Frequently Asked Questions about Equine Dentistry in the UK

The following is a list of questions and answers regarding equine dentistry in the UK. If you have any further questions please contact us.

Frequently Asked Questions – Equine Dental Technicians

(some reproduced with kind permission from BEVA)

What is an Equine Dental Technician?

An Equine Dental Technician, or EDT is the name given to a lay person who is performing equine dentistry. The term 'dentist' ('horse dentist', 'equine dentist' etc) should not be used as it is strictly  for use only by human dentists, i.e. those with a human dentistry university degree qualification.

How do I know if an EDT is suitably qualified?

There are increasing numbers of properly qualified EDT's throughout the country, however there are still many unqualified persons practising equine dentistry to a variety of standards.  The BAEDT (British Association of Equine Dental Technicians) has a list of members who have passed the joint BAEDT/BEVA examination and who keep their membership up to date. The list can be found at www.equinedentistry.org.uk

Can an EDT do everything that a vet can do?

The law states that any person may perform the basics of equine dentistry e.g. examination and rasping of sharp edges (see later Q's for description of categories of procedures). More advanced procedures however can only be performed by veterinary surgeons e.g. incising the gum to extract teeth. 

There is a new government 'exemption order' soon to be passed that will allow properly qualified EDT's to perform some of the procedures that at present only vets may perform (see below).  

Sedatives, pain killers, antibiotics, tetanus prophylaxis or any other prescription drugs may only be administered by a veterinary surgeon and that will not be altered in the new legislation.

Can a vet do everything that an EDT can do?

All vets receive a certain amount of training in equine dentistry during their university degree course. However, some vets do not follow this up with further training and may not be as skilled as some EDT's with regard to basic equine dental procedures. Other vets however take a special interest in equine dentistry and train to a very high standard offering their clients a full 'in house' equine dental service.

I am interested in becoming an Equine Dental Technician. How do I go about training?

To become a fully trained EDT will take many years of hard training. It must also be recognised that EDT work is physically very demanding, requires excellent horse-handling skills, good client communication skills, high initial capital outlay on training and equipment and finally, excellent business skills to build up and retain a good client base.

Training can be achieved via a number of routes. In an ideal world, such training would include a large component of an apprenticeship-type teaching with a series of experienced qualified EDTs, obtaining much teaching on a one-to-one basis.

Information on EDT training can also be gained from the British Association of Equine Dental Technicians (BAEDT) Convenor, Mary-Lou Lees mllees@dircon.co.uk. The BAEDT membership consists solely of EDTs who have passed the joint BEVA/BVDA (British Veterinary Dental Association) examination.

www.equinedentistry.org.uk

It is possible that the BAEDT may be able to put you in touch with a fully qualified EDT could who could give you an introduction to the type of work which is involved.

The (BAEDT) do also provide basic introductory equine dentistry courses. The recently advertised one-week courses at UK “Dental Colleges” which will instantly train you to become an EDT will not work!

There are various “Colleges” in America who run short courses (which vary between a few weeks duration) and some of these have definite benefits. However, some graduates of these “colleges” believe that after even a week or two of training, that they can perform any kind of major dental surgery, despite having had minimal information on dental pathology, infectious processes or wound healing. Very serious injury has been caused to horses in Britain by grossly untrained people, aggressively performing very advanced dental procedures, including illegally using drugs at times. The ethos of the EDT training course chosen should be borne in mind if considering gaining training abroad.

2). Can you explain the different categories of equine dental procedures to me?

The law in Britain on equine dentistry (covered in The Veterinary Surgeons Act 1966) clearly specifies which equine dental procedures lay people can perform and which can only be carried out by registered veterinary surgeons. The current law, which will not be affected by new legislation due to be passed shortly, allows certain designated routine equine dental procedures which are not considered to be acts of veterinary surgery to be performed by lay-people whether they are trained or not. These are termed:

Category 1 Equine Dental Procedures and include:

* The examination of equine teeth
* Routine rasping (excluding the use of power dental tools)
* Removal of sharp enamel points and small dental overgrowths (less than 5mm high and involving less than half of the tooth’s occlusal surface) with manual rasps
* Removal of digitally (finger) loose deciduous cheek teeth (“caps”)
* Removal of calculus which lies above the gum line.

