Transcript

Krysten Bennett: We invited you on the show today to talk about your sessions at the 2024 Midwest Veterinary Conference. But before we get into that, we’re going to begin with some introductions. Now, you both practice at Veterinary Dentistry and Oral Surgery of Ohio, which I believe is just a hop, skip and a jump away from OVMA, right? Don’t you have an office in Powell?

Jamie Berning: We are actually located in the Linworth area currently, and then we recently purchased a new building that is in Hilliard. And we will be relocating shortly after the first of the year. So that should be really exciting too.

KB: So business is good.

Jamie Berning: Business is good!

KB: So, Dr. Berning, let’s start with you. You are one of fewer than 200 AVDC-certified veterinarians in the U.S. Can you tell us a little bit about how your path led you to veterinary dentistry?

Jamie Berning: Sure. Absolutely. This was not at all in my plans. And I was that student in class who sat there fully expecting that I would end up working with pigs and only pigs for the rest of my life. So anytime somebody came in to talk to us and tell us their path did not lead them where they thought they’d go, I thought to myself, “Well, I know where I’m going to go, so I wish they’d stop saying these things to us.” But I listened to all those people, and now I am those people. 

I decided that after graduation I had applied for a job working with just pigs down in the Carolinas. I was married at the time and my then-husband had asked me if I would be happy if he was if he got deployed, if I would be happy on my own, done in the Carolinas because he’s in the military. And I said I would not. So we ended up buying a beautiful home on a lake in Michigan a mile down the street from my parents. I blindly mailed out cover letters and resumes to small animal general practices, and I landed myself a job as a small animal veterinarian at a school, instead of pigs, like I thought I would do.

So shortly into my career, with my dad, having been a human dentist, I got him to give me his hand dip X-ray tank and convinced my bosses to purchase a used warm generator from a local human dentist who was retiring. And our technicians has been mounted on the wall. And there I was starting dentistry and I was super excited to be doing so, but had no idea what I was doing and no idea what to do with the things I was seeing.

So I took a radiograph of a Labrador retriever who had a retained tooth root of a mandibular incisor tooth, which is just a tiny little tooth on the bottom. And it was retained tooth route and I didn’t know what to do because nobody had ever taught me dentistry and nobody had taught me what to do. If I found something on those radiographs that I didn’t know what to do with. So I called the owners and I told them, “You’re going to need to go to a veterinary dentist.” And so they did. They took my recommendation and they went to a veterinary dentist.

I asked if I could shadow for the day, so I went along and watched the case and I was at that point in time training with a veterinary dentist. Her name is Dr. Ruth Barthel, and she’s out of Lake Michigan. And so she asked me if I wanted to start coming back every Friday. And so I did. I had Fridays off at the time, so I started going back every Friday. She eventually asked me to do a training program under her, and that was to the Academy of Veterinary Dentistry, which no longer exists. That program went away within a couple of months of me signing up for it. I was probably the last person to ever sign up for that program. Then it completely dissolved and my options were do nothing or do a full residency with the veteran dental college. And so I decided to do a full residency, not completely knowing what I was getting myself into.

But I love dentistry and I loved everything about dentistry, so I decided that that would be the best route for me. So having had my dad and my brother as human dentists, I do think you have to be just a little bit crazy to love dentistry. And I do think it’s probably genetic, but I definitely have the genes for it.

So here I am and I couldn’t at this point imagine doing anything else. They absolutely love what I do and I really have the pleasure of teaching dentistry the way that I wish the dentistry would have been taught to me. I had to learn a lot when I started that residency, not really knowing what I was getting myself into. So I teach dentistry starting with the most foundational stuff first, because that’s where I was even multiple years into my general practice career.

KB: I’m curious, it sounds like veterinary dentistry isn’t covered in vet school? And you can’t be that far out of that school, but I would hope that it would have changed since then. Do you have any insight on that? 

Jamie Berning: So I graduated in 2011—which feels like it was just yesterday, but as it turns out, the calendar tells me differently. And so I’ve been out a little while now, but just in the last few years, actually, the AVMA started to require that dentistry is now taught in veterinary schools. So that’s just in the past few years it’s been since we’ve been open here. So it’s been since maybe 2021. 

And that’s crazy and incredible to me because there are veterinarians out there doing dentistry every day that never learned how to do dentistry. And so they’re just doing the best they can and everybody’s out there doing their best, but they didn’t learn it in school. And so if they want to know it, they have to go seek an alternate route for that information.

