Wednesday, January 25, 2012

Brita’s Dentist

When Brita needed dental work this is where she went.  Her lower canines were growing inward and back instead of forward and outward.  She had surgery to reconstruct the roof of her mouth so the point of the canine wouldn’t continue to put a hole in her palate like it was starting to do.  Dr. Dale Kressin of Oshkosh is one of four veterinary dental specialists in Wisconsin.  This is a great article about him from the local newspaper.  Dr. Dale Kressin of  Animal Dentistry and Oral Surgery in Oshkosh removes a splint from the jaw of  12-year-old Taylor, a Pug. Periodontal disease led to a weakening of the dog's  jaw and the eventual break. Dr. Steven R. Honzelka assists. Veterinary dental  specialists are able to identify and treat periodontal disease, perform root  canals, replace metal crowns and many other advanced treatments for pets  including orthodontics.   Oshkosh Northwestern photo by Joe Sienkiewicz

OSHKOSH - Elton John crooned his rendition of "Don't Let the Sun Go Down on Me" in the cozily warm second floor operating room of Dr. Dale Kressin at Animal Dentistry and Oral Surgery Specialists, LLC on Omro Road as the veterinarian laid a plush towel over the top of Taylor and patted her lovingly.

Not only was the 12-year-old Pug enclosed in a special blanket that circulated warm water, she was blanketed by that extra towel pretty enough for a spa. The extra towel would help keep the anesthetized dog warm.  "Little dogs lose more heat than big dogs," Kressin said.

Kressin is a Board Certified Veterinary Specialist recognized by American Veterinary Dental College. As such he is able to perform a host of services most veterinarians do not, including endodontics, periodontics, orthodontics, restorations, dental radiology and oral surgery. Specialty certification requires from three to six years of training in the area of specialization beyond the Doctor of Veterinary Medicine degree.

Resident Dr. Steven R. Honzelka, wearing a burgundy scrub suit identical to Kressin's, prepared Taylor for her procedure. She would have a splint removed from her jaw. He inspected equipment that provided a reading of her blood pressure and other vital signs. He checked her breathing tube. He prepared the X-ray viewing monitor for images of her jaw and the splint used to keep it in place while her fracture healed over many weeks.

Taylor suffered periodontal disease, which weakened her jaw bone and led to the fracture, Kressin said.  He would use those X-ray images as he worked on Taylor.  Later, she would be good as new.  "No more tug of war, but she won't have any other major restrictions," Kressin said. "Usually they can eat immediately following."

Increased sophistication of veterinary medicine along with the acknowledgment by society that pets play an important role in their owners' lives have resulted in establishment and growth of such practices as Kressin's, ones that provide services similar to those offered in human medicine.

Dr. Kim Krause, a veterinarian at Animal Medical Surgical Clinic in Wisconsin Rapids, referred the Pug's owner to Kressin.  "I am overjoyed he was available and has the specialized training. The average practitioner can't do these specialized procedures. It takes significant advanced training," she said.  Krause has observed a growing need for veterinary specialists. As patients learn that specialists are out there and can provide advanced care it opens the door for even more specialists. Krause took her own cat to Kressin for a procedure Wednesday. "We want the same care for our pets that we want for ourselves," she said.

Kressin offers many advanced procedures such as root canals, orthodontia, crowns, fillings bridges and implants for dogs and cats. About a third of Kressin's cases involve oral tumors and another third is devoted to periodontal issues. The remainder covers a variety of treatments for other conditions.

The two doctors discussed Taylor's case as they assessed her readiness to undergo her surgical procedure. Her long pink tongue was clamped and pulled to one side to keep it out of the way.

It was a typical morning at the clinic. In the next room, Randall, the year-old domestic long haired cat of Nicole Hoffman and Rich Clark waited for his procedure. His owners brought him to the veterinary dental specialists when they detected problems inside Randall's mouth. Nicole is a trained dental assistant for humans with a professional background in pet care at Petco. "We've noticed smelly breath," Hoffman said. She had no qualms whatsoever regarding the cost of the day's treatment, which she estimated at "upwards of $800." That covered a cleaning, X-rays and a surgical procedure to cut away gums that grew too far up the cat's teeth, creating pockets between gums and teeth where bacteria could grow and cause decay, Hoffman said. Follow-up care includes daily tooth brushing for Randall and annual cleanings. Hoffman and Clark are happy to brush Randall's teeth and bring him to the clinic for professional cleaning. "We want all our pets to live up to their potential and be happy and healthy," Hoffman said.

Kressin became interested in specializing when, in the mid 1990s, he handled a patient with a very unusual tumor that he wanted to refer to a specialist. He sought help at a veterinary school and learned there was no one specializing in the area for which he sought help. "That turned on the light bulb to that niche," Kressin said. He took the training to become a specialist. Today, there are just four veterinarian dental specialists in Wisconsin that do what Kressin does. Other veterinarians call on Kressin and the three others when they need work done that is beyond their scope of expertise. Kressin treats patients in Oshkosh, Green Bay, Milwaukee and Minneapolis.

Randall sat quietly in his carrier watching the activity in the next room where Taylor was having surgery. The fracture had made it difficult for the Pug to chew her food. Kressin had removed teeth from the fracture line earlier before bonding the splint to her jaw. The tooth removal promoted healing of the fracture, he said. "The splint creates stability. It's made of a temporary bonding material that is used in human dentistry," Kressin said. On this day his task was to remove the splint and wires holding it in place. It was precise and painstaking work that required a number of different tools.

"It's very rewarding doing this work," Kressin said. "Patients do extremely well really fast."

Procedures are oftentimes costly and Kressin is aware not all pet owner can afford it. He tries to give them a few options so people can make a good choice, he said. Dawn Wood of Wisconsin Rapids is the Pug's owner. "Dr. Kressin is the rock star of animal dentistry. I wanted the best for Taylor," Wood said. Wood did some research and was impressed with Kressin's credentials. "He's an international consultant with offices in Minnesota and Wisconsin. We are lucky to have such an expert." Like Hoffman and Clark, Wood had no qualms about dropping big bucks for her dog's care. "She is 12 but small dogs can live to be 17 or 20. She is part of our family."

Kressin's favorite advice for pet owners who want to avoid costly treatment is to brush their pets' teeth. "It gives you a chance to look in their mouth and notice problems so you can get help early," he said.

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