A further group of procedures have recently been designated as advanced dental procedures. These procedures are at present deemed to be acts of veterinary surgery but are currently being deregulated by The Department for Environment, Food and Rural Affairs (DEFRA) and the Royal College of Veterinary Surgeons (RCVS) who are amending the Veterinary Surgeons Act 1966. This deregulation will legally allow certain defined procedures to be performed by qualified EDTs who have passed the BVDA/BVDA EDT examination. These advanced equine dental procedures are termed:

Category 2 Equine Dental Procedures and include:

* Extraction of loose teeth, including both cheek teeth and incisors, including deciduous cheek teeth or teeth suffering from advanced periodontal disease. However teeth which have been loosened by trauma must have further investigation performed by a veterinary surgeon – including x-rays if necessary – before being extracted
* Extraction of normal, fully erupted and non-displaced wolf teeth
* Removal of large dental overgrowths (over 5mm tall and involving over 50% of the occlusal surface of the tooth) and overgrowths over 5mm tall of the whole occlusal surface
* Techniques requiring the use of dental shears, inertia hammers and motorised dental instruments, including power rasps
* Treatment of fractured and diseased teeth
* Extraction of dental fragments and palliative rasping of fractured and adjacent teeth

Many of these advanced dental procedures will require sedation of the horse, which can only be performed by a veterinary surgeon. Additionally, many cases will require tetanus prophylaxis, analgesics, anti-inflammatory and antibiotic treatment following the above dental procedures. These drugs can only be administered or dispensed by a veterinary surgeon.

Certain equine dental procedures will not be deregulated to equine dental technicians and these procedures can at the present, and in the future only be performed by veterinary surgeons. These are termed:

Category 3 Equine Dental Procedures and include:

* Any procedure which involves making an incision (except elevation of the gum for the purpose of intra-oral extraction of teeth under veterinary supervision)
* Extraction of teeth by repulsion, or lateral buccotomy
* Endodontics (root canal treatment)
* Orthodontics (e.g. bracing parrot mouths)
* Repair of mandibular fractures. 

3). Where can I train to be formally recognised as an EDT in this country?

The BEVA currently only recognises those EDTs who have passed the BEVA/BVDA exam.

Training can be obtained formally by undertaking a 3-year degree course for example at Hartpury College www.hartpury.ac.uk. This will cover the theoretical side of the work and successful attainment of the degree will exempt you from the theoretical part of the BEVA/BVDA exam. Practical experience has to be obtained outside the course, working with other qualified EDTs.

The BAEDT have a list of EDTs willing to assist trainees and also run introductory courses in equine dentistry and BEVA provide a 2 day Advanced Theoretical EDT Course which must be attended as part of the entry requirements to sit the BEVA/BVDA exam. This is to help prepare for the theoretical part of the exam.

4). I have heard about various colleges who run dentistry courses in the UK and in the USA. Are these courses suitable to train at?

Answered in 1) and 3)

5) I have trained as an EDT in the USA/Australia. Am I formally recognised in the UK?

No (see details on legal position in section 2.) There are many people who have undertaken formal and informal EDT training and built up experience over many years who only wish to remain as competent “tooth raspers” i.e undertake only Category 1 procedures as detailed in section 2. These people are working within the law. It is strongly advised that they should build up a working relationship with the veterinary practices in their area so that when referral for more advanced dental work is necessary or sedation is required for routine rasping there is good cooperation between all parties involved.

To undertake any other procedures in the UK at present you must have passed the BEVA/BVDA equine dentistry exam. However until there is an exemption order to the Veterinary Surgeons Act with regards to equine dentistry then even having passed the BEVA/BVDA exam means only category 1 procedures may be carried out. (See question 7). However the Royal College of Veterinary Surgeons has indicated that whilst waiting for the relevant legislation to be passed, it will not seek prosecution of BEVA/BVDA qualified EDTs performing category 2 procedures on horses which have overall care by a veterinary surgeon – or similar.

6). Can you recommend any EDTs who would be willing to accept an apprentice?

Please contact the BAEDT www.equinedentistry.org.uk

7). I understand that there is a DEFRA exemption order for EDTs being finalised. When will this law be passed and will this mean I cannot practice without taking an exam?

