Today is National Dentist Day, and PETER BARRON visits a North-East equine dentist as he battles to extract an infected tooth – a whopping 10cms long – from a thoroughbred patient

ERNIE, the retired racehorse, stands sleepily in a stall, his mouth clamped wide open, ready to have a troublesome tooth extracted.

It’s another busy day for James Marshall, who looks after the teeth of thousands of horses every year in his role as one of the North-East’s leading equine dentists.

“Open a bit wider for me – there’s a good boy,” says James, soothingly. Not that Ernie has a great deal of choice, because the clamp – or the speculum as it’s known in veterinary circles – has gone up another ratchet to give James a bit more room to work.

He’s part of the team at Hambleton Equine Clinic, in the shadow of Roseberry Topping, where a steady stream of patients arrive: from little Shetland Ponies to giant Shire Horses, with plenty of thoroughbreds in between.

Growing up on a farm in Lincolnshire, James was surrounded by horses, sheep, and dogs, and found himself “fascinated by the science” of the business, often watching the vet who came to treat the animals.

His early ambition was to join The Army but medical reasons, resulting from a car accident, meant he had to change tack. Instead, he became a gamekeeper for five years before studying to be a vet.

After joining a practice in Cambridgeshire, he became increasingly interested in dentistry, and moved north to specialise with the Hambleton Equine Clinic in 2017.

The job comes with its unpredictable moments – like the time he had an appointment to treat a horse at the yard of one of the lesser-known racehorse trainers. When he got there, he was quickly ushered inside the house by flustered family members and shown into a room where a man was flat out on the floor.

“He’d had a heart attack and they thought I was the paramedic!” laughs James. “It wasn’t quite what I was expecting but, luckily, the real paramedic arrived in the nick of time, and I went to look at the horse.”

What James loves about horse dentistry is the fact that it’s so hands-on and there’s an immediacy about the results of his labours.

“Often with veterinary medicine, you’re waiting to see the results, but with horse dentistry, the results are much quicker,” he explains.

“Horses are prey animals, so their instincts are to hide any weaknesses, so they might have gone a long time without showing any signs of pain. When you remove an infected tooth, or rasp down a sharp edge that’s causing discomfort, you tend to see the difference in the horse very quickly.”

Ernie is a case in point. He’d come in for his annual check-up and a tooth root abscess showed up on the x-ray. There was nothing else for it – the tooth had to come out.

While the average size of a human molar is around 10 millimetres, the average length of a young horse’s tooth is 12 centimetres. And horses’ teeth continue to grow with age, which is where the saying “long in the tooth” comes from, as an expression for getting old.

Ernie, who won two races under his unusual racing name, Eye Knee, for North Yorkshire trainer Tim Easterby, is a six-year-old – still relatively young – but James estimates that it will take at least an hour to get the tooth out.

“It looks relatively straightforward, but you can’t rush these things – you’ve got to tease them out gently and that takes time,” he says.

The Northern Echo: Nice and gently...James teases the tooth outNice and gently...James teases the tooth out (Image: Chris Barron)

Ernie is being well cared for, having been sedated, as well as being given a nerve block and pain relief, and student veterinary nurse, Robynne Goodison, is on hand to keep the sedative topped up. It helps that horses commonly sleep standing up.

Robynne’s been around horses all her life and loves her job: “It’s so rewarding to see an animal come in for treatment and be rehabilitated,” she says. “We get some sad stories but there are also lots of happy endings and I wouldn’t want to do anything else.”

The Northern Echo: Student veterinary nurse Robynn Goodison assisting JamesStudent veterinary nurse Robynn Goodison assisting James (Image: Chris Barron)

While he’s working, James can see a close-up of the operation via a tiny camera linked to a laptop computer. He wears a head-torch to shine a light into Ernie’s mouth, and starts with an implement called a ‘spreader’ to separate the infected tooth from its neighbours.

Once the tooth is loosened, he uses a pair of forceps large enough to send a shudder through the spine of anyone who’s nervous about going to the dentist. At regular intervals, Ernie’s mouth is given a good rinse, and James gives him credit for being a “pretty good patient” despite a tendency to try to chew on the speculum.

“Sometimes, you get horses trying to push you away or tossing their heads, and that makes life much more awkward,” he says.

Like an angler battling to land a big fish, it’s a job that requires strength but plenty of patience too, and James has to bide his time for fear of the rotten tooth cracking.

Suddenly, the cry goes up: “I think we’re just about there!” A few more gentle tugs and twists with the forceps, and it’s finally out.

“Got ya!” sighs James, holding a bloody 10-centimetre tooth in his white surgical glove.

The Northern Echo: Got ya! James with Ernie's extracted toothGot ya! James with Ernie's extracted tooth (Image: Chris Barron)

As if in celebration, Ernie chooses that precise moment to have a big wee. “It’s glamour all the way!” smiles James, as the patient does his best to fill a large bucket that’s been swiftly shoved underneath him by the ever-alert Robynne.

His cavity is plugged with putty that will quickly harden and, within minutes, the ‘operating theatre’ is spick and span again.

Ernie is led away by Robynn to recuperate in a stable out in the yard. The sedative will wear off within an hour or so and he’ll be ready to go home, with a couple of check-ups over the next few weeks to make sure all’s well.

In the meantime, James is ready for the next patient of the day – a cob called Bud. He’s in for a regular check-up, so it should be a simple enough appointment.

Mind you, Bud’s 13 years old – he’s getting a bit long in the tooth, so who knows?