Dr. John Scheels - Exotic Animal Dentistry
Dr. John Scheels - Exotic Animal Dentistry
 
Dr. John Scheels - Exotic Animal Dentistry Dr. John Scheels - Exotic Animal Dentistry
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Mission Statement

The purpose of this website is to share the experience and knowledge accumulated while serving as a zoo dental consultant. I have been very fortunate to have had the opportunity to treat over 90 species primarily at the Milwaukee County Zoo since 1981. I have also worked with numerous other zoos and private veterinary practitioners. These efforts have provided a wealth of experience that has revealed patterns of pathoses and effective treatments.

Dr. John Scheels - Exotic Animal Dentistry

I correspond with veterinarians and zoo dental consultants regarding treatment regularly. The questions and case types are often repetitive. It has been clear to me for some time that the information necessary to facilitate optimal treatment of exotic animal dental cases in the zoo setting is still not that readily available. Resources do exist to learn how to approach these cases, but finding them can still be a challenge. Zoo dentistry presents unique challenges involving determining whether an oral or dental problem exists, diagnosis, treatment planning, comprehensive treatment, often times in less than ideal situations and with limited follow up.

Many zoo veterinarians enlist human dentists as dental consultants. Until the zoo dentistry specialty developed, this was their only choice other than learn dentistry themselves. Some do that to a limited degree. Veterinary dentistry has become a specialty since the 1990s. There are still less than 200 Board Certified veterinary dental specialists worldwide.

Veterinary dentists are primarily expert at treating carnivores, dogs and cats. They also commonly treat other "exotic" pets such as small monkeys, guineas pigs and ferrets etc. The range of species in zoos still presents many additional groups of animals. And there just aren't enough veterinary dentists to serve all the zoos and other exotic animal entities yet.

I am pleased to see the impressive growth of comprehensive equine dentistry in recent years. It has become the focus of many dedicated equine veterinarians. The equine dentition anatomy and physiology has become much more thoroughly understood and addressed. Many new treatment modalities are being developed based on this increasing depth of understanding. Alongside this knowledge, specialized equipment has become developed to optimize treatment outcomes.

For approximately 10 years in the 1980s and 90s I worked with Dr. Jo Randolph, an equine veterinarian. We performed operative procedures, endodontics and oral surgery, with very gratifying, successful outcomes. Those cases were very enlightening regarding treating exotic ungulate cases also.

My intention is to complement the excellent, expanding literature of veterinary dentistry regarding the specific nature of treating captive exotics as a zoo dental consultant. I intend to share some general insights and specific treatment details, gleaned from hundreds of zoo cases. If this is considered of value by zoo veterinarians and their dental consultants, my next intention is to enlist the contribution of others experienced in this field.

The Zoo Health Care Team

Many zoos have a veterinary staff that deals with hundreds of species. My experience working with zoo veterinarians and their staff has been an immense privilege. The range of veterinary medical care they provide boggles the mind. Just the challenge of diagnostics is phenomenal.

Dr. John Scheels - Exotic Animal Dentistry

Zoo animal management and medicine has become so sophisticated that the average life span of an exotic species is three to four times that of their wild counterparts. In fact, zoo populations are often considered geriatric. Therefore, if we keep these animals captive, we owe it to them to maintain their health and comfort as they serve as ambassadors for their wild relatives and environments.

Professional zoo keepers are the first line of daily health care. They play a large role in their daily routine, noting any signs or changes in animals' habits which might indicate a medical concern. Signs of dental or oral disease that zoo keepers must be looking for include the following:

Facial swelling; lesions on face or jaw; moist or disrupted hair spots on face or jaw; abnormal head posture, especially when eating, tilting or abnormal lip or tongue actions; changes in eating habits, volume, limiting choices, dropping food, and eating slowly.
Other signs may include changes in stool composition: large pieces of food appearing in stool because they were not initially chewed fully; loss of weight, obvious broken, mobile or protruding teeth; malodor, excessive drooling, colored (bloody) saliva. Nasal drainage, particularly unilateral, may indicate a maxillary tooth abscess. A periapical or periodontal lesion can fistulate into the nasal chambers or sinuses creating lesions and infections there.
Negative changes in social behavior may indicate that an animal is in some physical distress including pain.

When the veterinarian decides that there is a significant issue, they may consider intervention. This frequently requires a sedation or general anesthesia in order to do an exam, gather information and provide treatment. If a dental or oral problem appears to be present, the dental consultant is included in the team.

The one area that zoo veterinarians master is that of general anesthesia. The logistics of dealing with the various types and sizes of animal patients present complex challenges. This process includes all the considerations of the physical confinement of the patient in order to initiate an anesthesia, through recovery. Safety of the patient and the zoo staff is of paramount importance. The success of any procedure is predicated on a successful anesthesia.

Dental Consultant Collaboration with the Zoo Health Care Team

Dr. John Scheels - Exotic Animal Dentistry“ Zoo dentistry presents unique challenges involving determining whether an oral or dental problem exists, diagnosis, treatment planning, comprehensive treatment, often times in less than ideal situations and with limited follow up ”

In most states in the US, it is illegal for a dentist to treat animals, unless under the direct supervision of a veterinarian, as it should be. The zoo veterinarian is in charge of veterinary procedures. Zoo curators and directors may have some degree of influence in veterinary care decisions.

General anesthesia parameters determine procedure time limitations. These include the unique challenges of a safe initial sedation, including consideration of the patients' enclosure situation regarding controlling the patient. Then the veterinarian must consider the inherent physiological risks of general anesthesia. These challenges will determine the opportunities for long, multiple or follow up procedures. They frequently dictate where examination and treatment procedures can be performed also. The dental consultant will also be challenged by these situations to provide diagnosis and treatment.