The draft legislation has been with the DEFRA lawyers for many months now. We have been promised that it will be finalised shortly but other legislative work has continually delayed this final hurdle. The BEVA continually ask for updates on the progress of the exemption order.

Until this exemption order has become law it is only lawful for veterinary surgeons to carry out the more advanced category 2 and 3 procedures. (see Q 2 and 5).

8). If I attend your Advanced Theoretical Equine Dental Technician Course on 27th and 28th August 2004 at Hartpury College, Gloucestershire will I be formally recognised as an EDT?

No. You have to pass the BEVA/BVDA equine dental exam to legally be able to carry out procedures other than those in category 1 (see section 2).

Download Advanced EDT course registration forms here

9) I have heard of qualified EDTs that sedate horses and inject local anaesthetics – is this legal?

No –In the UK only veterinary surgeons can legally sedate (by injection or oral paste) or inject local anaesthetics. Therefore it is illegal for non-veterinarians to even possess such drugs. Possibly fatal side effects can occur with sedatives, particularly when used by personnel not trained in their use and dealing with their side effects.

It is also important to realise that because use of sedatives, local anaesthetics and indeed antibiotics by non-veterinarians ARE illegal acts, the insurance on any horses having such drugs administered will be fully invalidated and any injury caused to the horse by an EDT, or further veterinary treatments that may be required, or even death of the horse during such illegal acts will not be covered by the owners insurance policy. Injury to clients or bystanders during such illegal acts would also not be insured by the EDTs insurance – if any were in place. 

10). I am interested in taking the BEVA/BVDA exam. How do I obtain a place and what are the requirements for this exam?

In order to sit the BEVA/BVDA examination candidates must write formally to the BEVA office expressing their desire to sit the exam and provide the following;

a. A CV and two veterinary references

b. A case log (dental charts) of 300 dental cases. These dental charts will have to include 40 dental charts of more advanced dental procedures taking place under sedation and signed by a vet. (BEVA reserve the right to contact clients or veterinary surgeons involved in each individual case study to verify the work carried out by the candidate).

c. Have attended the BEVA/BVDA Advanced theoretical EDT course.

d. The candidate must also spend a minimum of five days, within the three months before taking the exam with a BAEDT member or a vet who performs a high amount of equine dental work. The EDT or vet will then be independently asked to sign a form confirming that the candidate is ready to sit this examination. If the BAEDT member or vet does not think the candidate is ready to sit the examination the candidate will be asked to defer sitting the exam at that time. The examiners feel that it is very important that candidates do not sit this examination until they have the correct training and experience to give them the very best chance of passing it at the first attempt. 

11). What is the format for the BEVA/BVDA exam?

The BEVA/BVDA examination consists of a written element, 2 practical examinations on specimens and skulls (“spot” examination and cadaver skull charting) and a practical (clinical) examination. It is a very rigorous examination, with a current failure rate of 75% and sitting it should not be considered until extensive training and experience are achieved.

The written examination consists of 50 multiple-choice questions where it will be clearly stated if one or more of the answers are correct. The first 25 of these questions will cover basic anatomy, physiology, microbiology, prevention of disease spread and legislation that affects EDTs in the UK. The second 25 multiple-choice questions will relate to equine dental anatomy, function, various dental disorders and their treatment. To date candidates have had no apparent problem in completing the written questions within the allowed time.

The practical “spot” examinations consists of two separate 30-minute examinations. The first will involve 20 short questions on various equine dental instruments, anatomical specimens, dental photographs, dental specimens and skulls. Short written answers (usually less than one line) are required for all. These should take about one minute to complete, but 1½ minutes is allowed before candidates are asked to move on to the next specimen/photograph/instrument. To date candidates have no problems in completing this part of the examination within the allowed time. 

The second part of the practical “spot” examination consists of examining three fresh cadaver skulls that have some dental abnormalities. The candidate will be expected to complete a dental chart for each 3 skulls, allowing 10 minutes per skull. Candidates may use the provided charts or if they wish, their own dental charts for this examination.