But yeah, that that has recently changed, but it’s still not being taught by dentists. So every other specialty is being taught by specialists in those fields. And the universities are teaching dentistry with general practitioners, and it’s the best that many of those universities can do, but it’s still not up to where it needs to be.

Mia Cunningham: Well, Dr. Berning, we’re going to assume that you’ve seen quite a few cats and dogs as patients, but we also understand that you have relationships with several zoos across the country and have seen exotic animals as well. And it sounds like really exciting, but also like terrifying because I think I saw a photograph of you with a gorilla? So I am just curious, like, can you give us an indication of your most memorable patient?

Jamie Berning: Yeah, that’s a great question. So we do a lot of zoo dentistry at least every month. We have multiple cases and we do those both locally here with the Columbus Zoo. We work with them primarily and then we also work very closely with Zoo Miami down in Florida, where we do dental weeks a couple of times a year and go down and kind of do three or four cases a day.

So we’ve done and seen a lot of different things, everything ranging from orthodontic work in some of these patients to oral tumors or cancers. I would say that one of the most memorable cases that I ever did was a lion at the Columbus Zoo, where I saw a very small lesion in the mouth when I was extracting an upper fourth molar tooth, which by the way, is quite large and I took a biopsy of that and we were able to diagnose this lion with a fungal infection that we were able to then treat. And he had been having some ocular discharge that was hemorrhagic. So he had some bleeding kind of coming from his eye. And we were able to get that under control by figuring out what the actual cause was and getting in and treating him systemically and locally with some antifungals. And that was a nice collaborative approach. We worked with the internist from OSU on that one as well, and that’s probably one of the most memorable cases because we were able to make such a huge difference in his quality of life.

MC: So for those civilians like myself, can you just give me an idea of how large the tooth was?

Jamie Berning: Probably a few inches. The roots were a few inches. So that’s not the the crowns that big, the, you know, the razor. Another couple we were doing on a root canal on a bear last week. And just the files that we needed to be using are ten centimeters, so…

MC: I love how blasé she is about working on a bear.

KB: I know! Like, she’s demonstrating with her fingers, “It’s this big—but, oh, but that’s just the roots there’s more on top!” (Laughs) Well. You are you guys are brave. Okay. So thank you for that. 

Jill, let’s move on to you. You began your career in 2013, but earned your dentistry credential a few years ago. And from what I understand, that’s a pretty rigorous process. So can you tell us about your background and what led you to pursue this certification? 

Jill Bates: I was in general practice, so I got to do pretty much everything, but I didn’t know exactly what I wanted to do at the time. I had a doctor I worked with back then that really liked dentistry. I kind of was on the border of, “Do I go to vet school or do I stay working as a technician?”I really loved what I got to do as a technician. I really enjoyed doing the dentistry aspects, so I looked into very vaguely what it all entailed. I thought, “Let’s just jump in and do this.” The disclaimer was I needed to essentially get all my cases with a boarded dentist, and at the time there was no boarded dentist when I started. 

I then left that general practice and I actually went to the university and one of the doctors I worked with at the university was like, “You should reach out to Dr. Berning. She’s moving back from Michigan to back to Ohio.” So I blindly reached out to her and was like, “Hey, I’m thinking about credentialing as a registered technician in dentistry. Could I come and see cases with you?” And she was like, “Yeah, sure.”  And started seeing cases with her. I started that in about 2018, when she was still finishing her residency. I would leave the university to go get my cases and then go back, and obviously I was a full-time employee there at the time for about a year and a half. So we joke that I had a year and a half working interview before she hired me to join her mobile practice.

She passed her boards and hired me in the same week. So that was very exciting for both of us. Then I became a part of her team when we were still traveling, and I can’t think of any other career that I essentially would love to be in. It was a very rigorous tracking period. We have to get, you know, a certain amount of cases in each specialty of dentistry.

So at the time, you know, we were traveling and she would call me up and be like, “Hey, we have this orthodontic case. Are you able to come?” And I’m like, “Of course, let me see what I can do.” 

So I submitted my packet. My packet was accepted on the first try, which is it’s very challenging. Then I sat for a board that following year and passed both my written in my practical, my first time and our pass rate is about 37% I think it was this year. So it was very challenging, just like the VTS exam, so I’m pretty proud of that. 

