You can’t exactly promise your horse a fun sticker or a toy at the end of a dental visit to get him to behave. No, if you want a dental exam to be not only safe (for both horse and practitioner) but also worthwhile, sedation is a necessity.
“You need to get equipment back in the mouth if you’re going to do a complete dental exam and see all the structures, and you just can’t do that without sedating the horse,” said Jeff Reiswig, DVM, Dipl. AVDC (Equine), who founded Equine Veterinary Dental Services in Newark, Ohio.
Equipment includes a mirror and sometimes an endoscope, as well as a mouth speculum that holds the horse’s jaws apart, he said. “You need a quiet horse so you can see the detail. Without sedation they may throw their head, which makes it dangerous for the horse and veterinarian.”
Sedative Safety and Administration
Your veterinarian will select the best drug and administration route for your horse, said Reiswig. Those drugs include alpha-2 agonists such as detomidine, xylazine, and romifidine.
“These drugs are incredibly safe,” he added.
That safety depends on qualified administration, however, which is why sedation necessary for dental exams and care can only be carried out by a veterinarian or a licensed veterinary technician under a veterinarian’s direct supervision—meaning the vet must be present. “Nonveterinarian dentists lack the authorization to provide the necessary tranquilizers, and they have variable amounts of education about a horse’s oral anatomy and physiology,” he explained.
Amount and Length of Sedation
The amount of sedative depends on the horse’s size but also his temperament, said Reiswig. “If they’re more easily excited then they might need a stronger dose to keep them calm,” he said. The objective isn’t to “knock the horse out,” but rather to keep him quiet and anxiety-free for the approximate half-hour the veterinarian is carrying out dental care.
“The horses will stay awake and alert but relaxed,” said Reiswig. “But the nature of sedation is that if the stimulus is high enough, they can arouse out of that relaxed state. So we need to take into consideration the horse’s basic temperament as well as the kinds of procedures we’re carrying out (which could cause more or less noise or discomfort).”
Even though each sedative has a labeled dosage, each horse will have an individual response to the drug. Still, there’s little risk even if the horse becomes excessively sedate and ataxic (wobbly), he added.
Some sedatives last 20-30 minutes when administered intravenously; others a bit longer. If they’re given into the muscle—which is necessary when the equid is “too wild” to hold still for a safe needle prick into the jugular vein—they’ll require higher quantities that will have a longer-lasting effect.
Examining a horse’s mouth without sedating him is “essentially pointless,” said Reiswig, because such an exam would be too limited to give reliable information about the horse’s dental health.
“Sometimes clients ask, ‘How much would you charge to just take a look without sedating him to see if he needs anything?’” he said. “I always tell them it’s free of charge—because that’s about how much that kind of exam is worth. It might let me point out something obvious that needs treatment, but it would never let me determine that he doesn’t need treatment.”