Often when a horse has dental work done, he is sedated before the procedure begins, whether hand floats or power tools are used. The use of sedation is important to keep the veterinarian and the horse safe.
A thorough dental exam includes the looking at the entire oral cavity: the inner and outer surfaces of the teeth; the gums, tongue and cheeks; and the spaces between the teeth. To do this properly, a light source and a full-mouth speculum must be used, as well as tools to fix any issues and a means of flushing the mouth. A full exam and any floating needed can take up to 30 minutes or more.
Most vets choose sedation rather than a nose twitch during dental procedures as it reduces the horse's anxiety and provides some pain relief so the horse stands quietly during the procedure. This is safer for both the vet and the horse. A common drug in equine dentistry is detomidine, which makes the horse's muscles relax; it can take three to five minutes to take effect when given intravenously and can last for about 45 to 60 minutes.
A low dose of detomidine is generally given along with butorphanol, which can last between 1 and 2 hours. This drug also offers sedation, but stabilizes the horse while he stands. Both of these drugs are generally given in a low dose and repeated as needed. There are rarely abnormal reactions to these drugs.
Nose twitches are generally not used in equine dentistry because of the time needed to complete the exam and any floating. A twitch squeezes the upper lip of the horse; when applied by an experienced handler, a twitch can provide distraction from pain for three to five minutes, says Dr. Sue McDonnell of the University of Pennsylvania.
After that, the horse's experiences a pain-relieving sedative effect for about 5 to 10 minutes. At 12 to 15 minutes after twitch application, the endorphins are no longer elevated and the horse receives no relief from pain. If the twitch was removed and the vet and handler waited, the twitch could be reapplied. In addition to the time needed to apply and reapply the twitch, the twitch also hinders the vet's access to the horse's mouth.
Also, with two people standing so closely to the horse, the vet may not have all of the room needed to work thoroughly. Should anything go wrong, both the vet and the handler of the twitch are in harm's way. For safety and efficiency, many vets choose to use IV sedation instead of a nose twitch when preforming dental work.
Read more at EQUUS.
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