After that we kind of became the dynamic duo. And when COVID hit, we decided that we wanted to get our own brick and mortar and then hired, you know, more of a team to proceed with that. But for about two years, we traveled and went into clinics and and got to do a lot of cool cases.

MC: Well, congratulations. That’s quite a story. So I am kind of curious, do you have a background or a familiarity with dentistry in your family as well?

Jill Bates: No, I grew up on a farm in northwest Ohio, so I really had a passion for animals when I was growing up. We had pigs, we had horses. My parents raised a steers for, you know, meat purposes and stuff like that. I always knew I wanted to be in the field, but I didn’t know to what level there was a law in dentistry that technicians could do that I felt versus other specialties. We can, you know, take dental radiographs and, you know, do the cleaning and do the other things. And then I think assisting in the cases and making, you know, the doctors’ lives easier. So on certain aspects, I always found a natural niche. I think I can always for myself, be a few steps ahead of what they need, which I take a lot of pride in enjoying that, knowing what Dr. Berning needs before sometimes she may even know she needs it, which I feel that is very satisfying in my role.

MC: So now this is just a curious question for me, but do animals get braces?

Jamie Berning: So yes, in a way. It’s not in the same conventional sense that you think of in people. So in people, a lot of orthodontics is done for aesthetic purposes, whereas in our animal friends, we are doing orthodontic work for function and comfort. Basically, so that they can have a comfortable functional mouth. Where we might have teeth on the bottom—mandibular canine teeth—the most common malocclusion that we see in our practice would be mandibular canine teeth going into the palate. And that’s obviously painful. So when an animal has teeth that are stabbing into the roof of the mouth, we need to do something about it. So sometimes we can move those teeth. And so putting brackets on is an option.

Usually if you need to move teeth on the top, you can do it on the bottom. But sometimes we need to move canine teeth backwards, so we’ll put buttons or brackets on those and then also buttons and brackets on teeth in the back and move those in the chain. So it’s not the same exact because the spacing of teeth and animals is quite different than the spacing of teeth in people and of the teeth are not touching each other in the same way that they are in people.

So the principles of orthodontic movements are the same, but the concepts need to be applied a little bit differently because we need to take into consideration that our dog friends and our cat friends occasionally when we’re doing that, are not actually going to be compliant necessarily when they go home and they’re going to still need to be doing whatever it is that dogs and cats do with their mouths and they’re not going to just follow every instruction and be, you know, taking care of the same kind of way.

So the answer is yes, kind of. We can put chains and brackets on. We also do other orthodontic treatments in order to end up with a comfortable functional occlusion, which is our purpose when we’re treating any kind of orthodontic work in our patients.

KB: Wow. I had braces in middle school and I just I feel bad for my poor mother having to take me to these orthodontist appointments and listen to me whining about it. Having to do that to a dog or cat just sounds impossible.

Jamie Berning: It’s rare in cats. I have done a handful of cases in cats, but it’s much more common in dogs. And even so, though, we do have to very carefully select our clients and our patients that are going to be the candidates to have orthodontic work done if we’re actually doing what we call active orthodontic work, where that’s where we’re moving teeth.

So if we’re opting to move teeth, then we have to have clients that are going to come back for those rejects, like your mom had to take you to the orthodontist. We have to have the clients that are going to come back. We have to have the patients that aren’t going to go home and destroy everything that we’ve just put in their mouth under anesthesia, because in order to put it back on, they have to go back under anesthesia. So we we definitely carefully select those cases, but we absolutely can move teeth.

KB: Well, as if voluntarily sticking your fingers into animals mouths wasn’t daunting enough, you’re both speaking for two full days at the conference, which I think is very brave. Dr. Berning, you’re speaking in the Pet Animal dentistry track on Thursday, and Jamie, you’re speaking in the technician to track also on Thursday. And then on the following day, you’re tag teaming two wet labs. That’s a lot of ground to cover. So can you just kind of give the briefest of overviews on your Thursday sessions to start with?

