Carry out Category 2 Equine Dental Procedures

This standard covers the procedures described as Category 2 Equine Dental Procedures and includes the safe handling of horses, customer care, the use of appropriate equipment, the promotion of animal welfare, and the process of working within legal and professional responsibilities.

Under the Veterinary Surgeons Act (1966), all diagnostic and treatment procedures in the horse’s mouth are considered to be acts of veterinary surgery, with the exception of the manual removal of dental overgrowths with hand instruments. This means that most equine dental procedures are legally restricted to veterinary surgeons.

The Category 2 Procedures, although deemed to be acts of veterinary surgery, can be delegated to an equine dental technician (EDT) who has trained and passed an industry recognised examination (BEVA/BVDA examination or a WWAED Cat 2 exam).

The Category 2 Procedures form part of a grading system for equine dental procedures and have been accepted by the Royal College of Veterinary Surgeons (RCVS), British Equine Veterinary Association (BEVA), British Veterinary Association (BVA), British Veterinary Dental Association (BVDA) and the British Association of Equine Dental Technicians (BAEDT). Details of the equine dental procedures in Categories 1-3 can be found in the glossary.

This standard is for qualified equine dental technicians. Users of the standard will need to ensure that their practice reflects up-to-date information and policies, and that they work within the limits of their authority, expertise, training, competence and experience.

1. work in accordance with the Veterinary Surgeons Act (1966) and the limits of your authority, expertise, training, competence and experience
2. identify and address health and safety risks in relation to the work area and the work being carried out, for yourself, the horse and others
3. obtain a history of the horse relating to general health, dental and oral disease and previous dental treatments
4. confirm that equipment is prepared and assembled ready for use, including personal protective equipment (PPE)
5. ensure that the horse is appropriately handled to enable dental procedures to take place
6. recognise the behaviours, conditions and procedures/treatments required that indicate chemical sedation is required
7. communicate professionally with a veterinary surgeon to arrange provision of sedation at a mutually convenient time and location, if required
8. conduct a physical assessment of the horse focusing on the external structures adjacent to the dentition
9. perform a visual and manual/digital examination of the horse’s mouth and record your findings
10. explain, advise and agree a treatment plan with the owner/agent of the horse, including recognition of when treatment is not required
11. undertake Category 2 Equine Dental Procedures as appropriate for the horse and the agreed treatment plan, ensuring that horses are sedated unless it is deemed safe to undertake any proposed procedure without sedation, with the full informed consent of the owner/agent:
    P11.1 examination, evaluation and recording of dental abnormalities
    P11.2 the removal of loose teeth or dental fragments with negligible periodontal attachments
    P11.3 the removal of erupted, non-displaced wolf teeth in the upper or lower jaw under direct and continuous veterinary supervision
    P11.4 palliative rasping of fractured and adjacent teeth
    P11.5 the use of motorised dental instruments where these are used to reduce overgrowths and remove sharp enamel points only.
12. work in accordance with the special considerations for the removal of erupted, non-displaced wolf teeth as a Category 2 Equine Dental Procedures, as follows:
    P12.1 chemical sedation and analgesia should be administered as appropriate by a veterinary surgeon before wolf teeth removal
    P12.2 the veterinary surgeon is in attendance for the provision of sedation, analgesia and aftercare
    P12.3 contingency arrangements for complications are organised prior to starting the procedure
13. use motorised equipment correctly to avoid iatrogenic injuries to the horse’s mouth
14. identify and recognise which lesions require veterinary referral and make the appropriate recommendations to the owner/agent
15. maintain a professional working relationship with the horse’s veterinary surgeon
16. confirm that the horse’s welfare is maintained throughout and that your interaction with the horse does not adversely affect its behaviour
17. comply with the current animal health and welfare legislation and codes of practice at all times
18. confirm that working methods promote health and safety and are consistent with the relevant legislation and codes of practice
19. maintain appropriate levels of hygiene and biosecurity throughout the process
20. maintain your own professional standards and ethics as an equine dental technician

