The British Equine Veterinary Association (BEVA) has clarified regulations on equine dental procedures following a survey which showed confusion, even amongst vets, over who is allowed to do what in a horse's mouth.

In the survey of BEVA members, more than half were unaware of the dentistry techniques that equine dental technicians (EDTs) are permitted to perform and the levels of veterinary supervision required.

In response, the association has put together a new information leaflet which explains the regulations surrounding equine dental care and describes where recommended practice differs from the letter of the law.

All diagnostic and treatment procedures in the horse's mouth are Acts of Veterinary Surgery under the Veterinary Surgeons Act 1966. The only exception is the manual removal of small dental overgrowths and sharp enamel points with hand instruments.

However it is acknowledged that there are a limited number of procedures that, despite being considered Acts of Veterinary Surgery, may be delegated safely to suitably qualified EDTs without compromising the horse's welfare and safety. In 2009 the RCVS, with assistance from BEVA, BVDA and BAEDT, listed these processes and categorised all dental procedures into three groups:

• Category 1 - Procedures that are not Acts of Veterinary Surgery, and which can be performed after recognised training but without qualification
  
  • Examination of teeth
  • Removal of sharp enamel points using manual rasps only
  • Removal of small dental overgrowths (maximum 4mm reductions) using manual rasps only
  • Rostral profiling of the first cheek teeth (maximum 4mm reductions), previously termed 'bit seat shaping'
  • Removal of loose deciduous caps
  • Removal of supragingival calculus.
• Category 2 - Procedures that are Acts of Veterinary Surgery but can be safely delegated to suitably qualified EDTs
  
  • Examination, evaluation and recording of dental abnormalities
  • The removal of loose teeth or dental fragments with negligible periodontal attachments
  • The removal of erupted, non-displaced wolf teeth in the upper or lower jaw under direct and continuous veterinary supervision
  • Palliative rasping of fractured and adjacent teeth
  • The use of motorised dental instruments where these are used to reduce overgrowths and remove sharp enamel points only. Horses should be sedated unless it is deemed safe to undertake any proposed procedure without sedation, with full informed consent of the owner.
• Category 3 - Procedures that are Acts of Veterinary Surgery and cannot be safely delegated.
  All other procedures and any new procedures, which arise as a result of scientific and technical development, would by default fall into category 3, which are those procedures restricted to qualified veterinary surgeons and are not proposed for deregulation. It is therefore NOT legal for these to be performed by non-veterinarians. 

Despite there being no legal basis supporting non-vets performing Category 2 procedures, the RCVS has stated that there would be no public interest in prosecuting vets who collaborate with suitably qualified EDTs to perform non-invasive (Categories 1 and 2) procedures.

BEVA recommends that, for their own protection, all vets who deal with horses:

• Are familiar with Category 1 and Category 2 procedures (see below and http://www.beva.org.uk/_uploads/documents/current-regulations-on-equine-dental-procedures.pdf)
• Ensure they know whether or not any EDT that they are collaborating with is qualified to perform Category 2 procedures (i.e. has a "Defra approved" qualification - BEVA/BVDA or WWAED).
• Report to the VMD instances of non-vets supplying oral sedatives or other prescription only drugs.

Vicki Nicholls, equine vet at Wright and Morten in Cheshire, chair of BEVA council's Paraprofessional Committee and member of the British Association of Equine Dental Technicians (BAEDT) said: "The lack of awareness is alarming and clearly emphasises the need to make vets and equine dental technicians fully conscious of current regulations regarding equine dentistry. Non-adherence to the regulations is a serious matter and could lead to prosecution of the veterinary surgeon, EDT and/or owner."

The number of vets taking the BEVA/BVDA exam in equine dentistry has increased in recent years with about 15% of those who have passed the exam being vets. BEVA says this is indicative of the growing awareness, amongst owners and vets, of the importance of dental health. It also reflects a desire to develop and demonstrate both practical skills and a theoretical understanding of equine dental care to augment the vet's broader medical knowledge. Expertise in equine dental care has, for many veterinary practices, become a valuable asset.

Copies of the dental regulations information leaflet can be downloaded from the BEVA website at www.beva.org.uk. BEVA also runs regular dentistry CPD courses, details of which can be found on the website.

Image source: Rachel C from Scotland

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