Jill Bates: I am going to do oral anatomy, which is really important for the technicians to essentially know what we need to look at. So directional term from the mouth and how many teeth dogs and cats have in all different stages of life. Another one I’m going to talk about I think is my second one is periodontal disease. So what we are essentially looking for signs, symptoms and treatment options that our doctors may be presenting, whether that’s in house or it’s something that they’re going to refer to a specialty clinic like us to essentially have treatment done. And then another one is going to be the fundamentals of doing a prophylactic cleaning. So just a step, some important things to do and not to do. Also talk about ergonomics, posture, things that we should be essentially wearing and using to make that a comfortable procedure for us as the technicians doing that procedure. Another one, I think, is X’s and O’s of oral anatomy. So kind of what we are going to be seeing in the mouth also on Radiograph, I have a prerequisite for the lab that we will be doing so dental radiographs. It’ll go through how to obtain specific angles, talk about bisecting angle and parallel techniques. And then I think the last session I’m doing is the role of the technician. So because we play a vital role for our doctors, what technicians can be doing essentially, and what they should and shouldn’t be doing or, you know, state laws and stuff like that. So kind of finding that that baseline of what we can do to assist our doctors, but where we go from that point and sometimes we may be put into uncomfortable situations and how we can navigate doing things that we are allowed to do.

Jamie Berning: So what I will be covering is a series of lectures that will hopefully give veterinarians confidence going back into their practices. So we’re going to spend a little bit of time talking about indications for extractions. So figuring out when we need to take a tooth out and when that is warranted, as well as figuring out if there’s a tooth in the mouth or teeth in the mouth, that may be a case that would be good for referral.

And then we’re going to actually cover extraction techniques. That’s going to allow veterinarians the opportunity to see some different ways to do some tooth extractions, other than just taking away a lot of bone, which is what a lot of people are used to doing. And I like to teach ways that we can extract teeth in a less painful way to our patients because removal of a lot of bone we know from human dentistry is actually quite painful. So I like to teach a little bit different kind of extraction techniques. Then we’re going to talk about mouth occlusion. So going along with the clues, old stuff that we were just talking about, including orthodontics, we will cover some definitions of malocclusions, treatment options for malocclusion. We’re going to cover some oral tumors that we see in both dogs and cats, treatment options, prognosis and everything that goes along with that.

And then we’re going to be spending some time going through dental x ray interpretation, which is hugely important. And so we’re going to cover some basic oral pathology, common oral pathology that everybody is going to be seeing very frequently in their practice. And then we’re actually going to spend an hour going through tooth resorption in dogs and cats so that everybody becomes familiar with what they’re seeing on those radiographs.

So the goal is to really give everybody the ability to competently and confidently go back to their practices and be able to make decisions in a little bit faster way, because that’s what makes me really efficient and skilled at doing dentistry, is that I know what I’m looking at and I’m able to make decisions about what I’m looking at, and I would love for veterinarians to develop those skills in order to minimize the time that their patients are under anesthesia.

So I’m really excited to be able to share a lot of that information with people. And then we’re going to do an extraction lab as well.

MC: Awesome. So thank you, ladies. Both of those great overviews, and I’m hoping that will really excite people about attending your sessions. And you did mention a lab, so we do want to talk about that a little bit. So on Friday morning, it looks like we’ve got dental radiographic positioning followed by surgical extractions in the afternoon. So ideally, who are the target audiences for each of these labs and is there a specific like skill set that they need to already have coming into the door? What does that look like for participants?

Jill Bates: In the dental radiology lab, we’ll touch on how to get a diagnostic image and if there are complications with different parallel or bisecting angle techniques, how to work on correcting that and getting our doctors a diagnostic image so it would be open for both technicians and doctors.

Jamie Berning: The surgical extraction lab that will be for veterinarians only. So we’ll do a four hour lab where everybody gets some hands on opportunities to really get in there and practice these new and different extraction techniques that will just make their lives easier and better and their patients lives better and easier. While legal in Ohio, technically, for technicians to remove single rooted teeth with direct oversight of a veterinarian, we are actually changing the anatomy of these animals when we are removing teeth. And so it is something that the AVDC or the American Veterinary Dental College feels pretty strongly about having doctors doing that. And so this is a lab that is open to veterinarians in order to learn how to make surgical flaps, because surgical flaps are so important in actually being able to close these extraction sites that we have fewer complications afterwards. And so that’s really important that the doctors are the ones that are doing those things. So my lab opportunity is going to be open to just veterinarians.

MC: Now, will attendees be required to wear anything specific by participating in the lab?

Jamie Berning: For the extraction lab, we would recommend xcrubs because we will be working with cadavers. We’ll be working with cadavers in the radiograph positioning as well. So, scrubs is probably ideal for both.

