By Jack Easley, DVM, MS, Diplomate ABVP Dentistry - Jul 6th, 09
Finding the right person to provide dental care for your horse can be confusing for some owners. Proper dental care can be the key to maintaining overall health in many horses and, just as with other important areas of equine health, owners should consult with an equine veterinarian about best health-care practices.
To help you make an educated decision about who provides your horse’ s dental care, it is helpful to know the extensive education, in-the-field and on-the-job training and continuing education that veterinarians complete in order to provide the high level of professional health care that each horse needs.
Veterinary Education Requirements
All undergraduate students interested in entering veterinary medicine are required to complete college course work over and above general language and liberal arts classes. Prerequisite work includes courses in higher mathematics (calculus and statistics), chemistry (organic and biochemistry), biology (vertebrate and microbiology) and animal science (husbandry and nutrition). Most veterinary colleges also require animal, laboratory and veterinary work experience prior to acceptance.
Veterinary school requires four years of graduate-level course work. First-year students are exposed to 900-1,200 hours of classroom, clinical and laboratory instruction. Classes include gross anatomy, histology, physiology, nutrition, animal husbandry, microbiology and virology. The curricula covers the study of normal muscle, nerve and bone formation of the mouth, comparative dental structure and function, and the effect of the teeth and oral cavity function on digestion and absorption of nutrients.
The second year of veterinary school concentrates on the study of disease processes, including the diseases of the oral cavity, the muscles of mastication, nerves and joint disorders. Students also learn how the masticatory system relates to the function of the other body systems (muscles for locomotion, chewing, swallowing, etc.), the bones that support the teeth and associated structures necessary for eating.
Conditions associated specifically with the horse are also covered. Additionally, students are expected to learn material on pharmacology, how drugs work in the body (effects on the musculoskeletal, respiratory, urinary and gastrointestinal systems in detail), principles of drug selection, adverse drug reactions, toxicities, treatments, and principles of pain management. Often, veterinary schools offer courses in alternative/complementary medicine as well during the second year of study. At this time, students with special interests are given opportunities to further research these conditions in greater detail. Vacation time and breaks from school offer students additional time to concentrate on areas of special interest—one of which is dentistry.
The third year of veterinary school focuses more on exposure to the medical and surgical disciplines such as infectious and contagious disease, disease prevention, and the control and treatment of disease.
Radiology, endoscopic techniques, ultrasonography, surgery, medical diagnosis, and therapeutic techniques are all part of students’ junior year learning experiences. Such courses relate directly to all body systems and organs (including the oral cavity and teeth). Lectures as well as hands-on dry laboratory work, clinical techniques, and surgical labs define and refine students’ clinical skills.
The summer after the third year, most veterinary schools direct their students into a 12-month clinical rotation schedule. Formal classroom lecture is limited to smaller groups with a narrower topic. Students rotate through all clinical areas of the hospital (medicine, surgery, imaging, gross pathology, dentistry, field service, clinical laboratory, etc.), but may concentrate more hours in an area of special interest (equine, food animal, small animal, research, etc.). During equine field service rotations, students are instructed in the finer points of oral examination and dental charting. Proper dental corrective procedures are performed with both hand instruments and power equipment. Students receive guidance from instructors on both the science and art of practice as they deal with university animals as well as private practice patients. In hospital rotations, students work up cases (consisting of a large number of unusual referral horses offering students’ exposure to a vast array of case material) using the most advanced
diagnostic equipment.
Equine rotations in and outside the veterinary school setting include instruction on animal restraint, performance of a complete oral examination, and recording clinical findings. Diagnostic techniques such as sinocentesis, skin and bone biopsy, cytology, blood sample collection, radiology (safety, positioning, developing and interpretation), endoscopic evaluation, and neurological assessment are covered. Students with a special interest in dentistry or equine practice can enroll in elective courses and laboratories that provide a more in-depth exposure in any of these areas. Pathology specimens are also made available for evaluation and in-depth study. Clinical case material presented to the veterinary school teaching hospital is also discussed in rounds or clinical seminars. Required large animal medicine and surgery courses
cover diagnosis and treatment of dental and sinus disease. Elective courses and laboratories are available on tooth extraction, sinus flap surgery, tooth repulsion, and treatment of oral and sinus tumors for students interested in equine practice.
Many schools also offer off-campus student preceptorships for senior students. Many students, with an interest in equine, elect to spend several weeks in an approved equine veterinary practice at which time they are mentored in the “ real world” of private practice. These extern blocks are structured and graded, but allow some flexibility for students to pursue practical exposure and advanced training in an area of special interest. Many senior students elect to spend several days, weeks or even months studying in the area of equine dentistry.
Upon completion of four years of full time study, the veterinary student must pass testing in all the described classes. To be qualified to work as a regulatory veterinarian and issue state and federal health certificates, the veterinarian must pass a federal examination issued by the U.S. Department of Agriculture. Each state in the United States also requires a state examination and qualification process to be licensed by the particular state veterinary practice board and thus practice in that state.
After Graduation and Beyond
The coursework and training that is required of a student to graduate from veterinary school ultimately prepares them to provide medical, surgical, and dental care to their patients while protecting the health and welfare of the general public. A veterinarian is trained to protect the food supply, prevent the spread of infectious or zoonotic diseases, care for mankind’ s companions, and safeguard the financial investments their clients have made in their animals. Veterinarians are expected to read and critically evaluate scientific research and adapt it to clinical practice.
Many veterinarians, who plan to enter equine practice after graduation, choose to work a year in a rotating internship. They have the option to go into general practice or pursue specialty training through a two- or three-year residency program. These programs are available in surgery, reproduction, medicine, dentistry, ophthalmology, pathology, or equine practice. Only veterinarians who complete a post-doctoral specialty training program and successfully pass an extensive battery of examinations are designated as a specialist such as surgeon, dentist, or ophthalmologist.
Licensed veterinarians are compelled to meet the ever-changing challenges presented in all fields of veterinary medicine, including equine dentistry, and must commit themselves to a lifetime of continuing education. Continuing education opportunities are offered year-round by the AAEP and other veterinary organizations. Specifically related to equine dentistry, short courses and hands-on wet labs are offered annually by the AAEP, American Veterinary Dental Society (AVDS), American Veterinary Dental Forum (AVDF), British Equine Veterinary Association (BEVA), and Minnesota Equine Dental Society (MEDS). Additionally, the American Veterinary Medical Association (AVMA), local, state, national, and international veterinary associations offer equine dental research, clinical presentations, and wet labs at their annual meetings.
Choosing the Most Qualified Professional
Before you, as an owner, select someone to perform dental procedures on your horse, the question must be asked: Do you want the most educated, accountable and trained individual to care for your horse? Do you want the assurance that a licensed professional will be available and accountable to you and your horse in the hours and days following the care provided? If the answer is yes, then an equine veterinarian is the professional who can best meet your horse’ s dental needs. This same level of consideration and caution should be given for all aspects of your horse’ s health.
For more information about equine dental care and your horse’ s individual needs, talk with your veterinarian or visit http://www.aaep.org/info/horse-health?publication=734.
Dr. Easley of Shelbyville, Ky., is a past member of the AAEP board of directors and served on the Equine Dentistry Committee.