Equine Dentistry Insight – What Kind Of Medicine Are You Believing?

Geoff Tucker, DVM EDWD Post Leave a Comment

Anecdotal versus Evidence

You know I hate to do this. First it was a law of physics (F=ma) and now it’s vocabulary. But you need to get out of the barn once in a while! OK, here goes.

ANECDOTAL and EVIDENCE are the two words to learn about.

Remember when humans thought the earth was at the center of the universe and the sun, moon, and stars revolved around us? We believed it because we could see it and therefore we could understand it. This is anecdotal observation. My dictionary describes it this way: “not necessarily true or reliable, because based on personal accounts rather than on facts or research”.

When Copernicus published that the earth revolved around the sun (only 460 years ago), it was a radical change in the way we think. However, it was because his evidence was contrary to what people believed to be true. My dictionary describes it this way: “the available body of facts or information indicating whether a belief or proposition is true or valid”.

So an anecdotal belief is based on what we observe which is always filled with bias. In other words, it often says what we want it to say or what we believe. For example; I added this stuff to the feed and ever since then, my horses run faster and jump higher. In reality, you also changed farriers, got their teeth floated, and found a new trainer! But we all know it was the new supplement, right? This is Anecdotal Based Medicine.

Evidence is when someone asks a question, for instance, can we make a horse jump higher by adding this supplement and doing nothing else? Then a group of horses are selected of a certain age, gender, and breed (assuming coat color will have no bearing on the outcome BUT stating this assumption in the details of the study). With all else kept the same, all are fed the same feed and all are fed an unidentified bag of stuff. Half the horses get a bag with the supplement and half of them get something that looks similar but does not contain the stuff. The person feeding it and the person measuring the jumping height have no idea which horse is being fed what. This is called a double blind study which is a very unbiased type of data collection. The data is taken and the results are compiled. Finally the study is published.

Now, the peers (fellow researchers) review the study. The first thing they look at is whether the study was funded by the maker of the supplement (which is usually a form of bias). Then they review it for certain standards of research and compare it to other studies done. They sometimes try to reproduce the study to be sure the facts are correct. Finally, a peer reviewed paper is published that either supports or negates the findings.

What Does Evidence Have To Do With Equine Dentistry?

Phew! Did you just see a lot of time and money spent? But that is exactly what is done in Evidenced Based Medicine.

I have so much to say about this in so many areas, but let me try to stay on track and relate this to equine dentistry. One of my chief complaints about equine dentistry today is that it is based on anecdotal medicine. Someone a long time ago made the observation that the sharp edges of the horse’s teeth were creating pain and affecting the way the horse went under bit control. They filed the teeth and problems went away. And dentistry remained this way for centuries.

In the past 10 to 15 years, both veterinarians and non-veterinarians have been coming up with new ideas including incisor reduction, equilibration, lateral excursion of the jaw, orthodontics, filling of cavities, and periodontal infection treatment. We are in the age where from the space program we have seen some amazing things come our way including zip ties and velcro™. Cars once tuned with a screw driver and a good ear are now plugged into a computer. Need I remind you of where telephones were in the last few decades.

And in medicine we now have technology that allows us to see inside the body better than ever. So the equine dentists have followed suit by creating procedures and instrumentation that are anecdotal and not evidenced based. While some of the “scientific” studies appear compelling, for me they raise many more questions than are answered.

Horses Are Not Cell Phones Or Pick Up Trucks

Whoa, hold up, Doc! Ya just left me in your dust! What the heck are you saying? Anytime you apply technology to living things, there better be plenty of either good evidence or a lot of time tested anecdotal evidence because while new technology is good for cell phones and pick up trucks, it is not always good for living things. At the core of every life form is the ability to adapt to outside forces. This has occurred since the beginning of time. In the last 4000 years we have altered horses by breeding them for beauty, strength, speed – anything but for teeth. For 100 or more years we have been successfully relieving the pain inside the horse’s mouth by filing off the sharp points. Suddenly, equine dentistry becomes advanced through untested technology. While many horsemen willingly went toward it, they are now seeing the lack of horsemanship as well as the damage caused by this technology.

If equine dentistry really wants to become “advanced”, more peer reviewed and quality scientific study needs to be done. However, this will require a tremendous effort with abundant funds coming from somewhere. I don’t see this happening.

Until then, you the horse owner need to become suspicious of everything you read and hear because almost everything in equine dentistry is anecdotal. Is hanging the head and over drugging the horse really helping your horse get the best dental procedure? Or is there a chance for harm? But be prepared for slick answers. We have been conditioned to receive smooth answers as truth by listening to commercials and news media for decades. Remember when salt and eggs were bad, and now they are OK. Finally, we decided that anything in moderation is OK because we were tired of being confused and even being lied to.

Real evidenced based science is only maybe 1000 years old, but story telling or anecdotal reporting has been around since the first fish got away. So please listen to your horse and your gut feelings when it comes to your horse. Remember, I am a Cornell Vet School graduate and if I thought there was any merit in the new ways, I would be the first to follow, but nothing has swayed me. So until then, my Equine Dentistry Without Drama™ will stay. The anecdotal evidence of time and over 40,000 floats in my career far outweigh the agenda driven pseudo-evidence of the recently emerged power dentistry. But I still have an open mind.

Thanks, Doc T

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