June 20, 2011 | | Comments 0

Paul Drake: Equine Dental Technologist

“Equine dental technologist” is a rather long term for what Paul Drake does. In essence, he’s a “horse dentist.” Since Paul does not have a doctorate or PhD, he prefers the longer specification because he doesn’t want to mislead anyone. Simply put, Paul specializes in the care and maintenance of the teeth of horses and ponies.

How did he get into this business? Paul had been involved with horses for a number of years, primarily in the racing industry. He very much enjoyed working with and being around the horses, but he worked long hours, six days a week, for low pay and with no benefits. Much of his time was spent mucking stalls, which he didn’t find particularly appealing. He wasn’t afraid of hard work, but he liked the “hands 0n” aspect of the job much better – the direct contact and interaction with the animals, like grooming and caring for them. In the back of his mind, Paul always believed there was a better equine-related career out there somewhere.

Equine Dentist
In most of the racing facilities where Paul worked, a “horse dentist” made regular rounds to provide dental maintenance for the equines. Paul was fascinated by these caregivers, realizing that the work they did was highly specialized – even most experienced horsemen actually knew little about their horses’ dental health. The seed was planted in Paul’s mind to learn this type of work.

After mucking more stalls, Mr. Drake finally reached a point of frustration with his low level in the horse business. It was then and there that he made the commitment to become an equine dental technologist. He enrolled in a nearby school, the American School of Equine Dentistry, for the required five-week course. Since the school provided board, Paul lived at the school for the duration of the course. The first week was spent attending classes, and the remainder was spent performing “hands on” duties under the instruction and supervision of a veterinarian. He then spent another year in an apprentice program. Paul has been performing as an equine dental technician on his own since 2005.

Paul states that many people are surprised by the brevity of his training when compared to the years a human dentist must invest in school, but he explains that there are few similarities between a horse’s teeth and a human’s: “As horses’ teeth are always lengthening through ‘eruption,’ the majority of corrective work consists simply of filing teeth to remove sharp edges that are uncomfortable, and of reducing the length of long teeth that could be impeding normal chewing patterns.”

Paul explains that no undergraduate degree is required to become an equine dental technologist, although he does have a degree in English. An applicant does, however, have to document sufficient experience around horses and have references from three equine veterinarians. Since Paul had so much experience under his belt, this was not a problem.

In most states, an equine dental technician cannot administer sedatives to their “patients.” Paul strongly supports this, stating, “While the administration of such drugs is easily learned, an allergic reaction or similar occurrence could readily be treated by a veterinarian. A non-veterinarian would not have the resources or the knowledge to administer treatment. If a horse needs to be sedated to successfully work on its teeth, the owner’s veterinarian would have to be present to perform sedation. However, most dental maintenance can be successfully performed without the need for sedation if approached in a gentle and intelligent manner.”

Mr. Drake explained that most of the problems horses have with their teeth are inadvertently caused by domestication: “Horses teeth are not always growing, which is a common misunderstanding. Once a horse is physically an adult – about five years of age – they actually have all the teeth they will ever have, but the bulk of the tooth – a molar is about four inches long – is in the skull or in the jaw. As the tooth wears, it pushes down from the skull into the mouth, or up from the jaw into the mouth, in a process called ‘eruption.’ So, if a horse gets old enough, it will run out of teeth.”

“Horses chew in an elliptical motion, and in doing so, ‘hone’ very sharp edges on the outside of their top teeth, and on the inside edge of their bottom teeth. These sharp edges can cut the horse’s tongue and their cheeks. ‘Floating,’ which just means filing, is the occasional removal of these sharp edges so that the horse can perform under saddle and eat without being uncomfortable.”

When asked to describe the floated process, Paul replied, “Floating is defined differently by different people, but generally refers to the removal of the sharp edges that develop along the buccal aspect (cheek side) of the top teeth, and the lingual side (tongue side) of the bottom teeth. “Floating” is synonymous with filing. “Floating” might also refer to the shortening of teeth that have grown too long. It is the most basic form of maintenance performed to a horse’s teeth, and should be done on a regular schedule. It will assure maximum comfort for the horse, and ensure that they are maximizing their use of feed (if their teeth are working well, they will not drop feed, and the feed they swallow will be chewed up well and be highly digestible– they will not be pooping-out undigested grain).”

Why does Drake cite domestication as a major problem? He explains that horses in the wild don’t develop these sharp edges on their teeth as quickly or to the extent that domesticated equines do. Wild and feral horses have to work harder to chew their food because it’s generally of poorer quality. All this extra chewing increases the lateral movement of the jaw and thereby retards the formation of sharp edges on the teeth. Domestic horses, on the other hand, are fed easy-to-chew grains and processed hays, for the most part, so they can quickly develop sharp points on their teeth.

