Posted by Geoff Tucker on Mon, Mar 08, 2010
Please vote against the "equine dentist" bill that has just passed the house (3202).
I am a veterinarian (Cornell 1984) who has incorporated equine dentistry into his practice since graduating plus the year before in vet school. Since 1998 I have limited my practice to exclusively equine dentistry. My totals then are 27 years of performing equine dentistry with an estimated 43,000 floats to my name (36,000 documented, the rest estimated in the early years including the year in vet school).
Due to client confidentiality I can not list current clients, however, I have floated all types of horses from miniature to draft and crossed all disciplines. From back yard geriatric to Olympic to the Thoroughbred horse of the year and Kentucky Derby winners. I have also served on the New York State Equine Practice Committee in the late 1990's where this issue of lay dentistry was thoroughly discussed. Because of this experience I would like to address the flaws in your legislation.
There are two key important issues. First is that there is no accredited equine dentistry school and there is no clear agreement as to what constitutes an adequate equine dental procedure. Without accreditation and independent oversight, how can a lay dentist be adequately and effectively trained? Second is that there is no clear veterinary/client/patient relationship when giving a legend drug by a non veterinarian. This relationship is a basic and fundamental principle of the American Veterinary Medical Association as well as a federal regulation of the Food and Drug Administration. In other words, for a vet to sell a bottle of legend medication to a lay dentist for that person to administer at will to his clients is a clear violation of law.
Equine dentistry is really an art form that has been neglected in the veterinary schools. It was only through my mentor that I learned it in my third year and practiced it during the summer before my forth year at a veterinary clinic. There were no schools of equine dentistry then. In the late 1980's a school was formed by a non veterinarian and since then many schools have evolved owned by veterinarians and non veterinarians. From this there developed an association which "grants" degrees that are applied to the member's name. Through their certification program members can rise in the ranks to become "masters" at what they do. However, there is no outside oversight by anyone who is there to protect the public from fraud as there is with licensing boards in each state. No one is verifying that what they are teaching is safe or harmful to the horse.
From a scientific stand point, using any and all standards as to what good science is, there is no substantiation for what these schools are teaching. Theories grow like weeds in the equine dentistry community with little to no substantiation for their proof. As you may know, all theories are just thoughts that are then tested against facts until proven. To date, there is no effort to prove these theories accurately. Only the facts are twisted to fit the unproven theories. Thus, the theories promoted now in equine dentistry are only ideas made up without proof. Further, because most of these theories are benign, through eloquent people they become dogma and accepted as truth.
Until theories can be accurately and scientifically proved, there is only evidence based medicine to justify techniques and goals in equine dentistry. With 27 years and 43,000 floats, my evidence appears to fly in the face of these new methods that are heralded as the "only way" to float teeth.
In my practice I statistically use drugs on approximately 1 in 10 horses (360 uses in 3400 horses over the last 12 months). This includes all extractions and procedures that are not routine floats. The rest are effectively floated using horsemanship skills. Size and strength of the dentist does not matter, only their ability to handle a horse. This has been going on for centuries yet the old picture of the horse with wild eyes and a twitch applied to the nose has become seared in our memory. This graphic along with drugs overcoming the lack of horsemanship has allowed both vet and non vet equine dentists to promote the use of drugs in every horse they touch. The reasoning used is that a more complete and accurate job can be performed. This is pure nonsense and it is proven daily in my practice.
So what is the "correct" use of drugs? Simply for the removal of pain and on occasion for overcoming anxiety. In my practice the threshold of pain of the horse is the limiting factor. If the sores from the sharp points are too much pain for the horse to stand still, then a combination of a sedative plus a potent narcotic is used. The narcotic is a controlled substance which is absolutely not allowed to be dispensed to lay dentist for use in any horse. On rare occasions some horses are fearful and require an additional drug which then allows the horse to relax enough for the sedative and narcotic to become effective. This anxiolytic drug is also a controlled drug.
To summarize the drug use in my practice, I use two controlled substances and one non controlled substance for the relief of pain in the horse and not for the convenience of the one doing the work. Drugs are unnecessary for 9 out of 10 routine floatings and when drugs are required, the use of controlled substances are effective in the elimination of pain.