During the procedure, the dental consultant and anesthesiologist (veterinarian) must be in constant communication. Usually a third individual, veterinarian or veterinary technician is closely involved monitoring the patient and managing IVs etc. The animals' depth of anesthesia must be maintained for its safety and the safety of the operator. Any movements or changes in jaw tension should be continually discussed. Constant communication regarding all aspects of the ongoing procedure will result in safe and successful outcomes.

Treatment Choices

All the considerations of actual operative treatment choices will be unique to each case. Examination, diagnosis, deciding whether treatment is justified and prioritizing multiple issues presented, must be done promptly when safe general anesthesia is achieved. Again, the opportunity to follow up will be limited, therefore the most definitive treatments must be chosen.

Infection is of course the most important condition to address. Teeth that are obviously painful or at risk to become infected or painful must also be addressed. Having the benefit of treating human patients that describe their discomfort, relative to dental and oral pathologies, I am confident that my animal patients are experiencing the same symptoms. Although they may appear stoic, animals attempt to socially hide their pain so as not to appear weak or impaired.

My philosophy toward treatment choices has evolved to become very conservative for some pathoses, and very aggressive for others. Working closely with experienced veterinarians we have developed this philosophy together. Some species of captive exotic animals' lives are not as critically dependent on their dentitions' as they would be in their wild environment. For others they are just as critical, those are the ones which must be addressed very aggressively.

Herbivores, in particular ruminants for example, must be able to masticate their food in order to digest it to survive. Most primates and carnivores can be fed food in compositions that do not have to be chewed and they will be able to digest and survive. Therefore, extraction of herbivores posterior teeth is only done when absolutely necessary. Particular teeth, such as mandibular canines and carnaissals in carnivores are especially important to their jaws physical integrity. Therefore, endodontics will be seriously considered to maintain them. Of course there are always exceptions to consider. I review animal groups and particular species relative to these treatment considerations in another section.

I usually only consider relatively simple procedures or restorations on animals. If I can simply polish smooth a sharp or rough enamel fracture, I will do that rather than place a restoration. Functional durability is my main consideration of restorations in animals.

I have placed full cast crowns on dogs trained in law enforcement. I have provided crowns that remained in place for the remainder of the dogs' career, permitting challenging duty functions. Other than on law enforcement dogs, my philosophy toward performing the multiple anesthesias (or a very long single anesthesia) required to provide a crown would only be warranted in a very few situations. These would be considered on a domestic or captive exotic animal canine or perhaps a carnaissal tooth that has had an endodontic prodecure on a relatively young animal. I have observed endodontically treated teeth in such animals fracture after several years. They became infected and had to be removed. A conservatively shaped full cast crown would serve well to avoid this complication.

Preparation to Diagnose and Provide Treatment

To be continued...

THE WEDGE®

Radiolucent Mouth Prop for Dogs and Cats

  • Anatomically designed to provide secure, open mouth
  • Use for anesthesia, radiography, oral surgery, and dentistry
  • No moving parts, use if canines are absent
  • Ultrasound, heat, or cold sterilize
  • SMALL size for cats and smaller dogs, LARGE size for medium to large dogs
Dr. John Scheels - Exotic Animal Dentistry(click image to enlarge)
 

The WEDGE® is a one-piece, radiolucent mouth prop. The patented, anatomic design holds the carnivore mouth open during anesthesia by securely engaging the premolars and molars.

Dr. John Scheels - Exotic Animal Dentistry
PATENTED
 

The WEDGE®:

  • Replaces the metal "gag" which catches whiskers and gloves on springs and slides.
  • Has no grommets to be lost, permitting metal to enamel contact.
  • Can be used if the canines are broken or absent.
  • Can be used on either side of the mouth and switched quickly.
  • Radiolucency facilitates clear open-mouth radiography.
  • May be ultrasounded and heat or cold sterilized.
  • Has a hole provided for attachment of a safety lanyard if desired.
  • Is useful during anesthesia, intubation, oral examination, oral surgery, dental procedures, and radiographic examination.
Dr. John Scheels - Exotic Animal Dentistry(click image to enlarge)
 

Developed and patented by Dr. John L. Scheels, dental consultant to the Milwaukee County Zoo, Adjunct Assistant Professor, University of Wisconsin-Madison School of Veterinary Medicine.

"The (Scheels) Veterinary mouth prop's biggest asset is its simplicity - open the mouth and stick it in!...it does not interfere with radiographic detail, can be ultrasounded, and autoclaved...can be used for dental and oral surgery procedures...is positioned within the mouth, unlike the spring loaded (extra-oral) devices which can be in the way of the operator and interfere with positioning the patient..."

~ Paul E. Howard, D.V.M.,

Vermont Veterinary Surgical Center, Burlington, Vermont.

Order The WEDGE® from any of these veterinary equipment suppliers:

Also available:

 
Dr. John Scheels - Exotic Animal Dentistry
Dr. John Scheels - Exotic Animal Dentistry
Dr. John Scheels - Exotic Animal Dentistry
Dr. John Scheels - Exotic Animal Dentistry
Dr. John Scheels - Exotic Animal Dentistry
Dr. John Scheels - Exotic Animal Dentistry
Dr. John Scheels - Exotic Animal Dentistry
Dr. John Scheels - Exotic Animal Dentistry
Dr. John Scheels - Exotic Animal Dentistry