Anthony Caiafa has university degrees in both veterinary science and human dentistry. He is a highly regarded veterinary dentist and one of only a handful of practicing human and veterinary dentists in the world. His hope is to improve dental skills in the veterinary profession. “The biggest challenge is to get universities to change their curriculum to include more dentistry training in the undergraduate vet course. Vets are not yet graduating to the point where they’re safe in dentistry. My goal is to increase the level of knowledge of vets and to try to get the profession to be better at what they do in the oral cavity.”
In 1978, when Caiafa graduated from the University of Melbourne with a vet degree, dentistry was far from his mind. In fact, as veterinary dentistry was not taught in the undergraduate curriculum, very few vets at that time had knowledge of dental disease or how to treat it. Instead, he embarked on a career in small animal practice.
A few years after graduating, he bought a practice in Rosebud on the Mornington Peninsula, where he and his wife, Alison – also a vet – lived and worked at the clinic. After-hours clinics were yet to appear so, working 24/7, constantly on-call, was par for the course. And with few specialist clinics around, veterinary practitioners had to deal with all kinds of surgeries including orthopaedics.
While working in general practice, Caiafa developed an interest in small animal surgery. Under a scheme that gave rise to the Practitioners in Residence program set up by the Melbourne Metropolitan Practitioners Branch of the AVA, Caiafa attended the University of Melbourne to further his interest and skills in surgery. For one year, on his day off from clinical practice, he drove 180km to Werribee to learn and assist on small animal surgeries. In 1992, he sat Membership exams in Small Animal Surgery. The following year he sat Membership exams in Veterinary Dentistry.
The decision to return to university to study human dentistry was a pragmatic one. “After more than ten years of fairly constant on-call and after-hours work, I knew I couldn’t sustain it for the rest of my life. So, I took a deviation in my career.”
His interest in dentistry was sparked and encouraged by a dentist friend who occasionally helped on animal patients. Caiafa recognized a need for more veterinary dentists, but the demand was quite low in the 1990s. Specializing in veterinary dentistry would also require a residency in the USA. Studying human dentistry, however, would ensure good work prospects as he could work either as a dentist or a vet (or both), there would be no after hours as a dentist, and he could also apply his newfound knowledge on his animal patients.
At 38 years of age, he enrolled in the University of Melbourne dental school, graduating in 1998 as dux of his class. After graduation he worked in a dental practice in Rosebud, ironically just down the road from his first vet clinic, which led to a few interesting encounters with former clients. A few years later he bought a dental practice in Melbourne where he worked for the next seven years.
Caiafa’s goal was never to switch professions. “The main reason I studied dentistry was to learn more about vet dentistry.” While studying dentistry at university, he began treating dental disease in animals at the university vet school, a practice he continued once a week on a teaching and referral basis when he returned to Melbourne. “A lot of what we do in veterinary dentistry comes from what we do in human dentistry.”
Of human dental practice, Caiafa found his veterinary experience came in handy when working in school dentistry. “You have to try to read the symptoms as you can’t rely on the kids’ answers. In that way treating kids is similar to assessing, diagnosing and treating pets.” And like animals, kids can bite.
By the time Caiafa moved to Queensland’s Sunshine Coast in 2008, veterinary dentistry was gaining momentum. Although he continued working in human dental practice, he began consulting at North Coast Veterinary Specialists and at private practices. In 2010 he was offered a role as Adjunct Professor at James Cook University, teaching veterinary dentistry to vet students – a position he still enjoys. Over the past decade he has become firmly established and recognized in the veterinary dental world. He is a former President of the Australian Veterinary Dental Society, conducts workshops for IM3 and corporate vet practices and travels extensively around the globe giving lectures, workshops, and webinars.
Caiafa’s achievements extend beyond the academic realm. An athlete all his life he has competed in five Ironman events, two in the prestigious Hawaii Ironman competition, where competitors swim 3.8km, cycle 180km and run a 42.2km marathon. As a triathlete, he represented Australia in the 2006 NZ Olympic distance triathlon. “But my wife is more impressive,” he says. “Alison has competed in ten Ironman events, four of them in Hawaii.”
Working in both the human and veterinary dental fields provides Caiafa unique insights into the challenges faced by both. “The biggest challenge human dentists face is fear and anxiety from the public which is usually driven by misinformation or from personal experience, often from childhood. Treatments aren’t painful any more but it’s a process to desensitize clients. The challenge in vet dentistry is that oral pathology is picked up quite late or missed altogether.” Animals are better at handling and hiding pain, but Caiafa believes vets often overlook performing a thorough oral examination.
Other common mistakes vets make with regards to animal dental health is to miss pathology that may not be visually obvious. “Take X-rays,” he says. “Also, discuss treatment options with clients.” Is an extraction or a root canal filling a better solution? Should you refer the case?”
“Finally, vets need to plan, to have better time management. Don’t rush in. Sometimes it’s better to stage procedures.” He advises performing diagnostics and devising a plan before beginning treatment. “Dentistry is usually performed on older animals that often have co-morbidities. Two short anaesthetics are better than a four-to-five-hour GA.”
Dental prophylaxis is also crucial. “Advise clients to start active home care from six to eight weeks of age. I wipe hexarinse on my cats’ teeth every second day. Start young and get them used to it. Use hexarinse or brush teeth every day if possible but no worse than every second day.”
Caiafa has worked in the mouths of several species including primates, crocodiles, lions, and tigers. At Lionsrock Big Cat Sanctuary in South Africa, he assisted with dental work on rescued lions, tigers and wild dogs. “We mainly performed root canal fillings but also a few extractions.” Considering the root of a lion’s canine tooth is approx. 10cm long, extractions can be lengthy, difficult, and laborious.
In 2022, Caiafa will travel to Malaysian Borneo with animal charity, Animal Assist, to perform dental surgery on sun bears rescued from the bear bile trade. Sun bears used in this cruel trade often have badly damaged teeth where handlers have roughly hacked off crowns to prevent bites and attacks. The bears are in constant pain. Preparation for the project will take quite a deal of organization especially as the extent of dental disease won’t be known until the animals are anaesthetised. IM3 is supplying dental X-ray equipment but power equipment and specialized instruments will need to be transported from Australia. “We might need more than one vet working in the mouth at one time. It won’t be easy but hopefully we can make a difference.”
Caiafa’s charitable work extends to the Noosa RSPCA where he does pro bono dentistry on shelter animals. “If I can put something back into the profession, or help others with dentistry, I want to do it. I don’t like to see animals suffer needlessly for something that can be corrected.”
For more information, visit www.mobilepetdentistry.com.au.
Olivia Pozzan