BEVA council recommends to its members that we work with members of the BAEDT and co-operate with them as fully as we can within the law. As the law currently stands non-veterinarians are only allowed to rasp and float teeth in un-sedated animals, or in those that have been sedated by a veterinary surgeon.

If the Veterinary Surgeons’ Act is re-opened one possibility is that such procedures may be classed as belonging to category 1. Procedures involving the removal of overgrowths with mechanical instruments and the removal of wolf teeth would be designated as category 2; these procedures could be performed by qualified dental technicians who are members of the BAEDT. Equine veterinarians not wishing to perform dental procedures themselves are encouraged to refer cases to suitably skilled veterinarians or to BAEDT members for treatment as appropriate for the case, within the terms of the law.

The removal of incisors, canines or cheek teeth involving any loosening of periodontal tissue, gingival incision or invasive techniques, deep periodontal correction, and all endodontic procedures and any other invasive oral procedures will be designated as category 3. These are all invasive acts of veterinary surgery and should not be performed by anyone other than a veterinary surgeon; such procedures cannot legally be devolved to dental technicians. This type of procedure should only be performed by veterinary surgeons or referred to another veterinary surgeon with expertise in this area.

To reiterate, it is illegal and is likely to remain illegal for non-veterinarians to remove non-loose cheek teeth with instruments, even under direct and continuous veterinary supervision. If the Veterinary Surgeons’ Act is amended, only cheek teeth which are digitally and palpably loose (such as those found in a geriatric horse) and do not require periodontal separation or the use of instruments, may be removed by non-veterinarians.

Many dental technicians are technically competent and enthusiastic to co-operate with veterinary surgeons to their mutual benefit and have joined the BAEDT. However, there are a minority who continue to flout the law to the possible detriment of the horse’s welfare. In some cases, those individuals may be illegally performing oral surgical procedures and obtaining and administering prescription only medicines, including sedatives, or supplying them for owners to administer. Horse owners may be unaware of the illegality of this and of the absence of any form of indemnity insurance by such operators, in addition to the possible risk to the horse. Individuals acting in such a manner, in addition to being dangerous to the horse’s welfare are likely to impact negatively on the good reputation established by the committed EDTs working within the law.

Evidence of any non-veterinarian who is illegally using medicines, including sedatives should be reported to the Veterinary Medicines Directorate (VMD) which will take enforcement action. It is now illegal for anyone to possess veterinary medicines which have been acquired illegally and the VMD assures us that it will enforce the law and prosecute those involved. If any of our members have evidence of the illegal procurement or administration of medicines for equine dental work they should contact the VMD. Veterinary surgeons are reminded that the supply of medicines, including sedatives, to dental technicians, qualified or otherwise, remains illegal.

If the dental work itself has been performed particularly badly, then with the owner’s consent, the trading standards department of the local council are usually keen to take the necessary action. If equine welfare is an issue the SSPCA or RSPCA may also be of help. Discussion about the work of BAEDT members should be referred to the BAEDT secretariat, to be addressed by their council. The BEVA office would also like to hear of any poor work performed by paraprofessionals; please send details to the BEVA office, Wakefield House, 46 High Street, Sawston, Cambridge, CB2 4BG for the attention of Keith Chandler.

BEVA recommends that veterinary surgeons should not sign insurance forms for any procedure which they were not directly involved in or were directly supervising (i.e. physically present). Most insurance policies for veterinary fees do not cover veterinary procedures being performed by non-professionals and procedures performed out with the law may invalidate the insurance policies.

One major area of uncertainty is liability. A requirement of membership of the BAEDT is that sufficient indemnity insurance is in place and as long as the EDT is working within the law then he or she is covered against such claims.

Where liability is in question, such as in the case where a lay person requests assistance from a veterinary surgeon in the sedation or treatment of the animal, then we as the attending veterinary surgeons may be held responsible. This is irrespective of whether the majority of the work was performed by a paraprofessional or not. It is therefore imperative that the owner is aware of the situation, and that the veterinary surgeon is aware of what procedures are proposed. It is advisable for the veterinary surgeon to establish a clear understanding with the owner of just what duties he is accepting - i.e. those relating to the sedation - and those that he is not – i.e. those relating to the dental work, which is entirely a matter between the EDT and the owner. Written evidence of such understandings is always preferable. Where veterinary surgeons are co-operating with dental technicians performing procedures outside the law there is a risk of the attending veterinary surgeon being deemed professionally responsible for the work unless the limits of obligations have been clearly defined beforehand. So be aware, if you are sedating a horse for any paraprofessional – do you know what he or she is doing and why they are doing it? Are they qualified to do the procedure and is it legal? Have you discussed your role with the horse owner or keeper? If the answer to these questions is no, then you should reconsider co-operating with the paraprofessional and you should reconsider sedating the animal for the work to be performed.

• A summary of suggestions to establish an effective working relationship between veterinary surgeons and equine dental technicians is shown below:
• Support the services of skilled dental technicians who are members of the BAEDT who work within the ethical and legal objectives of the profession
• Encourage the dental technicians to arrange for requests for sedation directly, (and not via the clients) to establish the estimated length of the procedure and the requirements for sedation
• Discuss the proposed procedures before arranging the visit
• Discuss the legal position with the client before attending, including the role of the veterinarian and paraprofessional
• If possible, remain present during the procedure and establish the habit of examining the horse’s mouth after the procedure.