The EDT clinical (practical) examination will be conducted on the lines of a University Clinical Examination for Veterinary or Dental Students - as also are the multiple choice and “spot” examinations. Consequently candidates will have most of this 1 hour practical examination performed in front of examiners who will discuss during the procedure, the general handling of the horse, the case history, the candidate’s examination techniques and their findings, their interpretation of findings and their proposed rationale for treatment and their actual skill in treatment. At least one horse will be given to all candidates for this examination, but with more straightforward cases a second horse may also be used. An examiner may also request that a particular technique e.g. power tool tooth reduction be demonstrated on a cadaver skull. The range, quality and condition of candidates equipment will also be examined.

This Standard University examination technique gives the candidate a much fairer and better chance to show their skill and knowledge over a longer period, rather than the previously proposed more hit and miss examination technique, i.e having the horse examined by the examiner before and after the EDT had performed corrective procedures. It is accepted that due to time restraints (with a maximum of one hour possible for each candidate for this part of the examination) that it may not be possible for some more difficult cases to be completed by the candidate. These horses will have their dental treatment completed by another operator.

Whilst the above examination format may sound intimidating to the EDT candidate, both the BEVA/BVDA examiners are very experienced with examining veterinary undergraduates using this format. The external BAEDT examiners are also very experienced examiners who have taken part in previous similar examinations. The examinations will be conducted as calmly and as stress-free as possible for the candidates, who will be allowed every chance to display the full range of their dental knowledge and techniques.

A veterinary surgeon will be on standby for each Equine Dental Technician throughout their clinical examination and treatment of the horse. If the Equine Dental Technician feels it appropriate, the horse can be sedated and re-sedated as necessary. The examiners, bearing in mind the nature of the horse and the type and amount of the dental procedures that have to be performed, will also evaluate the decision to request re-sedation(s).

As the examination will be conducted as a University type examination, standard rules will apply, i.e. candidates should not bring to such examinations any written material pertaining to the examination and should not communicate with other candidates or allow other candidates to communicate with them during the examinations. Breaches of these rules could cause candidates to permanently disqualify themselves from this examination.

Following the examination, an examiners’ meeting will be held to discuss the marks obtained at the various written, practical and clinical part of the examinations (all examiners independently mark each candidate) allowing some compensation between the different components of the examination. However, we will always require an overall minimum standard for animal handling, oral examination and dental procedures. In order to keep up the high standards and reputation of this examination, no significant compensation will be allowed for these aspects of the examination. This examination meeting can be prolonged whilst the various examiners put forward their case for each candidate. The examination results will be posted by BEVA, first class on the following Monday. The examiners decision is absolutely final and BEVA/BVDA will not enter into any dialogue concerning the examiners decisions.

If candidates fail either the written, “spot” or clinical part of the examination they will just have to repeat the failed part of the examination, but not any part of the examination that they have passed. A full report will be given to any candidate who fails part of an examination to highlight weak areas and to suggest constructive theoretical and practical ways that these shortfalls can be rectified prior to re-sitting the examination. BEVA/BVDA will also recommend a specific interval to individual candidates before they should re-sit the examination, to allow them to gain appropriate training to have a good chance of being successful with this examination.

Failure of part or all such examinations will occur (as also occurs in veterinary and dental examinations) and at the time, this can be very upsetting to the candidate. However, candidates who initially failed and later passed this BEVA/BVDA examination have, following initial intense disappointment, later spoken and written to us about the very positive nature of this process and freely admit that the standard of their knowledge and work was not of the highest standard at the initial sitting, and that it improved enormously before sitting and passing the examination at the second attempt. On retrospect, but not at the time of the examination, they felt the examination was fair and acknowledge that they did in fact require additional skills and knowledge to achieve the high level of knowledge and competency, which we are all trying to attain.

12) What knowledge and skills are required for the exam? Are there any recommended books that I could read to learn the theory for the exam?

The required knowledge and skills for the exam are;

Basic understanding of common equine infectious diseases and their control

Understanding of legal and ethical issues currently applicable to the EDT in the UK

Ability to handle a horse in a safe, calm and humane manner

Understanding of bitting and of bit-related problems

Ability to examine the head and oral cavity, identifying all dental and soft tissue abnormalities

Ability to document the findings of the oral examination (using standard Triadan nomenclature/terminology) on an equine dental chart

EDTs may if they like bring their own dental charts which must be in standard ( 3 numeral) Triadan format (e.g. 311 is 6th left mandibular cheek tooth)

Ability to explain the relationship between dental disease and abnormal tooth wear in the individual animal

Ability to formulate a list of procedures necessary to correct any abnormalities detected, with awareness that some more serious dental disorders require veterinary attention.