Paul adds, “This is not to say that wild horses would not benefit from dental maintenance; they would, and in fact, studies of deceased wild horses have shown that many dies prematurely and indirectly due to poor mastication resultant from problem teeth.”

Paul works with all kinds of horses: racehorses, pleasure horses, and work horses, including those utilized by the Amish. His equine clients span the spectrum of disciplines, also, and range from barrel mounts to dressage horses.

When asked which breed Paul preferred working with, his answer was not surprising. Based on his past work experiences, he cited the Thoroughbred. Although some members of this breed can be high strung and difficult to manage at times, Paul feels that he can “read” them better, allowing him better control.

Paul has also discovered that Thoroughbreds, in general, are most prone to dental problems because of their physiology. They often have malocclusions that make their teeth grow too long due to their long, narrow heads. Paul goes on to state, “I do not think, other than Thoroughbreds, that I have seen a greater propensity of some breeds to have greater dental problems.”

Paul added that the Rocky Mountain Horse and Haflingers are also usually pleasant to deal with, and that most draft breeds he’s worked with are calm and easy to handle.

Paul was also asked about his least favorite breed to work with, and he answered, “Without question, my least favorite horse to do is Quarter Horses; I find them to be very stubborn, and if they refuse the procedures, well, they really refuse! They can be quite obstinate!”

Paul explained that he usually works alone. “I generally prefer to be alone with the horse, in a stall, when I am working with it. In this way, if the horse insists on moving around, I can just move with him/her. Sometimes, however, the horse’s groom or owner can have a calming presence and is helpful if the horse is fearful or difficult.”

“Horses are very intelligent, and if I approach it sensibly and gradually, most horses understand what I am doing. The immediate relief from pain they experience makes the majority of horses cooperative and willing recipients of dental care. A small percentage of horses, though, will not be cooperative no matter how I approach it, and they would be candidates for restraint: a twitch, a martingale, etc. Some particularly fractious horses– even for just a minor float– will require sedation, which must be provided by a veterinarian (or by the owner provided the veterinarian has given them sedatives to use on that particular horse). I, personally, insist upon sedation – and a “nerve block” where applicable– for all tooth extractions.”

When asked about common problems he sees frequently in his work, Paul answered, “Many horses have a propensity for ‘hooks.’ Hooks develop when a tooth does not ‘occlude,’ or meet well with its opposing tooth. If a top tooth does not meet well with its opposing bottom tooth, it may not wear normally. As it is always getting longer through eruption, the unworn portion will become protuberant and may interfere with chewing or it may chafe with sensitive gum tissue. Regular dental maintenance will keep such protuberant areas shortened and will ensure that the horse does not have any sharp spots that make him uncomfortable.”

Paul was also asked about tooth damage from cribbing: “Cribbing can be devastating to the incisors – the front teeth. I’ve seen horses that have worn their front teeth to ‘nubbins,’ completely worn them away. Without incisors, such horses will have great difficulty grazing, and will, for optimum health, need to be supplemented with hay. Chronic cribbers can also erode their teeth to where the ‘pulp cavity’ is exposed, thereby making the tooth prone to infection.”

According to Paul, horses can get cavities on rare occasions, but these are usually repaired by themselves. The compromised area is typically repaired by secondary dentin that flows to the tooth through microscopic tubes. There have been some experiments with “filling” such teeth with artificial materials that were not repaired naturally, but it has not been met with much success. Again, such cavities are rare, but if they are not naturally repaired and the tooth becomes compromised, then extraction would likely be considered.

Do horses ever get fitted with braces? “Horses do not get braces, in general. However, if a foal is born with a particularly unusual congenital defect – an extreme ‘parrot mouth,’ or ‘wry nose’ – special ‘bite plate’ can be fitted that will guide the teeth to grow in a more healthy pattern.”

Paul was also asked about any unusual or especially demanding cases he’s handled: “I have had mostly very positive experiences in my job as an equine dental technician. One job stands out: Jenkin J was a beautifully bred Thoroughbred racehorse. He was expected to perform really well, but after a half-dozen races he disappointed all by performing very poorly. The farm was about to give up on him. I went to the owner’s farm to perform some maintenance on some broodmares, and was asked to look at ‘J.J.’ he had very sharp aspects of his mouth, which had lacerated his cheeks. He had a very swollen place in his jaw where his canine tooth had failed to erupt, so that there was a very sore spot in his mouth. He had hooks in the back of his mouth growing up from his jaw and into his skull. He was in immense pain but couldn’t tell anyone! I fixed him up. He clearly understood what I was doing and was very grateful. He started out being very difficult and fractious, but as soon as he figured out what I was doing, he became very cooperative. Anyway, he went out two weeks later and won his first race by many, many lengths. He went on from there to have an incredible career. So, it was nothing more than the discomfort from his teeth that was impeding his career.”

