We strongly encourage apprenticeships where candidates can prepare for IAED certification in addition to their time in school. This is no longer a requirement to attempt testing, but it highly recommended.
Candidates must pass the written exam with higher than an 80% in order to take the IAED practical exam. The written exam can be taken via proctor.
THE IAED STANDARD
(This standard is a functional working copy and is subject to change without notice.)
ALL PROCEDURES ARE TO BE DONE IN ACCORDANCE WITH THE ANATOMICAL GUIDELINES
IAED Standards & Expectations Requirements of Maintenance and Rehabilitation of the Dental Arcades
A. Incisors (follow anatomical guidelines)
1. The incisors should not prevent or interfere with the lateral excursion or rostral-caudal movement of the mandible.
2. The incisors should not displace the mandible from a neutral position.
3. The incisor length should not prevent functional cheek teeth occlusion.
4. Incisor table angle should be directed toward or near the TMJ. (see anatomical guidelines)
B. Canines (follow anatomical guidelines)
C. Wolf Teeth
1. Wolf teeth are to be extracted with approval of the steward and certification veterinarian only.
D. Bit Seats (follow anatomical guidelines)
1. The shape of the bit seat must not compromise the integrity of the tooth. Ideally there should be minimal loss of functional occlusal surface.
2. Finished bit seat should be smooth and uniform in shape.
E. Cheek Teeth (follow anatomical guidelines)
1. Remove sharp points that may abrade soft tissue.
2. Establish, restore or maintain optimally functional molar arcades by correcting malocclusions, while preserving maximum occlusal surface.
3. Functional table angles should be restored and/or maintained.
4. Prior to equilibration the Cheek teeth occlusion should be the same or greater (see exceptions in anatomical guidelines)
F. Removal of Teeth
1. Removal of retained fragments, permanent teeth and deciduous teeth should be discussed with the steward and approved by the certification veterinarian prior to their removal.
G. Malformations and Pre Existing Conditions of the Teeth and Oral Cavity
Note: When present, these conditions and others, should be noted on dental chart and possible treatment discussed with attending veterinarian.
a. Malformed teeth
b. Periodontal disease
d. Openings in the occlusal surface, i.e., open pulp chambers etc.
e. Buccal and or lingual lesions.
f. Damaged bars, damaged tongue.
g. Fractured teeth
h. Bone spurs
The purpose of this supporting document is to define parameters within which equine dentistry can be performed. While the practical exam will test to a basic standard of care it must be remembered that dentistry combines both the arts and sciences. To be performed at a high level, the practitioner must have a solid understanding of the hypsodont anatomy, physiology, biomechanics, and pathology combined with a knowledge of instrumentation and practical skills.
Currently, there is no practical “standard” in equine dentistry and it remains unlikely that one will be developed soon. It is too difficult and ambiguous to define exactly what work must be performed on each mouth. To attempt to transfer the art and science of equine dentistry under one rule would only muddy the waters and decrease the overall standard of care. Each individual horse has a unique anatomy and the work performed must be adapted to that individual. Equine dentistry cannot be performed using a cookbook approach. As such, the IAED has developed a set of parameters – Anatomical Guidelines – that provides practitioners with an understanding of the anatomy that must be respected during the process of equilibration.
The goal of equilibration is to distribute the pressure and wear of mastication onto as many viable teeth as possible in order to maximize the longevity and integrity of the equine dentition. The reduction of ONLY the protuberant teeth allows the opposing excessively worn tooth room to erupt, so that over time the amount of reserve crown is as symmetrical as possible for respective teeth. This will ensure an approximately even rate of wear on the respective teeth thus extending the viability and longevity of the dentition. During the process of equilibration, it is assumed that the sharp buccal and lingual points will be removed WITHOUT a functional loss of occlusal surface.
During the practical exam, the candidate must demonstrate that he/she understands all the anatomical landmarks and variations that must be considered for each animal. This will be documented through charting of the horse following a thorough oral exam. Abnormal pathology must be completely documented. The horse should be given regular breaks with complete closing of the speculum at about 5 minute intervals. The mouth should remain closed for at least 10-15 seconds and be rinsed during breaks.
· The incisors should be carefully evaluated prior to placement of the speculum.
· When dental work is completed, the incisors should not be placing lateral pressure on the mandible
· The incisors should be in contact on as many viable teeth as possible. It is understood that incisors that have been excessively worn may be left out of occlusion following the reduction of the protuberant opposing incisor. However, in cases where the incisors are well aligned, the pressure should be distributed onto as many teeth as possible
· Candidate must use the color of the secondary dentin to determine how much to reduce protuberant teeth
· For the purpose of the exam, the secondary dentin should maintain some brown coloration and not be taken so far that white dentin is visible.
