Why Do I Bother?

Why do I bother attending meetings if what they say I disagree with? Why be part of a group that is subsidized by feed companies (whose names are printed on the credentials lanyard) when my belief is that grain is hurting our horses? But right now I’m heading to San Antonio, Texas for this year’s American Association of Equine Practitioner’s meeting. I need the continuing education credits to remain licensed which is the only reason I bother. Otherwise it often is a colossal wast of my time. I have more horses to float and blogs to write and websites to update.

The good news is that my wife will be joining me this year and we are celebrating Thanksgiving together along the River Walk and The Alamo. Then I go back to NY for more work.

I am fascinated though that the keynote speaker is a veterinarian from Scotland who has done more research on horse’s teeth than anyone along with publishing countless articles and co-authoring several books on equine dentistry. He is also the director of surgery at the vet school in Edinburgh. His name is Paddy Dixon and I have a story to tell.

15 Years Ago

Back in 2002 or 2003 I traveled to Glasgow for the equivalent equine vet meeting (the BEVA) because they were focusing on equine dentistry. Non-veterinary equine dentists were being certified and registered by the UK allowing them to perform dentistry in horses legally. These dentists were invited to this meeting and were being treated as equals. Advancement was being made in this sector of veterinary medicine and I wanted to go find out on my own what they were doing. I was 1 of only 6 Americans attending.

The director of the program that year was a lovely lady who thought it would be a great idea if Dr Dixon and I could have a private lunch together and she arranged it. On the second day of the meeting, we each were given a small box lunch and sat alone at a small round table in a corner of a conference hall. He was excited (I think) to have an opportunity to talk with someone from the US practicing exclusively dentistry and I was excited to be sitting with such a well respected man in the field.

One of the first questions Dr Dixon asked me was about my thoughts on incisor reductions. This is the procedure where a dentist files the occlusal surface of the front nipper teeth to create an even length between the gum line and the chewing surface in all of the incisors. Some horses wear an altered angle from straight and even including a “smile,” a “frown” or a “slant.” The thought is that these “not normal” wear patterns are affecting the movement of the jaw as well as leading to an altered temporomandibular joint function and discomfort.

My immediate answer was simply that I did not believe in this reduction and furthermore I thought it was unethical in that we could possibly be altering the appearance and therefore the age of the horse. Since then I have determined that you cannot accurately judge the age of the horse by their teeth. But Dr Dixon passed over the ethics part and asked my why I didn’t perform incisor reductions. My reply in a way startled him.

My reason behind not filing the incisors is simply that their appearance is secondary to something going on with the chewing motion and the tongue movement of the horse. The altered jaw and tongue movement is almost always brought on by pain from the sharp tooth edges which prevent the normal movement. I suggested that if the sharp points on the cheek teeth were completely removed and the pain eliminated that 2 things would happen. If the horse was young enough, the incisors would wear evenly with routine removal of the sharp points. If the horse was older and the abnormal wear pattern was already established, then the horse over time would self correct. In either case, the horse would become more comfortable.

Dr Dixon replied with this. “Here in the United Kingdom, we are rapidly moving away from incisor reductions.” He further went on to describe that through the use of the electron microscope they determined that the enamel of the incisors was softer than the enamel of the cheek teeth. His conclusion agreed with my observation that the abnormal incisor wear was secondary to something happening with the movement of the mouth and not a primary problem.

Needless to say I was very happy with this as it confirmed what I had been seeing after over 15 years of experience at that point.

Another Question

Another question he had for me was about reducing over-erupted teeth on the last lower cheek teeth (also known as caudal hooks). He was against cutting them and observed that many horses were referred to his university for tooth extraction of these infected teeth after they were cut. I countered that I had been cutting hooks since 1983 without problems. But I was anesthetizing these horses to do this procedure. To Dr Dixon’s credit, at the podium when discussing the reduction of caudal hooks and his opposition to it, he publicly stated my good experience with cutting hooks. This however did lead me to a transition in my practice to adding antibiotics to every horse whose teeth I have cut and greatly reducing the number that I cut. I now reduce them by filing a little bit with each 6 month float and rarely ( 2 per year) cut them.

I am going to this AAEP meeting because I will receive my CE credits. But more importantly, I will be seeing Dr Paddy Dixon again for the first time since our lunch. He is giving a 3 hour lecture on the evolution of the horse and of equine dentistry. I wonder if he will remember me. I wonder is we will have another opportunity to talk now that another 15 years have past. I sure hope so because then it will be worth the bother.

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