Wednesday, December 1, 2010

Windy, With Snow Flurries and the Dentist

It's pretty cold today - due to the strong winds the wind chill this morning was about 10F - not quite full face mask weather but getting close.  It is a full long underwear day, though.  We've got snow flurries blowing around, but no accumulation expected.

Today Pie had a visit from our equine dentist, Mike Fragale.  Mike is a hard person to get an appointment with - he travels all over the country.  He normally does our horses in the late spring, but since Pie is 4 and has never had his teeth done, I wanted him seen before we do any softening work using a bit.

Mike practices natural balance dentistry, which is a particular way of thinking about equine dentistry.  He does some things that are usually done by equine dentists, he doesn't do some things they usually do, and he does a number of things they don't usually do.  He never uses power tools, and works in a way that is most comfortable for the horse (rather than the person doing the dental work) and that also allows him to best assess the functioning of the jaw.  This means he doesn't put the horse's head in a sling, but rather allows the horse's head to be unconstrained and to hang down if necessary, which requires Mike to kneel at times to work on the horse's mouth - he does wear knee pads.  He does use sedation, although as little as possible.  As I understand it, most equine dentists (and vets that do dental work) focus primarily on evening out the horse's molars, removing points, hooks and waves, often using power floating tools.  They also often install what are called "bit seats", rounding off the front premolars, supposedly to improve the functioning of the bit.

Mike's approach is somewhat different.  He focuses on the alignment of the incisors, the lateral excursion of the jaw from side to side - this creates the shearing action that allows the horse to chew forage - and the correct functioning of the temporomandibular (TMJ) joints that attach the jaw to the skull.  He does remove any points, hooks or rims that interfere with side-to-side motion or which are irritating the tongue or cheeks, but his objective is not to create a smooth mouth - a horse with a smooth mouth, where all roughness on the surface of the teeth has been removed, will have difficulty chewing.  A smooth mouth is particularly problematic in the case of a senior horse, where the teeth may no longer be erupting.  My Noble had this problem due to the dentist we were using prior to Mike - his teeth were overfloated using power tools, leaving him with much less effective chewing surfaces.  Mike prefers not to use power tools because it's too easy to take off too much tooth or overfloat, and because power tools can overheat the teeth to the point of damaging their structure.  (I have a suspicion that the reason so many dentists and vets use power floats is that it's easier for them and allows them to do more horses more quickly.)  He also doesn't do "bit seats" - he says the bit should never contact the horse's teeth in any event if the horse is properly bitted - because the alignment of the premolars has important implications for the alignment of the entire dental arcade.

The overall objective is a jaw where lateral movement from side to side is equal and unimpeded and where the angle and alignment of the incisors, and the angle and alignment of the pre-molars and molars, permit the TMJs to function normally, without being stressed, allowing the jaws to function properly.  Our equine chiropractor will often not work on a horse until the dental and TMJ issues have been addressed - they affect the whole horse and how it uses its body, and no amount of chiropractic work will properly address the issues in the horse's body that are created by poor dental alignment or one or more TMJs that can't work properly.  I saw how important lateral movement of the jaw is with Maisie - when Mike started to work on her a number of years ago, she had almost no lateral movement to one side, which affected her ability to chew as well as soften to the bit, and affected her entire body.  As that was gradually fixed, and we did chiropractic, her ability to soften and her ability to move improved.  Here's two pictures of Mike working on Maisie and Dawn last June:



Here's a close-up of him working last year on Dawn - he's working on her incisors and has his left hand fully inside and across her mouth:


One thing I also really like about Mike is that, before the horse is sedated, he carefully assesses the horse's mouth and only does work if it is needed - and he doesn't charge if he doesn't do any work.  We've had him out before to look at a number of horses, and sometimes he only ends up doing work on a few.  If a horse needs major changes, he will usually do them gradually over a number of annual or twice a year visits.  He also takes into account the shape and structure of each horse's head - many horses have asymmetries that have to be taken into account in working on the teeth.

