Last year, I had a new vet (for us) come out to do some of our horses. They didn't use sedative at all and all 4 of the ponies not only were very, very sore (i ended up rinsing mouths out with warm salt water 2x daily for a week in temps around the 20's as a high) and my old campaigner mares all became very head shy as well. Disappointing for me, as I'd heard their praises sung. As dental work goes, it was pretty in-expensive overall - since I wasn't charged for the drugs. I do admit though, that the work he did made them go much longer before needing to be done this year - but at what cost? It was pretty rough for several months with all 4 of those ponies - bridling took on all kinds of new meanings, LOL.
I've taken several of our ponies back to our old vet (North Star Equine) now that she has an actual vet hospital. From 2004-2006, she was mostly an ER type vet for us and in 2009, she recommended the vet that I started with (Dr E) and in 2013 went to work for (at the Spay Neuter clinic). She now uses power tools and it's GREAT. But it's been weird this year - trying to find the time to take ponies 45 miles one way (longer now since they closed off Ft Bragg to thru traffic and the new hiway go-round is a mixed up mess) when they have appointments and I have the time and so doing that has become a lot tougher.
I've been looking at dental tools myself. Figure if the oral Dermosadan works (got from my old vet as new ones won't sell it to me, yet), then I see no reason why I can't check them and do it myself. Would still need any issues (split teeth - which seems to be somewhat common in today's' shetlands - we've actually had quite a few in the last several years; wolf teeth extraction, any type of an abscess-haven't had) checked out, but I could see doing this using hand tools and maybe even learning to use power tools. Of course, it may become like trimming hooves - I have the equipment on hand when I want it (or need it) - but choose to spend the $$ to have it done by someone currently "up" on the procedures that I have only a basic knowledge of and whom can get it done in a more timely manner than I can. If I had the equipment, then I could do some that I know are a problem to do with the vet - and go from there.
Years ago, when I last checked, Equine Dentists were banned from practicing in NC and only came in from out of state. Due to that, yes, they required a minimum of horses to be done at one time. I don't know if that is still in effect - but have heard of a lot more farms utilizing Equine Dentists, so maybe not??