Dr. Kenneth M. Capron
He’s the kind of veterinarian who makes your pet smile—a glistening, pretty smile at that.
But make no mistake, Dr. Kenneth M. Capron is serious about his work as a board certified veterinary dental specialist, and he has many titles, letters and awards behind his name to prove it.
“It is just a great feeling of success when you can help something, such as an animal, that cannot help itself. I receive my highest satisfaction when I help law enforcement dogs get back to ‘duty.’ They ‘can do’ what man ‘cannot do’—sniffing out drugs and tracking down ‘bad folks’ with their noses. They cannot do it with malodor coming from their mouths and bad teeth—it decreases and blocks their ability to smell,” Capron said.
In 1994, Capron was president of the American Veterinary Dental Society and founded National Pet Dental Health Month (Campaign), which is observed yearly in February and has since become a worldwide campaign celebrated at different times of the year. It is a campaign to encourage veterinarians and pet owners to “Flip the Lip” of their pets and look for abnormalities in the mouth, whether it be periodontal disease, fractured teeth, oral tumors, orthodontic misalignment of teeth, fractured maxillas (upper jaws), fractured mandibles (lower jaws), sympysis separations, especially in cats (left and right mandibular separation), gingivitis, stomatitis and tooth resorptive lesion.
The most common problem in dogs and cats is periodontal disease. Research has shown that by age 3, 80 percent of dogs and 70 percent of cats have some form of periodontal disease, whether it be early gingivitis or severe periodontal disease. This disease can progress to deep pockets in the gingival sulcus of the teeth, leading to loss of the surrounding bone, and, ultimately, loss of teeth caused by the infection. Periodontal disease is inflammation of the gingiva and periodontium (gingiva, periodontal ligament, cementum and osseous bone) and is caused by gram negative anaerobic bacteria (the type that lives without oxygen below the gums).
It is recommended to start having your pet’s teeth professional cleaned and polished by your veterinarian between 2 and 3 years of age and yearly after. In cases of older pets, where the disease has already started, they may need to have their teeth cleaned more than once a year, and once the problems are addressed and taken care of properly, it may be possible to return to the once a year schedule. Home care by the pet owner, after the professional cleaning, polishing, intra oral dental X-rays and assessment by your veterinarian, is of utmost importance. Brushing the teeth is the “gold standard” (same as for people), and every day would be great, but no less than every other day, in order to prevent the bio film (plaque) from forming into calculus and tartar (the hard yellow brown deposit on the teeth at the gingival margins). It is impossible to be brushed away by the time it reaches that stage of the process of periodontal disease.
Periodontal disease can affect the internal organs (liver, kidneys, lungs), and toxins excreted by the bacteria causing the periodontal disease can cause seizures, which can be fatal. The smaller the pet or older, the faster and more severe the problem can occur. A number of commercial products are available and have been through rigorous testing by the VOHC (Veterinary Oral Health Council), which is similar to the human ADA (American Dental Society). When a pet owner purchases a product for home care of the pet’s mouth, he or she should look for the VOHC seal of approval, because that product has research and testing behind it. The VOHC website and many of the Veterinary Dental web sites can be reached through Capron’s sites: www.CapronVetHospital.com or www.AnimalDentalClinicofTulsa.com.
If a product is too hard for you to bite down on with your own teeth, do not feed it to your pet. It will break teeth or sliver down the tooth, cutting the periodontal ligament and starting the process of periodontal disease. So, no pigs ears, cows hoofs, hard bones, large knotted chews, hollow bones that you stuff with goodies, no chicken jerky or duck jerky. Salmonella bacteria have also been found in them and can be transmitted to man and animal alike.
Common signs of periodontal disease are malodor (stinky breath), pawing at the face, rubbing the face on the carpet or door jams, inflamed and reddened gingival margins, bleeding from the mouth, food falling out of the mouth with a whimpering sound, or not eating at all and weight loss. The power of observation by the pet owner at home, in the pet’s own environment, is very important in order to catch problems early. The longer a problem exists, the more time and effort is required to correct the problem.
Dental X-rays (intra oral radiographs) are “a must” when diagnosing dental problems. The battle against periodontal disease is won—or lost—below the gums (gingiva) and is prevented or treated by doing sub gingival cleaning and polishing, or even employing more advanced techniques. The problems are identified by measuring and charting the depths of the periodontal pockets and the diagnostic information from intra oral X-rays. If periodontal disease is caught early, then many times the problem can be treated with medications and other methods, such as laser therapy and antibiotic gel placement into the deep pockets, while the pet is under isoflurane gas anesthesia.
Many times, slightly mobile (loose) teeth can be saved by doing surgical soft tissue flaps and artificial bone placement around the tooth. The tissue is sutured and a splint device is placed on the tooth and to adjoining teeth to immobilize the movement while the new bone becomes more stable.