Finally, I would like to mention that certifying equine dentists was tried in the United Kingdom in 2003. By 2005 it was considered a "total failure" (personal communication with the British Equine Veterinary Association - the equivalent to our American Association of Equine Practitioners). Enforcement is the key to control and frankly, no one is willing to enforce the laws. In Florida in 2008 horse owners were allowed to hire lay dentists as long as they did no extractions and used no drugs ( http://www.leg.state.fl.us/STATUTES/index.cfm?App_mode=Display_Statute&Search_String=&URL=Ch0474/SEC203.HTM&Title=-%3E2009-%3ECh0474-%3ESection%20203#0474.203 ). Any lay dentist using power tools was doing so against the laws of the state. Yet today lay dentist are using power tools without fear of any enforcement in Florida.
This concludes my brief discussion on traditional versus modern equine dentistry. More information as well as pictures and videos can be found on my web site ( http://www.theequinepractice.com ).
If it were asked of me, lay dentists should be allowed to work under the guidance of a veterinary practice where the veterinarian has a vested interest in the result. Horse owners should be allowed to use non controlled drugs as long as the vet is aware (the vet has prescribed it for that horse) and the owner administers it taking full responsibility for any reactions. Preferably, the horse would be rescheduled for the vet to administer the appropriate medication.
Posted by Geoff Tucker on Mon, Mar 01, 2010
Last night we were sitting in the living room watching re-runs of The Cosby Show with my Father In Law who is visiting us in sunny South Florida along with another couple escaping the cold and snow of the north. They all are about 25 years older than we are.
My eyes drifted over to George, Tom, and Helen. In stead of looking at them as people, I objectively looked at them as life forms in their eighties. How did they get to this point in their lives and continue to thrive while others in their 80's are falling apart?
Then, as the 70 plus year old Cosby had the room laughing until all were crying, I wondered why some of the 25 plus year old horses I see have very healthy teeth while some others have loose teeth or multiple missing teeth. Besides genetics, was there something in the management of them that had caused this?
We know that in horses, the teeth develop into a fully mature set of choppers around their fifth year. In adult humans, what we see of the tooth is called the crown while the root part attaches the tooth to the jaw. But in the horse there is a long hidden portion called the reserve crown lying under the gum ready to replace worn tooth. This is a fundamental difference between humans and horses.
Thanks to the research of Katherine Houpt, VMD, an emeritus professor at Cornell's College of Veterinary Medicine (and a friend and former employer), we all now know that a horse chews between 10,000 and 40,000 times a day (Equine Maintenance Behavior: Feeding, Drinking, Coat Care, and Behavioral Thermoregulation) (Control Of Food Intake In Horses) (Feeding And Drinking Behavior Of Mares And Foals With Free Access To Pasture And Water). There are 86,400 seconds in a day which means that on average, the horse is chewing about one third of a day. Another way of putting it, on average a horse chews 25,000 times a day, one quarter of a million chews in 10 days, or 9 million 125 thousand times a year (9,125,000) - OR MORE!
As your horse chews, a portion of the hard tooth wears away from two effects: grinding against the opposite tooth and stropping of the tongue (like a steel razor sharpened by a leather strap). As the tooth is worn away, it is replaced by the reserve crown. This continues until there is no more reserve crown and the tooth eventually falls out. With all things going well, the horse finally dies because he can no longer create a bolus of food to swallow.
Where does dentistry for the horse fit into good management? There are two thoughts I have for you.
First, we remove the pain caused by the sharp tooth edges scraping the tongue and cheek. This allows for two things:
1) All the teeth receive an equal amount of pressure creating a healthy stimulus to cause the tooth to remain tight in the socket.
2) All the teeth receive an equal amount of cleaning and pressure from the tongue causing the teeth to remain healthy and firmly attached to the jaw throughout life.
Second, if we over grind the tooth when floating and remove more than just the sharp edges, then the tooth will run out of reserve crown and the horse will loose teeth long before he is ready to die.
