TVMA to back legislation to better define equine dentistry

Austin, Texas — The debate over who can perform equine teeth-floating procedures surfaced again in Texas.

In fact, Peter Rakestraw, DVM, a soft-tissue surgeon at Texas A&M University and board member of the Texas Veterinary Medical Association (TVMA), wants legislation to limit the practice of equine dentistry to qualified veterinarians or those under direct supervision of a veterinarian.

"As a teacher who looks at end-stage problems in a horse's mouth, dentistry is more than filing sharp points on teeth. How you manage the teeth, gums and associated structures has a profound effect on the health of the horse, its performance and well-being," he says.

Background

At its core, the debate focuses on the definition of equine dentistry. According to Elizabeth Choate, JD, TVMA director of government relations/general counsel, the current legal definition of veterinary medicine in the Texas Veterinary Practice Act includes dentistry.

"However, because the act lacks a specific definition of dentistry, our state is now plagued with unsupervised, unregulated, non-veterinarians who misrepresent themselves as skilled equine dentists," Choate contends.

In 2007, the Texas Board of Veterinary Medical Examiners (TSBVME) sent out cease-and-desist orders against many non-veterinarians who were practicing and promoting the practice of equine dentistry without a license. Answering the cease-and-desist measure, four non-veterinarians and two horse owners sued the state board, contending that it supported a "monopolistic licensing scheme" with aim to run lay equine dentists out of business. They wanted a permanent injunction barring prosecution. The lawsuit suit remains in the preliminary motions stage.

Protecting animal welfare

Texas veterinarians, for at least the last 100 years, have been committed to safeguarding the health and welfare of the 1 million horses in the state, counters Steve Golla, DVM, of Chisholm Trail Veterinary Clinic.

"With that comes a responsibility from veterinarians to guard the welfare of the horse in the state. This becomes an animal-welfare issue—determining who is truly best qualified to evaluate overall well-being of the horse," Golla says.

"The nonveterinarians who call themselves equine dentists are looking at the tooth of the animal and they're not looking at how the health of the tooth relates to the entire horse. By just addressing one issue and not encompassing the entire picture, that puts the horse in jeopardy," he adds.

However, according to Golla, not all equine teeth floaters are unsupervised and unregulated. Some in fact do practice under veterinarians, which is considered acceptable.

But critics contend there is a greater danger in having non-veterinarians practice dental medicine—their possession and use of prescription drugs in performing procedures.

"They are not licensed to use controlled substances, and we are not sure how and where they're getting them," Golla says. "They are sedating the animals — and the biggest law-breaking fraction is that they are not licensed to purchase these drugs, nor do they have any background in pharmacology or physiology to understand how the drugs work in the animals," he contends.

"Yet we hear horror stories of animals being sedated and flopping around on the ground. If I do that to a horse I am held liable for malpractice. But with non-veterinarians, there is no protection of the public if something happens," he says.

The root of the debate

Dr. Rakestraw, part of the TVMA taskforce to address dentistry, has been part of the TVMA's equine practice committee for years.

Two years ago, legislation was introduced in the agriculture/livestock committee by Rep. Sid Miller. The legislation supported unsupervised unregulated non-veterinarians trying to make dentistry a husbandry act, which is the same as dehorning cattle. The goal was to try to throw dentistry out of the practice act.

"It's been a heated issue for a while. But it took a while for the state board to act. In 2007, the board finally sent out cease-and-desist letters. And with those came pushback," Rakestraw says.

During the next legislative session TVMA will back legislation urging the licensure of "equine dental technicians." The legislation would ensure a minimum amount of education for equine dental technicians, so they can practice legally while shielding the public and their horses from those who lack such training.

"Without regulatory oversight and recourse, consumers lack protection from unscrupulous, negligent or unskilled non-veterinarians. If a veterinarian makes a mistake, they must answer to the TBVME and defend their license. But unsupervised, unregulated, non-veterinarians lack minimum enforceable standards and, therefore, are not held to the same level of professionalism or accountability," Choate explains.

How lay teeth floaters fit into the oral care of horses is the question, according to Ben Buchanan, a recent vice chair of the TVMA equine practice committee, who was asked to participate on a TVMA-sponsored Task Force. "What is not a question is that only veterinarians should be sedating horses, prescribing medication and diagnosing diseases," he says.

Buchanan sees the issue being resolved in Texas through the legislative process either through compromise or a modification of the practice act. In the courts, a judge who does not really understand horse welfare will decide the issue based on what is written in the law, how it should be enforced and how the supervising board is organized, he adds.

"We hope that legislation will adequately define dentistry, provide for regulation and oversight of non-veterinary professionals to legally work with veterinarians and provide for enforcement of the existing laws," Buchanan says.

Common sense will prevail, according to Golla, who believes it is vital that the public is educated on "the real issues" – animal welfare, protection of the public, controlled substance use and protection of laws in place that define the practice of veterinary medicine.