What
'Bitseats' refers to the shortening and rounding of first molars. This can range from merely removing the normal relief on the chewing surface of the molar to, in most cases, removing a portion of the molar from the mucosa to the chewing surface.

Why
The idea behind the creation of these bitseats stems from the conviction that this can avoid riding problems and leads to a better acceptance of the bit. By creating a 'seat for the bit' the horse would become more responsive to the bit. However, all this is highly subjective and there is no scientific basis for these practices. Given the risks, the basic medical principle of 'first do not harm' should prevail.

Risks
The biggest risk with drastic bitseat creation includes damage to the interior of the tooth. The blood vessels, nerves and connective tissue cells that are inside the tooth are shielded by a layer of toothbone (dentin). When this layer is removed, these sensitive structures are exposed to the outside world. This can lead to hypersensitivity and pain. In addition, the damage can be severe enough that the tissue dies off completely or partially.

Also, the heat produced by vigorous floating on a tooth is capable of creating thermal damage. This is why our own dentist always uses water-cooled equipment in the mouth. Surprisingly, this is far from standard in equine medicine.

Case report: 

Mare - thoroughbred - 5.5 years old.

Diagnosis:
Clinical examination: The horse has a body condition score of 0 (where 0 is the target, -2 anorexic and +2 obese). No nasal discharge present at this time.

Oral examination: An oroscopy (camera) was performed on the horse. The following findings are of interest:
Post-normal occlusion pattern.
Mucosal lesions at the level of 110/111 + 210/211
Bit/bridle - associated lesions at the level of first molars (severe "bit-seats")
306 and 406: pulp exposure both teeth (pulp 6) + changes other pulps + fistula mesio-lingual side of 406 + fistula mesio-buccal side 306.
Increased mobility of 306 and 406.

Radiological examination: An X-ray examination was performed on the horse. Following findings are of interest:
Changes of mesial apex of teeth 306 and 406.
No signs of fluid lines / sinusitis.

Treatment:
The horse is sedated and given injectable anti-inflammatories and antibiotics.

During the treatment, 3 teeth (209, 306 and 406) extracted from the oral cavity. This is the least invasive technique to remove a tooth and therefore has the fewest complications.

Oral extractions are performed on the standing horse after sedation and local anesthesia. Therefore, the procedure is done as painlessly as possible.
The gums were loosened around the tooth, after which the periodontal ligament was stretched with spreaders of varying thickness.
Using various forceps and levers, the tooth was rotated around its axis, gradually allowing greater and greater movement.
After the placement of a fulcrum (lever), in addition to the purely rotational movements, a vertical traction was exerted on the tooth, finally allowing the tooth to be lifted out of the alveole.
The alveole was rinsed and cured and checked for retained fragments.

Coe Pack (periodontal dressing) was used to temporarily seal the alveole to prevent food impaction.