Who should do my horse's teeth?

Dental problems are a common cause of oral pain, discomfort when ridden and difficulty eating. Because of this, most horse owners recognise the importance of regular dental inspection and treatment.

But who can provide dental care to horses? And how do services provided by equine dentists, including those accredited by profession bodies, and veterinary surgeons differ?

Currently, according to the Veterinary Surgeons Act 1966, all diagnostic and treatment procedures in a horse's mouth are legally restricted to vets. The exception is manual removal of dental overgrowths – commonly referred to as rasping or floating – using hand instruments.

However, given advancements in horse dentistry, and especially the training and certification of Equine Dental Technicians (EDTs), this legislation is widely recognised as archaic and badly in need of modernisation.

To this end, the Department for Environment, Food and Rural Affairs (Defra) and the Royal College of Veterinary Surgeons has worked with veterinary and dental associations to specify who can perform what in relation to dental care of horses.

Their regulations safeguard welfare of horses, particularly with respect to advanced techniques that carry risk of damage to teeth or serious, even life-threatening, injuries to the mouth, jaws and throat.

Three categories of procedures are defined. The first can be performed by any individual after recognised training; they do not need a formal qualification.

Category 1 procedures include examination of teeth, manual rasping of sharp enamel points and small dental overgrowths (less than 4 mm), and removal of any calculus that forms on teeth above the gum line. Shaping of the first cheek teeth to create 'bit seats' and extraction of loose deciduous teeth or caps are also permissible.

It is not clear, however, what is meant by 'recognised training' and there appears no policing of this by Defra. So, in practice, anyone can undertake these routine dental procedures, regardless of their training or qualification.

Category 2 procedures are more invasive in nature and can only be performed by individuals who have passed an examination approved by Defra. Courses and accreditation currently meeting these criteria are provided by the Worldwide Association of Equine Dentistry (WWAED) and the British Equine Veterinary and Veterinary Dental Associations.

Those who have passed these examinations are able to call themselves

Equine Dental Technicians, or EDTs for short, and are entitled to membership of the WWAED or British Association of Equine Dental Technicians (BAEDT). These professional bodies ensure that EDTs continue their education and provide appropriate insurance.

Additional procedures that EDTs are allowed to undertake include removal of loose teeth or dental fragments, rasping of fractured teeth, and extraction of wolf teeth albeit under direct veterinary supervision.

They are also the only non-vets allowed to use increasingly common motorised dental instruments. While this does not necessarily require that horses are sedated but, if it does, sedation can only be administered by a vet.

When carrying out category 2 procedures EDTs must work in consultation with the owner's veterinary surgeon. This usually means that they will discuss the case or send a treatment report to the vet.

When a vet sedates a horse for an EDT he or she should stay for the duration of treatment. The vet may wish to examine the horse prior to sedation, discuss the nature of the dental work and inspect the mouth afterwards since, if things go wrong, the vet may ultimately be liable.

Category 3 procedures, such as extraction of cheek teeth that are not loose, widening of diastema and treatment of dental caries, are still viewed as acts of veterinary surgery and can only be done by qualified vets.

This is because they often require further diagnostic evaluation, using radiography or endoscopy, and can be complicated by infection in the sinuses and bone. There is also a high incidence of complications with some of these procedures that will require veterinary attention and treatment.

So who should do your horse's teeth? The choice essentially boils down to using a dentist without qualifications, an EDT, or your vet.

There are some very experienced equine dentists who are not members of WWAED or BAEDT but work sympathetically with horses and perform routine rasping to a very high standard. The good ones will also recognise and respect problems that fall outside their remit, referring the case to a vet or an appropriately qualified EDT.

As well being able to undertake a wider range of work, EDTs tend to have more detailed knowledge and be familiar with latest developments in equine dentistry. While this doesn't necessarily make them better at routine treatment EDTs are, by virtue of their accreditation, more ably equipped to deal with horses that have dental problems.

Vets vary in their equine dentistry experience and skill, from general practitioners to specialists who devote their entire professional careers to horses' mouths. Some vets are members of the BAEDT and this is the only association for EDTs that the British Equine Veterinary Association currently endorses.

It is again vital that individual vets recognise limits to their expertise since, with the power of motorised tools it can be easy to do more harm than good. Taking on complicated procedures without appropriate diagnostic or technical support is also inadvisable.

Fortunately horse owners in Scotland are well served by experts at both veterinary schools, with Professor Dixon at Edinburgh an internationally-recognised leader, and the leading equine practices all performing advanced dentistry.