involving the oral cavity and head.
"A specific diagnosis relative to each tooth should dictate a detailed treatment plan,” he said. "The treatment plan involving enamel point reduction and odontoplasty of specific overlong teeth should be carried out using visual dentistry focally on a tooth-by-tooth basis.”
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First Step in Floating: a Thorough Oral Exam
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