If a pet’s mouth has not been examined regularly, hopeless teeth have to be extracted and artificial bone must be placed back into the boney socket and the gingival (gum) sutured. After the gum heals, the replacement bone placed into the boney socket gives support to the area where the roots used to be. In a couple of months, it will give a good biting surface, and pets can “gum their food” fairly well. “I have a few dogs—and several cats— that are running around town that do not have a tooth to their name (in their mouth) and they are eating canned food or dry food that has been moistened with a hot water soak before presenting the meal to them,” Capron said. “These drastic oral surgical procedures are avoidable if you take pet dental health seriously.”
“Kittens normally have 26 deciduous teeth, and adult cats have 30 permanent teeth. Puppies normally have 28 deciduous, and adult dogs have 42 permanent teeth. I have found up to as many as 51 adult teeth on a dog. The areas of missing teeth in the mouth need to be X-rayed, looking for abnormal development of the permanent tooth. Teeth that never erupted can cause problems later in life, such as dentigerous cystic caverns in the bone. This problem needs to be ruled out or identified as genetic inherited missing teeth.
Kitten’s deciduous (baby) teeth begin to erupt at 2 to 3 weeks of age, and their permanent teeth begin to erupt at 3 to 4 months of age.
“Puppy’s deciduous (baby) teeth begin to erupt at 3 to 5 weeks of age, and their permanent teeth begin to erupt at 3 to 5 months of age. Both cats and dogs vary somewhat by their breed, size and genetic background, just like in people, practically the only difference is that they walk on all four legs, and we (as people) walk on two legs.
“A few of the veterinary dentists on the East and West Coasts have tried placing implants with artificial tooth pontics, but this has not been very successful due to the fact that when we see the animal, and the tooth is so loose, the bone is almost eaten up with infection, and the strength of the metal implant is designed for man and not the power of a dog’s mouth.
“Other problems found upon doing an intra oral dental examination and assessment would be fractured teeth, non-vital (dead and discolored) teeth, resorptive lesions on pet’s teeth, especially found in cats, misalignment of teeth causing soft tissue trauma (orthodontic problems) and adding to the problem of periodontal disease.
“Orthodontics in veterinary medicine is performed mainly to correct the function of the mouth and to realign the teeth rather than for cosmetic appearance as done in human medicine and dentistry. Interceptive orthodontics is performed on young pets when they still have their deciduous (temporary, baby or milk) teeth. There should never be two teeth of the same type in the same alveolar socket at the same time. I see this many times in both the canine and feline (dog and cat) species, and if not corrected early, then when the permanent teeth erupt, they will be out of their normal position (misalignment).
“Orthodontic appliances can be made to correct adult pets’ problems. Alginate impressions are taken and stone models poured and sent to a dental lab with instructions on what is needed to be manufactured for the pet’s problem. When the appliance is received back from the dental lab, the pet is put back under gas anesthesia, and the appliance is cemented into place. Usually, orthodontic problems in dogs and cats can be corrected much faster than their human counterpart.”
Metal braces with rubber bands, which Capron designs, can help dogs with “bite” problems and aren’t just for cosmetic purposes, but for function. Fractured teeth are treated by performing endodontic procedures, such as indirect pulp capping, direct pulp capping (if performed within 24 to 48 hours from the time of injury) or root canal procedures if non-vital teeth are presented. Light cure composite restorative material is placed over access holes or fracture sites. Stainless steel metal crowns are highly recommended to be placed over the finished tooth in order to further protect the dental restorative work completed. Follow up intra oral X-rays should be performed yearly for about three years after an endodontic procedure is used to check the success.
Capron performs root canal procedures using battery-operated hand held light speed hand pieces with files that look like drill bits. Dental implants for animals aren’t yet standard because of dogs’ chewing on hard objects. “Our patients don’t have the power to follow instructions and reason,” he said.
“Ceramic-type of crowns can be used in dogs, but remember we are dealing with a patient that does not have the ‘power to reason,’ and you can tell a human not to chew on a hard piece of candy or ‘do not bite down on a steak bone’ (as in human dentistry), but the pet goes outside and chews on the fence instead or picks up a piece of firewood and carries it across the back yard—and shatters the ceramic crown—kind of like dropping a heavy metal soup spoon into a porcelain sink in the kitchen. So, for that reason, I recommend the stainless steel metal crowns on large dogs, but if you have a small dog that is very mindful, then it may work—‘may,’ that is.”
Recently, “Yari,” an 88-lb. German Shepherd police dog from Fayetteville, Arkansas, was in the Capron Veterinary Hospital & Animal Dental Clinic of Tulsa to have some restoration work done on one of his canine teeth.
Eight-year old “Yari” has been a patient since 2005 and had four stainless steel crowns placed on his four canine teeth. Three years later, he broke off one of the metal crowns during a struggle with a Bullmastiff over land rights. The existing tip of the root was restored with light cure composite, but it was too short to put another stainless steel crown back on the root. A surgical crown extension of the root was not feasible in his case.
Recently, he had bitten down on something hard (car trunk or cowboy belt buckle) during an apprehension and broke away the composite restoration, so he was visiting Dr. Capron for another restoration. The sooner it was fixed, the faster he could get back to work (on duty). “He is the type of employee that likes to work 25/8,” Capron said.
“He’s helped us find a lot of dope and bad guys,” said his handler, Sgt. Tion Augustine, with the Washington County Sheriff’s office.
