Equine dentistry

Equine dentistry

 

Equine dentistry



Equine dentistry is a growing branch of veterinary medicine requiring knowledge, training and skills.

The NZVA, New Zealand Equine Veterinary Association and its dental subcommittee have developed two new position statements on equine dentistry. The position statements provide guidance for general practitioners about what is acceptable equine dentistry practice.

The NZVA believes that all dental procedures on equidae, including horses, should be performed by veterinarians and be based on sound scientific knowledge, evidence-based medicine and surgery, and best practice standards. This is to ensure horses' welfare is protected, and that providers of dental care are held to account for services provided.

We acknowledge the current regulatory environment allows equine dental technicians (EDTs) to perform equine dental work. We have developed guidelines that recognise this.

It is critical that the veterinary profession understand their responsibility under the Code of Professional Conduct, when working with, or referring to another person. These expectations are set out in our position statements.

In the position statements, procedures considered appropriate for an EDT to perform on their own are outlined, as are those that need the supervision of a veterinarian, and those that are to be performed by a veterinarian only.

Our position and guidelines recognise that most equine dental procedures meet the new criteria outlined in the Animal Welfare Act Amendment Act (2015), section 16 (from May 2020). These criteria define significant surgical procedures.

Under the Animal Welfare Act 1999, no person may perform any significant surgical procedure on an animal unless that person is -

  1. a veterinarian; or
  2. a person who is acting under the direct supervision of a veterinarian and who is being taught veterinary science at undergraduate level.

Status of equine dental technicians in New Zealand

Equine dental technicians in New Zealand are currently unregulated. They have widely varying levels of knowledge and skills. Some are equipped with the appropriate skills and knowledge to competently perform some equine dental procedures while others are not. This compromises horses' welfare.

The NZVA recognises the service that is provided by EDTs and that of other allied veterinary paraprofessionals (AVPs). The NZVA supports the development of a regulatory framework to support AVPs ongoing contributions to the veterinary community. Regulation of AVPs is required and should include requirements for training, continuing professional development, minimum qualifications and a robust disciplinary process, such as that provided by the Veterinarians' Act.

Establishing a regulatory framework for AVPs, including EDTs, in New Zealand would bring this country into line with other similar developed nations, including the United Kingdom, Canada and the United States.

Equine dentistry is a specialist area of veterinary medicine and all contributors should be appropriately educated and regulated.

Consultation on significant surgical procedures

The Ministry of Primary Industries (MPI) is currently undertaking public consultation on the types of procedures that should be regulated, based on the criteria that define a significant surgical procedure. If approved, these regulations will allow non-veterinarians to undertake specific significant surgical procedures.

MPI has put forward two options for equine dentistry that were developed after significant previous consultation, including with the NZVA. During this current round of consultation the public are referred to the NZVA equine dentistry guidelines (linked to above), so that the veterinary profession's position on equine dentistry is understood.

Option 1

A competent person may extract a loose deciduous incisor or cheek tooth from an equid. All other extractions, including wolf teeth, are veterinarian only as these require pain relief to be used at the time of the procedure. The owner or person in charge of the animal has responsibility to ensure that only competent people perform this procedure.

Option 2

A competent person may extract a finger loose deciduous incisor or cheek tooth that has obvious visual recession of the gingiva and is protruding above the occlusal surface, but may not use tools or other equipment. All other extractions, including wolf teeth, are veterinarian only as these require pain relief to be used at the time of the procedure. The owner or person in charge of the animal has responsibility to ensure that only competent people perform this procedure.

Our view

The NZVA supports Option 2, which we believe will ensure the best health and welfare outcomes for horses.

It is similar to Option 1 in that it limits non-veterinarians to the extraction of loose deciduous incisor or cheek teeth only. Unlike Option 1, it does not allow non-veterinarians to use tools or equipment in the extraction of deciduous incisor or cheek teeth. In practice this would mean straightforward, finger-loose tooth extractions could be performed by non-veterinarians but they would need to refer all other extractions (including wolf teeth) to a veterinarian. We believe this is appropriate as only a veterinarian with the right skills, training and knowledge is equipped to perform such a procedure in a way that upholds the highest standards of animal health and welfare. Owners and persons in charge of horses should be reminded that there is currently no registration body, association, or recognition of training levels or qualifications for persons advertising Equine Dental Technician services in New Zealand.

MPI consultation finishes on 24 July 2019.

The NZVA will be making a submission to MPI, and we would like to ensure the views of each NZVA special interest branch is well represented in our submission.

Please provide this information to the NZVA by 15 July so we have time to incorporate your views effectively into the our submission.

Individual members can also make their own submissions. However, ideally we would have a united front to present to MPI. Please get in touch at nzva@vets.org.nz if you have any queries or concerns regarding this process or the proposed regulations.

More information on the proposals, including the consultation document, can be found on the MPI website.

Veterinarians with special interest in equine dentistry

See a list of NZVA member veterinarians with experience in equine dentistry here.

If you have postgraduate training in this area and would like to be included in this list please register your details with us at nzva@vets.org.nz. Please provide full contact details including confirmation of training.

Frequently Asked Questions

Many equine dentistry procedures require an understanding of horse anatomy, physiology along with knowledge and skills that support robust oral examination and decision making. This is provided as part of the undergraduate training in a veterinary degree, with some veterinarians then choosing to add to that skill set and undertaking further education, on top of their 5 year veterinary degree.

Most equine dentistry procedures require the use of sedatives, anaesthetic agents, and other drugs (many of which are only available to veterinarians) to ensure the safety of both the horse and the person performing the procedure. A comprehensive knowledge of the causes of dental disease is required to effectively communicate with the horse owner.

Currently, anyone can perform equine dental procedures, regardless of their level of skill, experience or training. In some cases this can lead to poor animal health outcomes for horses. After May 2020, any procedure that involves sensitive tissue and/or is below the gum line (per section 16, AWA 1999, significant surgical procedure criteria) will be restricted to veterinary only, unless a regulation allows for non-veterinary persons to under them.

Yes, MPI has proposed two options for new regulations for equine dentistry in its current consultation. Both of these seek to make some equine dental procedures that meet the criteria for a SSP to be veterinary only.

MPI will analyse submissions and the Minister of Agriculture will then decide which regulations will become law. Most new regulations will come into effect in May 2020, although there is the option of a delayed commencement date, if justified.

Some equine dental technicians do a very good job, while others do not. Because they aren’t regulated, meaning there’s no clear qualification nor standard of professional behaviour required, there is no way of horse owners knowing which is which. Just like veterinarians, equine dental technicians should be subject to a regulatory framework that protects the public, and animal welfare and is in the interests of horses and their owners.

In the last three years the Veterinary Council of New Zealand, which regulates the veterinary profession, has received several complaints about procedures performed by equine dental technicians. It has not been able to action these complaints as it only has the power to bring disciplinary procedures against registered veterinarians. During this time it has not received any complaints regarding registered veterinarians performing equine dental procedures. Also, our members also tell us they are sometimes asked to re-visit horses after dentistry procedures performed by EDTs have resulted in poor animal health outcomes.

Just like other allied veterinary professionals, equine dental technicians would require a minimum qualification, continuing professional development and a code of professional conduct. There would also be a mechanism for disciplinary action if the code or the law was breached.