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AF dentist, Army veterinarian team up for K-9 root canal in AOR

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U.S. Air Force Lt. Col. Brent Waldman (right), the Medical Operations Flight commander assigned to the 386th Expeditionary Medical Group, retrieves dental tools during a root canal procedure on a military working dog at an undisclosed location in Southwest Asia, Wednesday, Aug. 30, 2017. Waldman, an Air Force dentist, worked with a team of Army and Air Force veterinary and medical technicians to provide treatment to the military working dog. (U.S. Air Force photo by Tech. Sgt. Jonathan Hehnly)

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U.S. Army Pfc. Landon Kelsey (right), a military working dog handler assigned to the 1st Armored Division, places his hand on his military working dog, Arthur, as U.S. Air Force Lt. Col. Brent Waldman (left), the Medical Operations Flight commander assigned to the 386th Expeditionary Medical Group, performs a root canal procedure on the MWD at an undisclosed location in Southwest Asia, Wednesday, Aug. 30, 2017. The military working dog received a root canal to prevent infection after it recently broke a tooth during controlled aggression training. (U.S. Air Force photo by Tech. Sgt. Jonathan Hehnly)

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U.S. Army Capt. Margot Boucher (left), Officer-in-Charge of the base Veterinary Treatment Facility, 358th Medical Detachment, veterinary service support, observes U.S. Air Force Lt. Col. Brent Waldman (center), the Medical Operations Flight commander assigned to the 386th Expeditionary Medical Group, as he performs a root canal procedure on a military working dog at an undisclosed location in Southwest Asia, Wednesday, Aug. 30, 2017. Waldman, an Air Force dentist, worked with the Army's veterinary clinic to provide the medical treatment to the military working dog. (U.S. Air Force photo by Tech. Sgt. Jonathan Hehnly)

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U.S. Air Force Lt. Col. Brent Waldman, the Medical Operations Flight commander assigned to the 386th Expeditionary Medical Group, performs a root canal procedure on a military working dog at an undisclosed location in Southwest Asia, Wednesday, Aug. 30, 2017. Waldman, an Air Force dentist, worked with the Army's veterinary clinic to provide the medical treatment to the military working dog. (U.S. Air Force photo by Tech. Sgt. Jonathan Hehnly)

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U.S. Army Capt. Margot Boucher (left), Officer-in-Charge of the base Veterinary Treatment Facility, 358th Medical Detachment, veterinary service support, monitors the heartbeat of a military working dog as U.S. Air Force Lt. Col. Brent Waldman (center), the Medical Operations Flight commander assigned to the 386th Expeditionary Medical Group, performs a root canal procedure at an undisclosed location in Southwest Asia, Wednesday, Aug. 30, 2017. Waldman, an Air Force dentist, worked with the Army's veterinary clinic to provide the medical treatment to the military working dog. (U.S. Air Force photo by Tech. Sgt. Jonathan Hehnly)

SOUTHWEST ASIA --

In a deployed environment, adequate medical care is crucial to ensuring that people can execute the mission. Our airmen need to be physically and mentally healthy or the mission could suffer. The 386th Expeditionary Medical Group boasts a medical clinic, physical therapist, mental health team and dental clinic as just some of the available services paramount to keeping our airmen mission ready, and in the fight.

 But what do you do when an airman needs medical attention and isn’t a person?

This was a riddle that Army Capt. Margot Boucher, Officer-in-Charge of the base Veterinary Treatment Facility had to solve recently when military working dog Arthur, a military asset valued at almost $200K, was brought to her clinic with a fractured tooth.

“Arthur was doing bite training, bit the wrong way and tore part of his canine tooth off, so he had a fracture to the gum line on one of his strong biting teeth,” explained Boucher, a doctor of veterinary medicine with the 358th Medical Detachment here. “The big concern with that, in addition to being a painful condition, is that they can become infected if bacteria were to travel down the tooth canal.”

Boucher, a reservist deployed from the 993rd Medical Detachment of Fitzsimons Army Reserve Center in Aroura, Colorado, is employed as an emergency room veterinarian as a civilian. While she is well-versed in the medical side of veterinary medicine, she knew she wasn’t an expert in veterinary dentistry. In order to get Arthur the care he needed, Boucher reached out to her Air Force counterparts here at the 386th Expeditionary Medical Group for help.

“In this environment, I’m kind of all they’ve got,” said Air Force Lt. Col. Brent Waldman, the 386th Medical Operations Flight Commander and dentist here. “I’ve done four or five of these on dogs, but I don’t do these often. I felt very comfortable doing it, because dentistry on a human tooth versus a dog tooth is kind of the same, if you know the internal anatomy of the tooth.”

Waldman performed a root canal on Arthur, a Belgian Malinois. This procedure involved drilling into the tooth and removing soft tissues, such as nerves and blood vessels, to hollow the tooth out, according to Waldman. After the tooth was hollowed out, and a canal was created, it was filled and sealed with a silver filling. The procedure for Arthur was the same that Waldman would do on a human patient.

“The reason why you do a root canal is because the likelihood of there being an infection or other issue with that tooth is significantly decreased,” said Waldman, who is deployed from the 21st Medical Squadron at Peterson Air Force Base, Colorado. “This is crucial for a military working dog because without his teeth, Arthur may be removed from duty.”

Military working dogs are trained to detect and perform patrol missions. The patrol missions can involve biting a suspect to detain them or protect their handler. This is why dental health is crucial to a military working dog.

“Those canine teeth are their main defensive and offensive tools,” said Waldman. “A dog with bad teeth…It’s like a sniper having a broken trigger finger.”

While Waldman had experience doing dental procedures on military working dogs, he still needed the expertise Boucher had in veterinary medicine.

“Typically when we collaborate with human providers, we’ll still manage the anesthesia and the medical side of the procedure,” said Boucher, who has four years of experience as a vet. “Usually if they are unfamiliar with the anatomical differences we’ll talk them through that and familiarize them with the differences between animal and human anatomy, but in terms of dentistry, it’s very similar. The procedure is the same, but the tooth is shaped a little differently.”

Prior to the procedure, Boucher conducted pre-anesthetic blood tests to make sure 6-year-old Arthur didn’t have any pre-existing conditions that anesthesia would complicate. During the root canal, Boucher watched Arthur closely, and monitored his heart rate, and blood oxygen saturation while making minor adjustments to his sedation as needed.

The procedure was successful, and Arthur returned to his deployed location with his handler a few days after. Were it not for the inter-service and inter-discipline teamwork of Boucher and Waldman, Arthur and his handler may have had to travel back to the United States to get the medical care needed.

“It’s a great service to be able to do,” said Waldman. “If we couldn’t do this, Arthur and his handler would have probably had to be taken out of theater, to a location where they had the capability to do this procedure. It saved a ton of time to be able to do this here, and get Arthur back to protecting our war fighters.”