· Exposure of any pink material reflecting live pulp will result in automatic failure
· The incisors should feel free of mechanical restrictions during lateral excursion
· Incisor table angles should not be so steep that rostral movement of the mandible is restricted. The incisor table angles should be close to aligning with the TMJ.
· Large reductions of ALL the incisors should NOT be performed. If a diagonal bite is present, it is expected that candidate will realign bite as much as possible WITHOUT reducing the protuberant teeth so much that the secondary dentin remaining is white. Light brown secondary dentin should be used as the gauge for when to stop reduction.
· Complete flattening of the incisor table angle is not acceptable
· During equilibration of incisors, adequate technique must be used to prevent excessive heat generation.
· Any abnormal pathology such as EOTRH, necrotic pulp horns, fractures, periodontal disease, etc must be thoroughly documented on chart – if present, these must also be brought to the attention of the attending veterinarian.
· The canines should be smooth and rounded but not overly reduced
· Pulp exposure will result in automatic failure
· Any tartar present should be removed
· Presence of gingivitis should be charted accordingly
· Blind canines should be well documented on chart
· Any abnormal pathology such as EOTRH, necrotic pulp horse, fractures, periodontal disease, etc must be thoroughly documented on chart – if present, these must also be brought to the attention of the attending veterinarian.
· The occlusal surface should have as much width as possible without being sharp
· The buccal and palatal/lingual margins should not be beveled at a 45 degree angle resulting in a significant loss of mastication surface
· The tooth opposing a protuberant tooth should always have a rough occlusal surface. Only the protuberant tooth may be reduced, and not the low opposing tooth.
· Rostral profiling of the #6 teeth should only smooth the rostral aspect of the teeth while removing minimal occlusal surface. The rostral margins should be uniform and smooth.
· Proper technique must be used so that no iatrogenic soft tissue damage occurs within the oral cavity
· Proper technique and instruments must be used to minimize heat production from handpieces. This means using a precise approach to reducing protuberances and only working on the smallest surface area possible to obtain desired reduction. Instruments must be sharp and in good/safe working conditions.
· When reducing large protuberances, the candidate should continually assess the color of the secondary dentin of all pulp horns and make sure that some brown coloration is maintained throughout procedure. No teeth should be reduced so much that only white secondary dentin is seen. Any pink coloration on any pulp horn will result in automatic failure.
· Any abnormal pathology such as necrotic open pulp horns, fractures, periodontal disease, infundibular caries, peripheral cemental caries, masses, etc must be thoroughly documented on chart – if present, these must also be brought to the attention of the attending veterinarian.
· The occlusal surfaces should be balanced to the extent possible, but they should not be smooth! Only protuberant areas should be reduced!
· Exam horses will be screened to ensure that they have fairly uniform table angles (no shear mouths), therefore candidates should only do minimal adjustments of table angles – if any. There may be cases where a few teeth require an angle adjustment, but as a whole, the table angles should be respected and maintained at all times. They should remain uniform and consistent.
· During equilibration, candidate must not eliminate the curvature of spee.
· When the speculum is removed and the cheek teeth come together, the paired quadrants (100/400 and 200/300) should have simultaneous occlusion of as many viable cheek teeth as possible. Severe single tooth (primary strike) strikes will result in automatic failure. Small single tooth (secondary strike) strikes will result in a loss of points.
· Primary tooth strike is a single tooth or area of tooth causing separation of arcades for more than half of the “in occlusion excursion”.
· Secondary tooth strike is a single tooth or area of tooth causing separation of arcades for less than half of the “in occlusion excursion”
· “In occlusion excursion” for the purpose of testing is measured from the first point of contact during excursion through to the point at which the most lateral point of the upper arcade is vertical to the lateral edge of the opposing arcade.
· Lateral excursion should be free and unrestricted.
· Low teeth that were excessively worn from protuberances may remain out of occlusion during lateral excursion.
· Transitions between high and low teeth should be blended to allow for rostral/caudal movement of the mandible during mastication.
· Incisor reductions resulting in 100% cheek teeth occlusion (no lateral excursion prior to contact) should NOT be performed. Only mild angle changes or realignments of the incisors are necessary if candidate ONLY reduces the PROTUBERANT cheek teeth.
· The cheek teeth should have enough occlusion that some separation of the incisors occurs during lateral excursion – the only exception would be cases where very poor cheek teeth occlusion is present prior to equilibration. If this happens, the candidate must carefully document the poor occlusion PRIOR to equilibration and use that as a limiting step for how much work can be performed on the cheek teeth.All information posted here is subject to change without notice.