1. the requirements of the Veterinary Surgeons Act (1966) in relation to your role and the categories of equine dental procedures, to cover:
   K1.1 Category 1
   K1.2 Category 2
   K1.3 Category 3
2. the main risks to health and safety in the work area and how to minimise risk to yourself, the horse and others
3. how to handle and control the horse, the range of different methods of handling and control and their correct use
4. equine behaviour, including signs of pain, distress, alarm and avoidance
5. how to recognise when sedation of the horse is required and when it is safe to undertake any proposed procedure without sedation, with the full informed consent of the owner/agent
6. the anatomy and physiology relevant to the:
   K6.1 oral cavity
   K6.2 head
   K6.3 respiratory tract
   K6.4 digestive system
   K6.5 nervous system
7. the equipment, including personal protective equipment (PPE), and materials required to carry out Category 2 Equine Dental Procedures, including their correct use, maintenance and hygiene
8. the factors affecting the selection and correct use of instruments and equipment for the different Category 2 procedures
9. the risks of using motorised equipment, including health and safety risks to people and the iatrogenic injuries to the horse
10. the importance of discussing findings and treatment with the owner/agent and obtaining consent to continue
11. how to carry out the following Category 2 Equine Dental Procedures:
    K11.1 examination, evaluation and recording of dental abnormalities
    K11.2 the removal of loose teeth or dental fragments with negligible periodontal attachments
    K11.3 the removal of erupted, non-displaced wolf teeth in the upper or lower jaw under direct and continuous veterinary supervision
    K11.4 palliative rasping of fractured and adjacent teeth
    K11.5 the use of motorised dental instruments where these are used to reduce overgrowths and remove sharp enamel points only.
12. the importance of contingency planning for complications and what this involves
13. the role and importance of veterinary referral and communication with the veterinary surgeon
14. how to recognise the impact of your own behaviour on the horse and how to minimise any adverse effects on its behaviour
15. your responsibilities for the health and welfare of animals under the current legislation and codes of practice
16. your responsibilities under the relevant environmental and health and safety legislation and codes of practice
17. the importance and correct use of personal protective equipment (PPE)
18. the methods of maintaining hygiene and biosecurity and the reasons why they are important
19. your professional responsibilities as an equine dental technician
20. the importance of keeping your knowledge up to date on evidence-based medicine and how to apply it
21. the role of professional organisations to support your role as an equine dental technician and the requirements for continuing professional development
22. your legal and professional liability when working as an equine dental technician and the importance of appropriate insurance cover

Animal welfare legislation:
England and Wales – Animal Welfare Act 2006
Scotland – Animal Health and Welfare Act (Scotland) 2006
Northern Ireland – Welfare of Animals Act (Northern Ireland) 2011

Category 1, 2 and 3 Equine Dental Procedures:
Category 1 Procedures
Those procedures which an individual can perform after recognised training without specific attainment of qualifications:
examination of teeth;
removal of sharp enamel points using manual rasps only;
removal of small dental overgrowths (maximum 4mm reductions) using manual rasps only;
rostral profiling of the first cheek teeth (maximum 4mm reductions), previously termed “bit seat shaping”;
removal of loose deciduous caps; and
removal of supragingival calculus

Category 2 Procedures
Additional procedures suitable for delegation to an EDT who has trained and passed an examination approved by DEFRA:
examination, evaluation and recording of dental abnormalities;
the removal of loose teeth or dental fragments with negligible periodontal attachments;
the removal of erupted, non-displaced wolf teeth in the upper or lower jaw under direct and continuous veterinary supervision;
palliative rasping of fractured and adjacent teeth; and
the use of motorised dental instruments where these are used to reduce overgrowths and remove sharp enamel points only. Horses should be sedated unless it is deemed safe to undertake any proposed procedure without sedation, with full informed consent of the owner.

Category 3 Procedures
All other procedures and any new procedures, which arise as a result of scientific and technical development, would by default fall into category 3, which are those procedures restricted to qualified veterinary surgeons and are not proposed for deregulation. It is therefore NOT legal for these to be performed by non-veterinarians.

Horse
For the purpose of this standard the term “horse” includes donkey, ass, mule, hinny, pony and other equidae.