At our practice of Equine Dentistry Without Drama™, we take off only what makes the horse comfortable but leave remaining the tooth necessary for a complete life. We believe that over-grinding the tooth shortens the life span of the tooth and will eventually cause premature tooth loss. Can we prove this? Not yet. But we will see shortly. Power grinding teeth has been around for less than 25 years as a major technique of floating teeth. Only in the past 10 years has it become popular enough that many horses are affected. We will see in the next 10 to 15 years if the prediction of premature loss of teeth is associated with power grinding of teeth.
And I will be in the barn watching re-runs of Mr Ed while my son gently eyes me and my wife wondering, what will the next 25 years bring.
Equine Dentistry - Twenty Five Years From Now by
Geoff Tucker, DVM is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Posted by Geoff Tucker on Sun, Feb 21, 2010
Equine Dentistry Without Drama™
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Equine Dentistry Meets Like Minded Equestrians
It's 6 am Sunday morning and the roads are clear and fast in Lexington KY. Melissa and I are heading towards Hickory, NC for some horses teeth - as usual. But less than 36 hours ago we worked our way from a bunch of horses in Alpharetta, GA into this Bluegrass mecca for horses and equestrians. This blog is about those short 36 hours and the incredible equestrians we met and what was discussed.
These people came from all areas of the industry. In fact, I was the only veterinarian, let alone equine dentist. We had been invited by a forward thinking individual along with a nucleus of his friends to join a hand selected group of about 40 people to discuss social media and the equine industry. Twitter, Facebook, blogging, search engine optimization, and other yawn-able things to most horse owners.
But those of you that know me, I was in my element. You see, over the past 18 months I have immersed myself into this. This is an e-letter being blasted to all my clients using http://www.streamsend.com/. I then am posting it to my blog page ( http://www.theequinepractice.com/Blog/ ) which is supported by a content management system called http://www.hubspot.com/. Through this company, it is optimized for search engines such as Google. If you type in EQUINE DENTISTRY into Google, my web page will appear on page one.
Simultaneous to the blog post, a notice will appear on Facebook ( http://www.facebook.com/EquineDentistryWithoutDrama ) (1,999 friends this morning - who will be number 2000?), and Twitter ( https://twitter.com/EquinePractice ) (1624 followers) to people around the world. I will then make a special post to my Facebook Fan Page ( http://www.facebook.com/pages/Palm-City-FL/The-Equine-Practice-Inc/139814325299 )which is my business site (279 Fans). I need to work on this address!
By the time the Sunday morning cup of hot coffee ( or ice cold soda) has been poured, literally the whole world will know about the adventures of Equine Dentistry Without Drama™ over the weekend. And this is so awesome to me because our message of horsemanship as the basis of veterinary care and equine dentistry is important to the three of us here at The Equine Practice (http://wwwtheequinepractice.com).
Thank you and a big Florida HOWDY to all of you that made this fun and informative. All of you will be forever a friend and a source of information and inspiration. OK OK!! I'll get the Barn Pics™ going again.
Glenn (and Jennifer), you are a visionary. Chris, Chris and Jim, Samantha, and Jeanne - awesome job in putting this together and hosting the program. John and Bill (Succeed) and Mary (Markel Insurance) - thanks for the food and drink and supporting this group as sponsors. Templeton and Sam - great singers and songwriters that lift you with their words and sing blissful foot-tapping melodies (hey Nashville - wake up!). Tess, Chad, Erin, Sara, Sarah, Linda, Frankie & Sandy, Vinnie, Jackie, Jackie, Lizzy, Linda, Penny, Meg, John, Patrick, Lyndsey, Lisa, Laura, Karen (thanks for saying that this vet understands equine nutrition), Cheryl & Jerry & Courtney ( my dinner partners - great conversation), Lisa (my longtime Twitter buddy), Darcy, Steve and Jennifer, Debbie (all the way from California!), and Marya Z (always at the end of the list???)
