How did you decide you wanted to become a veterinarian? Was there a specific moment that you knew it was a career that you were going to pursue?
While there was no singular moment in which I knew I wanted to be a veterinarian, I chose to become one because I wanted to make a difference in the lives of animals. I grew up around all sort of animals and always knew they were going to be a big part of my life. In high school, I was interested in pursuing a career involving journalism until I took an anatomy and physiology course. During this course, I realized that I have a very science-based way of thinking; the combination of my love of animals with my love of science seemed to be a good match to work in the veterinary field. Therefore, I did some shadowing at a local veterinary clinic and that confirmed that I wanted to be a veterinarian. While my journey to becoming a veterinarian was competitive and not for the faint of heart, it was well worth it in the end. Taking care of animals and giving a voice to the otherwise voiceless is a privilege that I do not take lightly.
Before your residency, you worked in general practice. What is something about pet dental health that you view completely differently now compared to when you were a general practitioner?
I view the importance of the oral exam differently. Cats and dogs are very stoic and may not show signs of oral pain even when they are experiencing a painful oral/dental disease process or injury. Without clear signs of oral pain, it can be easy to skip over the mouth or not do a thorough oral exam, especially in an uncooperative patient. But, many things will be missed if the oral exam is not performed. This becomes even more important when you consider the fact that nearly 80% of dogs develop some level or periodontal disease by the age of two.
What does a day in the life of a dental resident look like, and what made you decide to take on the extra years of rigorous training to become a board-certified specialist?
A day in the life of a veterinary dental resident involves lots of learning! From hands on training to staying caught up on the latest publications and journal articles, there is never a shortage of knowledge to be obtained. Early on in my residency training, I focused mainly on exodontics. Later on in my residency, I gained experience in more technically complex procedures such as periodontics, endodontics, and oncologic surgery. Overall, residency is a rigorous training period of nearly three years prior to becoming eligible to take boards to eventually become board-certified.
While in veterinary school, I knew I really liked surgery but was not sure which area of surgery I enjoyed the most (i.e., soft tissue surgery, orthopedic surgery, or dentistry). Therefore, I went into general practice with an open mind to find which area I enjoyed the most. From the start, I found that I had the most confidence and excitement for my dentistry cases. During my first year of practice, I attended two veterinary dentistry continuing education courses that further solidified that I wanted to pursue dentistry full time. In the end, one thing led to another and I started by residency!
What is one of the most challenging or memorable surgical procedures you’ve performed so far during your residency?
One of the most rewarding surgical procedures I have taken part in involved a 6-month-old puppy that could not open its mouth due to temporomandibular joint (TMJ) ankylosis. Basically, the joint connecting the upper and lower jaw was fused shut. The cause of the TMJ ankylosis was unknown but likely due to a traumatic injury the puppy suffered shortly after being born.
As we all know, puppies love to use their mouths when they are young whether that is chewing, biting, or playing. Since this pup’s mouth was basically locked shut due to his TMJ disorder, he had never known what it was like to truly use his mouth. Also, he had only been able to consume a liquid diet, so he also didn’t know what it was like to eat kibble or treats.
He was ultimately treated via a procedure called a gap arthroplasty, in which the area of ankylosis within his TMJ was surgically removed. After his surgery, he was able to fully open his mouth again. He quickly discovered what it was like to use his mouth to play and eat crunchy food and treats!
Do any of the oral health supplements on the market actually work to prevent gum disease, or does nothing replace physical brushing?
The act of physically brushing a pet’s teeth is the gold standard of at home oral care for dogs and cats. While easier said than done, allowing your pet to be open to daily tooth brushing is a training process. Just like you teach your dog to sit and shake, you also have to teach them how to accept brushing. Slow introduction with positive reinforcement is key for pets to be willing to accept at home oral care. Additionally, there are many products on the market that are backed by the veterinary oral health council (VOHC) that are good supplements for oral care but are not true substitutes for brushing.
Is 3D printing—like creating custom jaw models or surgical cutting guides—being used in veterinary maxillofacial surgery to make procedures faster and more precise?
Yes! 3D printing in the form of virtual surgical planning is now very commonly used in the veterinary dentistry and oral surgery world. 3D models become extremely useful for more anatomically complex surgeries such as TMJ ankylosis or pseudoankylosis. These 3D models are created from diagnostic imaging modalities such as cone beam computed tomography (CBCT). These scans can then be printed off into 3D replicas of the patient’s skull. Therefore, surgical approaches and techniques can be practiced prior to the patient’s actual surgery.
How do you see AI changing vet dental procedures?
I foresee AI continuing to become more involved with the diagnostic imaging side of veterinary dentistry. While AI interpretation does not replace interpretation by a veterinarian, there is potential for it to be a useful training tool to alert veterinarians of subtle pathologies that they may not have picked up without it. The flipside of that coin is that there is potential for the AI interpretation to over interpret findings. Therefore, it really comes down to a veterinarian’s ability to put together the whole clinic picture of findings from diagnostic imaging, oral exam, charting, and clinical signs to determine an individualized patient treatment plan.
What is the most surprising, bizarre, or unexpected object you’ve ever found wedged in a pet’s teeth or palate?
Dogs with skin allergies are notorious for having hair stuck in all sorts of places in their mouths. This is due to the fact that they are itchy; they try relieve or soothe those itchy sensations by licking themselves. Overtime, this hair can accumulate and buildup at the gumline, palatal folds, or even within the tongue. There have been many times that we flush out a substantial amount of hair from these locations! Unfortunately, extreme cases of hair accumulation within the gingiva surrounding a tooth can lead to periodontal disease with attachment loss and potential extraction if not caught in the early stages.
What specific current research study or emerging technology in pet dentistry are you most excited about right now?
I am most excited about future research geared towards oral squamous cell carcinoma in cats. This is the most common oral malignancy in cats. It is quite aggressive and consequently caries a very poor prognosis. Currently, the most commonly recommended treatment option for cats with oral squamous cell carcinoma is excision, but this is commonly limited by location and extent of the tumor. Therefore, future research is looking towards advanced treatment options ranging from electrochemotherapy, immunotherapy, and targeted molecular therapy.
Nebraska Dentistry and Oral Surgery for Animals – Nebraska Dentistry and Oral Surgery for Animals
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