(I do believe that a usual equine dentist, or a vet doing equine dentistry, can help many horses, so long as they proceed with care and aren't in a hurry.  But I do think it's important for horse owners to learn as much as they can about equine dental matters to properly select and supervise the equine dentist.  I feel the same way about farriers/hoofcare providers, and about vets and chiropractors - we horse owners can't be experts in all these fields but we should learn as much as we can and pay attention to what is being done with our horses - in the end we're the ones who are responsible to be sure our horses get good care.)

Although Pie had never met a dentist before, he was a model patient, both for the sedation shot - he didn't move a muscle - and for the dental work.  Mike, who has a number of fine quarter horses himself, said that Pie was quite a well-put-together horse.  He did say that he might grow an inch or two more taller (I hope not) and would likely fill out a bit more.  Pie took only slight sedation. Mike said that Pie had all of his adult teeth (at 4 years and 7 months old - some warmbloods take longer), but that some of his molars were only partially emerged.  He did have some unevenness in his dental arcade due to some teeth being more fully emerged than others.  Mike didn't do that much to his teeth since they will change so much in the next six months - this is about the most active period of dental eruption.  Mike took a bit off some rims protruding above the place of the dental arcade on several molar teeth, and did some slight evening up of the incisors.  He said he wanted to be conservative at this point since Pie's mouth had some growing up to do.  Pie's mouth was bascially in very good shape, as were his TMJs.

Due to the low light in the barn and not using a flash to disturb the work, I failed to get any good pictures.  This is the only one that isn't too blurry - this is Mike assessing the incisors as he was working:


The interesting thing was that the longer Mike worked, the more cooperative and participatory Pie was.  Even as the sedation was wearing off, Pie stood well and really began to relax - he figured out that Mike wasn't going to hurt him and did his best to help Mike out.  Mike commented on what a fine smart young horse he was.  Good Pie!

24 comments:

  1. What a fascinating and insightful technique. All of our horses are natural balance trimmed when it comes to their feet, and I don't see why dentistry should be any different. I'll have to look into this. Are there sites where one can find dentists with credentials like Mike's? It makes sense that a smooth mouth would make chewing (especially of rough foods like alfalfa hay) difficult and inconvenient. I'd love to learn more. Ozzy doesn't need to be sedated for floating and will gladly stand still for the dentist without a speculum... I think he'd mesh very well with this type of dentistry.

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  2. Thanks Kate for a thorough post. I have to re-read this one a couple of times to get it. I hope I can get Mike to our boys (if he even comes to Pennsylvania) after my trip. Sovereign has a weird alignment, I am afraid, which may be the source of some of his idiosyncratic behaviours.

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  3. Dom - I'm not sure - search for equine natural balance dentistry. There's also a good video by a guy called Spencer LaFlure that is from the same school of thought.

    And I should have mentioned in the post that Mike is now starting to teach at one major vet school - the new way of thinking about equine dentistry is starting to get some notice.

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  4. Aw, good boy, Pie! He sounds like a terrific dentist! I wish we had someone like that around here. The closest I get is getting their wolf teeth pulled at gelding or hauling them in to the vet for a full float.

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  5. "He also doesn't do "bit seats" - he says the bit should never contact the horse's teeth in any event if the horse is properly bitted - because the alignment of the premolars has important implications for the alignment of the entire dental arcade." AMEN!! I had a pretty serious argument the other day with a lady insisting her horse needed a bit seat and argued that I don't know anything about bits because I ride bitless. Well excuse me lady but keep your friends close and your enemies closer, my major point of interest in university was bitting because it helped me understand bitless better.

    I've never had to sedate my horses for floating. our vet uses a device I hold with one hand so we can move forward/backward and make the jaw more open/shut and he uses the hand float on the opposite side. No power tools for us. He never files the teeth flat but takes off hooks and points. I guess playing with my horses mouthes pays off. I can do anything to them and they stand like model citizens for floating, even putting their heads down. I demonstrated this today as I gave Indigo her icky cough medicine with a syringe. She didn't even loll her tongue when I stuck the big 60cc syringe in the corner of her mouth.