Y'all are friends. Catch ay later and keep the shinny side up going home today. Geoff and Melissa
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© Geoff Tucker, DVM The Equine Practice, Inc
4150 SW Sundown Lane Palm City, FL 34990
Geoff (Dr T) 772-285-3866 geoff@theequinepractice.com
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Posted by Geoff Tucker on Sun, Feb 14, 2010
The equine body condition score helps horse owners to assess their horse's condition relative to a scale to determine if more or less nutrition is required. With an ideal score of 5, most horses today are kept at a higher score which is unhealthy as well as expensive. This video describes the score and how it can apply to your horse. See the related videos "Why Grain Is A Supplement", "Continuous Eaters", and "Does An Extra 50 Pounds Matter". (These videos will be added soon - 1 a week, or you can see them at YouTube now- my name there is horzvet)
Equine Body Condition Score by Geoff Tucker, DVM is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Posted by Geoff Tucker on Thu, Feb 04, 2010
Isn't there enough drama in our lives? Between the world events, politics, your favorite TV show, and getting the kids off to school, how can we cope? Then there is the drama in the barn. Should I go there???
So why would you call a professional to work on your horse only to have worry or regrets afterwards? Yet we have all experienced this and not just with our horses. We all have an expectation when we ask professionals for their expertise. Yet over the years I continually become disappointed. This stems from a range of reasons from unethical behavior to shear incompetence.
There may be another reason for disappointment, confusion, or just an uneasy feeling when a professional works on your horse. Some equine professionals have a foundation of either their practice or the procedure based on one or several beliefs that may not be the same as other professionals in their field. Add to this confusion is the plethora of information on equine care including deworming, lameness, nutrition, and of course dentistry.
Here is an example just for equine dentistry. At Equine Dentistry Without Drama™ we believe that the only reason to float teeth is to remove all sources of pain located within the mouth. Other equine dentists focus on the physics of jaw movement as the primary concern. These two different beliefs create confusion within the industry as well as with the horse owner. This leads to the horse owner looking for something else to place their trust in rather than understanding the principles of the procedures.
Again, we as buyers of a service want to believe in the professional doing the work. I believed in the accountant I hired one year but that trust led to a $13,000 bill plus and an IRS audit. Bad taste for every accountant since. Or how about the office manager who embezzled me? Both of these individuals talked the talk but were definitely bad for me and my business.
So with confusing reasons to float teeth and maybe either no experience or a bad experience with an equine dentist, how can you tell if things are right? Certainly it is hard to check the job inside the mouth.
Over the years I have found two things to help. First is to trust my gut feeling. If it doesn't feel right then I stop. Secondly I look at the results. For us there is nothing better that the horse showing gratitude immediately and the owner calling the next day saying their horse is immensely better on the bit or chewing hay.
We just started work at a farm with a lot of horses. They had another equine dentist that made all the drama one could imagine. Here is a list:
• over drugged every horse
• hung their head from the ceiling
• "pools of blood" at the work area
• advised no riding for 14 days after pulling wolf teeth
• pictures of the oral cavity before, during, and after floating
• full set of dental x-rays
• worked on only 6 horses per day
• a bill of over $500 per horse
• our review 20 days later showed the upper left edges were missed consistently
• 3 horses (stallions) he determined needed no work. They had extremely sharp teeth.
The manager of this farm tuned in to her gut feelings and asked the man to leave. She wasn't comfortable with many things she was seeing. And that was before she knew his bill (arrived a week later) or that he had missed areas or that he was afraid of stallions. This took a lot of courage even for a professional manager because he was a veterinarian specializing in modern equine dentistry. Many novice horse owners may not have enough experience to get the gut feelings into a warning mode. On the other hand, for others, this experience may be exactly what they want reminding them of the advances in human dentistry.
At Equine Dentistry Without Drama™, we feel that in every endeavor with the horse from teeth to trailer loading or grooming to leading, there should be as little drama as possible. We feel that you as a horse owner should not have to be worried in any way for the safety or treatment of your horses. You should be confident that your money is well spent with confidence the job was completed to the satisfaction of the horse. We should be a member of your team that cares for your horse, not the star.
When done, your horse should be relaxed showing gratefulness by licking lips, lowering head, advancing towards us hanging the head out the door asking for affection. You should either be smiling or have left to do other barn things confident in our care. When you pay us you should feel that it is money well spent. You should feel able to contact us afterwards with any concerns and feel like you were treated special and not just a number.