Paul also related another interesting case. He went to perform maintenance on a Quarter Horse that was extremely difficult. The horse was actually violent and aggressive. Since Paul isn’t a veterinarian, he couldn’t sedate the animal. Paul indicated to the horse’s owner that a veterinarian would be needed to administer a sedative before he could work on the horse. At that, the owner became very defensive, saying, “Xena wouldn’t hurt a fly! You are incompetent! If you knew what you were doing you could get her done! You obviously don’t know what you’re doing!”

After more yelling and screaming, Paul quietly gathered his tools and returned to his car. After his encounter, the owner had several other dental technicians out to work on the unruly horse, and they all had the same experience Paul had – none of them could do anything with the animal. Several months later, Paul was asked to return. This time, a veterinarian was present to administer sedation, and the owner had had a change in attitude.

When asked what he likes best about being an equine dental technician, he explained, ”Certainly what I like best about this job is the immense improvement dental maintenance makes in a horse’s comfort, performance, and health, and the improvement is often immediate. Every week I see horses that are in incredible pain and suffering silently, are horribly underweight, and that perform terribly, and my efforts quickly restore them back to health and vigor. It is an immensely rewarding profession! I also enjoy that every day is different, and you get to meet many different people and see many interesting things. One day I will be at a beautiful, elite racehorse farm, and the next day I will travel into a deep rural area to do one or two working draft horses that are having difficulty maintaining weight. Occasionally I will be called to a place where the owner really doesn’t want me there; they are being investigated by an animal cruelty organization and were told they had to get their horse’s teeth maintained. Some…most owners are lovely, friendly people; some are grumpy and nasty. Some owners regard their horses as members of the family; others regard their horses as lawn ornaments, or as tools used to accomplish work. Every day is different.”

Paul was also asked about the negative aspects of being an equine dental technologist. His reply: “I love my job except for one thing: Many veterinarians do not like us and are not willing to provide any assistance. Dental maintenance has been provided to horses by non-veterinarians for hundreds of years, but recently there has been a resurgence in dental care, and many veterinarians feel that they should be the ones to provide it. Such veterinarians have pushed for and succeeded in making dental care provided by non-vets illegal in many states. I really do not know how long I will have a job, and this makes me very unhappy.”

The irony here is that many equine dental technicians have more education in this specific aspect of horse care, along with more hands-on experience, than do many licensed veterinarians. “But veterinarians have the higher educational credentials and therefore seemingly more credibility to bring the debate as to whom should provide this aspect of care. This debate – which is a very hot topic right now – causes me much anxiety and many lost night of sleep,” Paul states.

Paul Drake is located in Maryland but travels outside the state to see clients, including trips to Delaware and Pennsylvania. Appointments need to be scheduled in advance so that Paul can have his tools clean and ready to go. All his tools are cleaned thoroughly between farms. According to him, cleanliness and sterility are an important aspect of avoiding the spread of diseases.

How often should owners have their horses’ oral health checked? “This is debatable, but is generally believed: young horses, under the age of 5, should have their teeth checked every 6 months. Their teeth are disproportionately high in dentin– and consequently relatively soft– and get sharp rather quickly. Also, young horses will shed 24 baby (deciduous) teeth before the age of 5 years, and, if they fail to “shed” properly, can be problematic. Horses after the age of 5 years can generally be checked once a year. Elderly horses– those horses whose teeth are starting to wear out– might, prudently, be checked every 6 months.”

How important is early detection of a problem? “Early detection is very important. If the horse is prone to any specific problems– such as developing protuberances–it can be put on a schedule of floating (filing) to keep the protuberances short. If the horse has been neglected, such protuberances can get very long and be very difficult to remove, necessitating sedation and a difficult and uncomfortable procedure for the animal. If the horse is young and has a “retained cap” (baby tooth) the problem can be remedied a.s.a.p. and therefore save the animal from great suffering (that ultimately may make it stop eating and go into decline). Generally, the earlier a problem is found, the easier it is to “fix” with the least amount of discomfort and ill effects for the horse.”

How can owners help maintain dental health in their horses? According to Paul, owners should have the horse’s teeth inspected regularly by a veterinarian or a reputable dental technician. Also, the wild horse’s eating lifestyle should be mimicked as much as possible by providing adequate pasture grazing. Hay racks and fence feeders should be avoided – instead, horses should be fed from buckets on the ground.

Paul Drake is located in Maryland but travels outside the state to see clients, including trips to Delaware and Pennsylvania. He’s willing to travel up to ninety minutes, one way, to treat horses. If several equine clients are at the same location, he will travel farther. Appointments need to be scheduled in advance so that Paul can have his tools clean and ready to go. All his tools are cleaned thoroughly between farms. According to him, cleanliness and sterility are an important aspect of avoiding the spread of diseases.

Paul can be reached at

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