MC: And will you guys be providing the equipment for everything as well, so they don’t need to bring anything?

Jamie Berning: Yes, the conference is working together with some sponsors to be able to provide everything needed in order to really gain all of the knowledge and information that they need without having to bring anything from home.

KB: No need to shop for dental instruments on Amazon beforehand.

Jamie Berning: That’s right! Though eBay’s a better find than Amazon. And yeah, it still exists! It is 2023, but eBay does still exist.

KB: You mentioned who it’s for, but what about skill levels? Is this more of an introduction or do you need to have some knowledge already?

Jamie Berning: So I would say that the extraction lab is open to veterinarians with all skill sets. So we do a ton of teaching at our practice and we find that we have veterinarians that come here that are just out of school and we have veterinarians that come here that are 20 years into practice and just want to kind of learn some new skills or gain some new knowledge. And everyone gives positive feedback on the things that they’re able to take away because there’s so much to learn about dentistry and there are so many ways to do things maybe just a little bit differently that could really change your life when you’re doing dentistry every single day. 

The radiograph positioning is the same thing. We when we teach that, we have people that come that have been taking dental radiographs for years and years, and we have people that have never taken a single radiograph. And by the end of the session we find that everybody can very confidently go back and be taking full mouth diagnostic radiographs.

KB: So it sounds like there’s a little something for everyone.

Jamie Berning: Yes, absolutely.

KB: Is there anything else that either of you wanted to share with potential attendees to kind of pique interest or promote your sessions and labs?

Jamie Berning: There’s so much to learn, no matter how much you know about dentistry and how good you think you are at dentistry already. There are things that I learned from my friends and colleagues regularly that make me a better dentist. And when I was learning dentistry and becoming an expert in dentistry, I spent a lot of time with both human dentists and a lot of veterinary dentists, and I have taken all of that knowledge and kind of put it together in order to be able to provide as much information and as practical of a format as possible for veterinarians and technicians to learn. So I think that just being very open minded to the fact that there’s always more to learn and that includes those of us who are technically experts in the field.

Jill Bates: I agree. There’s always something to learn, whether it’s about teeth, about anesthesia, you know, anything in our field, I feel like I’m still constantly learning every day something new, which is so exciting.

MC: Well, you guys are both rock stars and I’m sure people are going to want to know how to get in contact with you. So would you be comfortable sharing your contact information or maybe where people can find you online?

Jamie Berning: Yeah, absolutely. We can be found pretty easily online at ohiovetdentist.com and then our clinic email is [email protected]. That’s the easiest way to get a hold of us at the clinic. And then if anybody is looking to follow us on social media and Tiktok, Facebook and Instagram, they can find us on any of those platforms where we share interesting and fun cases and additional opportunities for learning.

KB: You guys are on Tik Tok? This is serious.

Jamie Berning: And people love it! 

KB: Thank you both so much for taking the time to talk to us today. We really appreciate it.

Jamie Berning: Yes. Thank you so much for your time. We look forward to Midwest Vet Conference. It’s going to be fantastic.

KB: Awesome. Hopefully we can meet up at some point.

Jamie Berning: Absolutely. We would love that!

KB: If you’re not exhausted from your two days of teaching.

Jamie Berning: We’ll be there. We’ll be ready and we have our booth and everybody will be floating around.

KB: That’s right, you guys have a big booth in the exhibit hall, too.

Jamie Berning: Yes, we’re really excited. We’re going to kind of set up a little area that’s similar to what our clinic feel is, so that veterinarians can kind of see what they can expect if they’re sending their clients and patients to us. And then we can get to know a lot of our referring veterinarians as well. And we’re excited about that opportunity.

KB: Sounds really cool. Be sure to get plenty of TikTok videos there!

Jamie Berning: Yes, absolutely.

Dr. Berning is speaking in the Pet Animal Dentistry track, and Jill is speaking in the Technician II track on Thursday February 22. That’s sessions 130 to 135 and 190 to 195, respectively. Both labs will be held on Friday, February 23, with dental radiography in the morning and surgical extractions in the afternoon. 

Special thanks to Bronze Sponsor iM3 for providing equipment for the dental labs.

Registration for the 2024 MVC is now open! To learn more about the dental programming and sign up for the conference, refer to the show notes or visit mvcinfo.org/attendees.