We at Equine Dentistry Without Drama™ know it is how we would want to feel after our professionals come to our barn.
Equine Dentistry - Where's The Drama? by
Geoff Tucker, DVM is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Posted by Geoff Tucker on Tue, Dec 22, 2009
Interview on the Horse Tip Daily Radio Show - The Horse's Tongue - 12/10/2009
Welcome to Horse Tip Daily
A short daily online radio show (horse podcast) packed with useful tips and information from the top names in the horse world. A different horse tip, a different equine topic, a different equestrian expert every day.
Listen here or subscribe through iTunes or Zune. Part of the Horse Radio Network.
Horse Tip Daily by
Geoffery W. Tucker is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Posted by Geoff Tucker on Mon, Dec 21, 2009
Interview on the Horse Tip Daily Radio Show - Flabby Cheeks 10/15/2009
Welcome to Horse Tip Daily
A short daily online radio show (horse podcast) packed with useful tips and information from the top names in the horse world. A different horse tip, a different equine topic, a different equestrian expert every day.
Listen here or subscribe through iTunes or Zune. Part of the Horse Radio Network.
Horse Tip Daily by
Geoffery W. Tucker is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Posted by Geoff Tucker on Sun, Dec 20, 2009
Interview on the Horse Tip Daily Radio Show - Floated Correctly? 9/19/2009
Welcome to Horse Tip Daily
A short daily online radio show (horse podcast) packed with useful tips and information from the top names in the horse world. A different horse tip, a different equine topic, a different equestrian expert every day.
Listen here or subscribe through iTunes or Zune. Part of the Horse Radio Network.
Horse Tip Daily by
Geoffery W. Tucker is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Posted by Geoff Tucker on Sat, Dec 19, 2009
Interview on the Horse Tip Daily Radio Show - Feed Efficiency 9/1/2009
"
Welcome to Horse Tip Daily
A short daily online radio show (horse podcast) packed with useful tips and information from the top names in the horse world. A different horse tip, a different equine topic, a different equestrian expert every day.
Listen here or subscribe through iTunes or Zune. Part of the Horse Radio Network.
Horse Tip Daily by
Geoffery W. Tucker is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Posted by Geoff Tucker on Sun, Dec 06, 2009
Horse's teeth erupt throughout their lives with constant wear occurring from teeth grinding against opposing teeth and continual stropping by the tongue. This wear is uneven and creates razor sharp edges that cause discomfort as those edges ulcerate the cheek and their tongue. So if eruption and wear is continuous throughout the life of the horse and the result is pain within the mouth, AND the removal of the sharp points (floating) is easily done, WHY DO SO MANY HORSE OWNERS AVOID THIS IMPORTANT ASPECT OF HORSEMANSHIP? 1) THEY DON'T KNOW ANYTHING ABOUT IT If you don't know about the process of floating teeth and why it is done but you are reading this, then spend some time on my web site www.theequinepractice.com. Here is a compact yet detailed area where you can learn more. In fact, there are lots of places you can go to learn more. However, be aware that there are many sites and references where what is said may disagree with what I describe. My ideas are based on over 26 years of floating horses and over 42,000 floats. It is based on horsemanship and common sense. 2) THEY HATE THE DENTIST THEMSELVES Horse and human teeth have very little in common. I realize that many of you fear the dentist more than death itself. But just one look at the relief your horse gets after having it's teeth floated will quickly dissipate any anxiety. The primary purpose of floating horse teeth is to remove the sources of pain within the mouth. Realizing this will overcome any irrational thoughts you may have based on your personal experience. 3) THEY DIDN'T KNOW THERE WERE TEETH BACK THERE What you don't see must not exist. Well, that's ridiculous. Ownership of an animal has the responsibility of knowing the basics. So here it is. There are 24 teeth in the back of the horse's mouth behind where the bit lies. They are out of site but they can cause so much problems if they are not maintained. Why do they need maintenance? Because we have bred them for beauty, speed, agility, and strength but we have NOT bred them for their teeth. 4) THEY WAIT TILL THERE IS A PROBLEM This is a button for me and all veterinarians you don't want to push. Why wait till a problem arises when some prevention could prevent undue stress and pain in your horse? This is when someone offers the example of changing the oil in the car. I don't because when you don't change the oil and the engine fails, then you replace the engine. A horse is a living being and simply put, they have evolved into a near perfect creature. We as humans alter their base state by stabling, bitting, and riding and, most importantly, through breeding. So we have created an altered living being with an altered purpose. Therefore we MUST apply prevention because the end result cannot be replaced with a simple part replacement. 