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  6. Does he have a website? I'd love to have him look at Dixie if he ever comes out this way.

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  7. Funder - I don't think so but you could search on the web.

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  8. I agree. A good post. Our vet does the dental work on our horses and he uses only hand tools and has talked a lot about similar things that he's looking for.

    Thanks for sharing.

    Dan

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  9. Yep, Mike is a great guy. I'm so glad you and others at the barn are using him now. I'm so glad he was willing to follow me to our little barn years ago!
    For the other commenters, Mike Fragale travels the country/internationally with a vet, farrier and chiropracter holding clinics and fixing horses as a whole being. The whole horse is connected. The more folks realise this, the better for the horse! He is a member of International Association of Equine Dentistry and the American Association of Equine Dental Equilabration.
    Nice post Kate.

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  10. Only licensed veterinarians are allowed to float teeth here in NC, which stinks to high heaven. My vet uses sedation, a sling, and power tools. I had a really good dentist in Michigan, but it's slim pickings here because of the law.

    It would be nice if newer methods were taught in vet schools, or if veterinarians received more training on dentistry.

    I'm glad everything went so well for you, even if it was c-c-cold! :)

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  11. Wow, very interesting post and great pictures. A dentist to horses... I don't know how I'd feel about cleaning those extra teeth

    - Dr. Robert Nelson DDS

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  12. Robert - cleaning isn't usually much of an issue with horses - their diet is fairly coarse and they usually don't get much if any tartar. The issues arise more from the fact that their teeth are continuously erupting (until old age) and wear from the top down - they have folded enamel/dentin ridges that wear down as they eat.

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  13. I wish there was an equine dentist up here in Alaska! We have vets who are capable of dentistry, but none of that caliber. It'd be nice...

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  14. My vet does my Boys' teeth and never uses power tools. Sedation, yes, but only enough to take the edge off. He usually checks the side to side motion as well.

    We do have some good dentists in the area as well, but I'm not sure if they follow Mike's theories.

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  15. I appreciated that info, as usual, thanks.

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  16. Great info-thanks for posting it for us. Good news that Pie didn't need much work done for now. It must be nice to know that you are starting off with a horse in good condition...

    I'm going to have to re-read the post and try to absorb all of that information. I like to have some knowledge when I speak to my vet so I can at least ask decent questions!

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  17. Wow, that's really awesome! I've heard of Mike from our friends, and they use him for their horses. What a small world! I hope that we can get him out here sometime. All of our horses have been floated by an Amish-trained gal from Pennsylvania and it would be nice to have Mike out to check out our horses' teeth.

    Say, Kate, where are you located in Northern Illinois? We live in Belvidere, and are planning on going up to Mark Rashid's clinic in Cedarburg, WI next May. Maybe we can meet you there!

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  18. Lea and Eddie - I'm actually riding in that clinic - I've got two rider slots - don't know yet in which of the two clinics. I'm definitely taking Pie and probably Dawn.

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  19. awesome post Kate ....glad to hear that pie has had his teeth all done and I will be really interested to hear how he goes now. Your horse dentisit sounds really nice ...how lucky you are

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  20. You just reminded me that I need to make an appointment with my horse dentist...

    The thought of power tools in my horses' mouths really freaks me out. I'm really glad that mine uses good, old fashioned muscle power.

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  21. Kate, What an interesting post about the dental work. It is amazing how important the working of the horse's mouth is. Buckshot is due for his annual dental work this month. We have a great vet who does wonderful dental work as well. Last year Buckshot had to have two teeth removed. That was an interesting thing, and I have his pulled teeth in my barn tote bag. They are fascinating to see. I'm glad Pie has a good dental foundation, and that he did so well with a strange dentist, perhaps his first dentist ever.

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  22. Good post Kate; and you ended it with my 2 favorite words! I wish my equine dentist didn't use power tools; he originally didn't but started using them about 5 years ago. I'd like to find a Canadian counterpart to your Mike.

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  23. Very interesting and informative post! I've saved it for future reference when I start looking for my equine dentist. Thanks!

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