Awareness of the value of ancillary aids eg. radiography, endoscopy, scintigraphy and of the limitations of a physical examination when dealing with oral problems

An understanding of age-related dental appearance and age related disorders

Knowledge of deciduous and permanent incisor and cheek teeth eruption sequence and “cap” shedding

Ability to age horses with awareness of the limitations of this procedure

Appreciation that the age of the horse and the overall status of the teeth will affect the degree of cheek teeth reduction, if reduction of the occlusal surface is required.

Candidates should also be competent in the following procedures;

Corrective procedures should remove sharp enamel points and reduce focal overgrowths (variously termed ‘hooks’, ‘ramps’, ‘beaks’, “prominent” or “tall” teeth) using hand or where appropriate power dental tools

Corrective procedures should maintain/establish correct cheek teeth occlusion (contact) and symmetry

Awareness that some major disorders of growth should not necessarily be fully corrected at a single session.

Awareness that some major disorders of growth e.g. advanced wave mouth and shear mouth cannot be fully corrected without compromising the long-term dental life of the horse.

Wolf teeth extraction when indicated

Smooth, tartar-free balanced canine teeth, reduced if very long and sharp

Balanced incisor table to aid occlusion and lateral excursion of the cheek teeth, striving to maintain occlusion (contact) of the upper and lower central incisors

Arbitrary formulae for reduction of incisors is not required, incisor contact must be retained 

Separation of the incisors must obviously occur on sideways movement of the mandible, when the normally sloped occlusal surfaces of the upper and lower cheek teeth come in contact. However it must be accepted that due to normal anatomical differences in the widths of the jaws, differences in the ratios of the widths between the upper and lower jaws and of the occlusal angles of the cheek teeth, that different ranges of lateral mandibular movement can occur prior to incisor separation.

No fixed arbitrary width of incisor separation in relation to a fixed amount of sideways mandibular movement will be required.

Rostral edges of 1st cheek teeth (‘06s’) should be rounded and balanced- as is appropriate for individual horse (e.g different requirements for broodmare compared to dressage horse). “Complete” bit seating (with possible risk of pulpar exposure) will not be required or allowed

Individual, abnormally large transverse ridges should be reduced and transverse ridges opposite a pathological diastema should also be removed - Normal transverse ridges even if tall should not be removed.

Excessive removal of lateral ridges (cingulae) of the upper cheek teeth e.g. full removal for over 1 cm from the occlusal surface is not required, especially on the caudal 4 cheek teeth

We do not expect the more experienced EDT examination candidates to demonstrate their “proficiency” by performing more aggressive reductions of the cheek and incisor teeth. In fact we would expect a more thoughtful and judicious approach from such candidates with in many cases, a less aggressive approach to dental reductions. “More is not better” - the goal of the EDT should be to ensure the optimal short and long-term dental health of horses and excessive reduction of dental tissues will compromise the latter. The requirement of this BEVA/BVDA examination will differ considerably from some of the American examination in this respect.

For the written examination all of the information required to answer these questions is covered in the prescribed reading course, ie; Veterinary Notes for Horse Owners. 1987 revised edition. Edited by Peter D. Rossdale. Elbury Press London is a recommended text in this regard. However, some chapters of this text give advanced details of eg. lameness, which is superfluous to the requirements of equine dental technicians. Pages 0-138 and 399-579 are recommended reading for equine dental technicians.

Additionally, the text: Equine Dentistry. 1999 edition. Edited by Gordon J. Baker and Jack Easley. W.B. Saunders Co. Ltd. London is also a recommended text, and chapters 12 and 13 are essential reading, Chapters 11, 14, 16 and 17 are not within the syllabus of the equine dental technician. The course notes of the BEVA Advanced Theoretical EDT course (information in small print eg lists of disinfectants, is reference only information and need not be memorised), the lecture contents and any handouts from these lectures are also course work for this examination.

The BAEDT can be contacted via the BAEDT website www.equinedentistry.org.uk.