5) THEY HAD IT DONE ONCE AND SAW NO CHANGE How many times will you dip your hand into your wallet and pay for something that you see no results in? Not often I'm sure. Not all tooth floating is the same. Some tooth floaters miss spots that continue to cause pain. Every float must address every point in the mouth to be effective. Pain is the most common cause of an incomplete floating. In our practice, pain is avoided by the place and pull technique as well as the use of pain relieving medication in the few horses that are extremely sensitive. 6) THEY HAD IT DONE ONCE AND VOWED NEVER TO HAVE IT DONE AGAIN This I hear often. The past experience of the horrific approach of over drugging, head hanging, mouth jacking, and the application of power tools that grind the surface of the teeth like a carpenter would approach a block of wood. I have heard reports of horses unable to eat for long periods of time after floating, horses falling down from over drugging, jaws breaking from improper use of the mouth jack, neck injuries from head suspension along with the horse falling down, and even death from application of unproven theories such as incisor reduction. We are grateful for those who have experienced atrocities and yet seek us out knowing how important it is to have the teeth floated. 7) THEY CAN'T FIND AN EQUINE DENTIST IN THEIR AREA OR THEY HATE THEIR EQUINE DENTIST Many rural areas have difficulties in finding competent horse care professionals. You may be reading this and live in a sparse area where the nearest vet, let alone equine dentist, live over 100 miles away. Worse yet, the dentist or vet that serves your area is incompetent or unreliable. Unfortunately, most quality professionals live in an area where they can make a better living. There are many reasons for this, but it boils down to money, or lack of it in your area. We are aware of this and therefore we drive throughout the US rather than fly. Many horse farms have gotten together to group their horses and wait until we come through the area. This way, an experienced equine dentist who has worked on some of the top equine athletes also work on your "backyard" horse. Someday I will teach many people to become competent in this skill so they can return to their areas and serve. 8) THEY HAVE NO FAITH IN THEIR VET This is a little tougher. If you don't like your vet doing your horse's teeth, and he or she is the only vet coming to your area, you don't want to loose the relationship and loose the emergency response for colic or suturing. Some vets are jealous of other practitioners and will make it hard for others to work in "their territory." Life is not fair. It is more important that you get the teeth floated even if it goes against your horsemanship. You may need him later for an emergency and this is always important. 9) THEY DON'T CARE ABOUT THEIR HORSE This possibility seems beyond most horse owner's imagination. Yet I hear this often: "Doc, this one's for sale so we aren't floating this one to save the expense." How much more money could have been received if the horse went without his head fighting the bit? In our opinion, ownership of any animal, no matter how brief, demands we give the highest level of care. However, as a vet, I have seen repeatedly abuses from not floating all the way to death by starvation. It is human nature. 10) THEY ARE BROKE OR THEIR EXPENSE PRIORITIES ARE WRONG This one is more apparent with the economy today. When horses are being abandoned or starved, how would teeth floating even be considered? Well, I am not talking about the extreme cases. It is the person whose expense priorities are not in order. When someone forsakes floating their horse's teeth for squandering their money on something whose value has no baring on a living being, a question must be asked. Who is your horse's advocate? It is you. Not me or the vet or the neighbor. SUMMARY - A CHRISTMAS GIFT You are reading this either as an E-Letter sent to your inbox, on Facebook, Twitter, or maybe you were notified of a blog entry on my web site. But you are informed or are seeking more knowledge and I appreciate this. Please take the time to pass this out to all your sources. This list applies to many other aspects of horse care. Hopefully it will stimulate someone be their horse's best friend and advocate. That would be the best Christmas gift. Bless you all this season and in the new year. Geoff, Brandon, and Melissa
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E Letter December 2009 by
Geoff Tucker, DVM is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.