While the doctor listened to the patient’s heart in an extensive pre-operative examination and assessment, “Yari” began to show his softer side, realizing that he and Dr. Capron had met previously. “It’s a V-12 engine in there,” joked Dr. Capron, a former Captain in the United States Air Force Veterinary Corps and a private pilot belonging to the Kansas State University Flying Club while attending veterinary college there.
Of course, he understandingly let “Yari” calm down from his long drive from Arkansas before performing a blood test, general gas anesthesia and intra oral digital radiographs (X-rays). Capron noted the importance of the blood test to detect underlying conditions, such as kidney, liver, pancreatic diseases or heartworms, before administering the anesthesia. Undiagnosed problems can have fatal results when a pet is under anesthesia, just like in people.
The extensive exam and lab work performed on “Yari” eased the anxiety of Sgt. Augustine. But not to fear, as always, Capron had it under control. “It’s all about paying attention to detail,” the officer said. “You’ve got to ‘flip the lip’ and pay attention to what your eyes are telling you.”
But back in the examination room, “Yari’s” eyes were beginning to droop from the pre-anesthesia medication, showing he was relaxed enough to begin his procedure.
General anesthesia was administered and “Yari” was transported to the dental suite.
Capron cleaned and polished “Yari’s” teeth while the dog was under isoflurane gas anesthesia; Capron took intra oral digital X-rays, (checking the remaining 3 stainless steel metal crowns and then replacing the damaged restoration. The doctor may need to perform a laser treatment for gingivitis).
After the successful, nearly three-hour procedure, the dog was walking within 20 minutes. Sgt. Augustine said “Yari” will be back to putting the bite on crime within no time.
Capron’s office—consisting of a dental suite, surgical room, treatment room, X-ray room, laboratory, four examination rooms and a couple of offices—offers various treatments (periodontics, endodontics, orthodontics, restorations, crowns, oral surgery, intra oral digital radiology and digital laser therapy) with state-of –the art dental and surgical equipment. A spacious backyard allows the pet patients to stretch and exercise their legs before and after surgical and dental procedures.
Dr. Capron uses a digital camera to document procedures; this allows him to show pet owners the entire process, easing any lingering anxiety, and they can understand the before and after aspects of the case. An intra oral digital X-ray sensor is used inside the mouth and X-rays are produced within 10 seconds. A back-up hand held X-ray gun is available for portable work.
Any oral tumors are surgically removed and sent overnight to the Oklahoma State University Diagnostic Lab where board certified veterinary pathologists view and fax back results within 5 days. Within two weeks, they also send back to him a microscopic slide of the tissue that was sent over to the OSU Diagnostic Lab. Capron has 26 years of slides—as long as he has been performing advanced dentistry. In the laboratory, he has a digital camera on a triocular microscope that can take digital pictures of the tissue, and also he can project the tissue slide on a large overhead monitor for teaching purposes to inform veterinary assistants, technicians and other veterinarians.
“Most importantly,” Capron said, “if you are not using a dental X-ray machine and doing intra oral radiographs, you cannot perform the advanced dental services that are needed on pets—only dental hygiene.”
Another high-tech piece of equipment is the cold laser therapy machine, used to treat pulled muscles, torn cruciate ligaments, ear infections, hip dysplasia, degenerative joints and arthritis, and it aids the healing process of periodontal disease after doing intra oral surgery. Laser therapy can be used on outpatients or awake/conscious pets, as well. Dr. Capron moves the laser over the target area, and the pets relax, responding to it as if they were receiving a good massage. Pain relief follows after just a few minutes of therapy. A similar device is used on people.
“About two-thirds of my business is dental and one-third general small animal practice,” Capron said, who calls himself “just a country boy,” who became one of 114 veterinarians in the world to go through the rigorous training and testing process to become a board certified veterinary dentist. He was president of the American Veterinary Dental College in 2002-2004. Recently, at the Veterinary Dental Forum held in Boston, he was elected the president elect of the Academy of Veterinary Dentistry.
Dr. Capron’s wife, Beverly, works chair-side with him on the dental patients, along with other veterinary assistants. One of Capron and Beverly’s sons, Dr. Steven D. Capron, is a graduate of Oklahoma State University College of Veterinary Medicine and is a Fellow of the Academy of Veterinary Dentistry. He has a 100 percent veterinary dental practice in Austin, Texas. Together, they were the first “Father & Son” members of the Academy of Veterinary Dentistry.
Back to the animals, it’s not just the humongous dogs like “Yari” that Capron treats. He also works on cats and tiny dogs, such as a 2-lb. Yorkie named “Toots.” He showed X-rays of “Rosita,” a 12-year-old 2-lb rescued Chihuahua on whom he has extracted all of her teeth—or what was left of them after years of neglect and gum disease. The dog put on a full pound about 6 months after the oral surgical procedures. “The new owner is one of the most responsible people I have ever known, and the lady with the 2-lb. Yorkie is another one, and both ladies have been clients of mine for about 35 years,” Capron says. Stories like these serve as proof that attention to dental health in pets makes a difference in their overall health and quality of life.
