Dr. Peter Kertesz is an unusual dentist. Yes, from Monday to Thursday he treats regular patients in a practice in central London, but he also has an exotic job on the side.
Dr. Kertesz travels all over the country - and the world - to perform oral surgery on all kinds of animals.
"We just treated a lion, a jaguar and a couple of monkeys. The lion had two broken teeth - one was extracted, the other was filled - and he's fine now," he told the BBC.
How did it get to not limit its services to humans, and what does it look like when you stick your hand in the mouth of a giant carnivore?
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The beginning of the adventure
Dr. Kertesz's long list of patients includes walruses, dolphins, tigers, elephants and many other animals, large and small.
He has been treating animals for more than four decades and estimates that he works on more than 200 cases a year.
Kertes is one of the few dentists specializing in wild animals living in captivity, and his path to this profession was far from planned.
He graduated in 1969 and treated people for nine years.
"In 1978, I received a call from a veterinarian who asked me to help his cat. I thought it would be difficult, but I did it in the end," he says.
That chance phone conversation marked the beginning of an unexpected new direction in his career.
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Dangers
His team consists of a nurse and an anesthesiologist. Large animals must be put to sleep, often by shooting an arrow.
"It is a very professional job. You do not have the luxury of giving in to your emotions and you must not relax. You have to be constantly on edge to do your job well," he says.
"You are in a race against time because of the effect of the anesthetic. I always want to get it done quickly and efficiently."
This is understandable, since your hands are up to the elbow in the jaws of a giant carnivore - a polar bear, for example, the largest terrestrial carnivore in the world weighing up to 600 kilograms.
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Dr. Kertesz had an appointment for one such in October.
The danger of a grumpy polar bear waking up with a toothache during surgery is obvious, but putting his animal patients to sleep has some other challenges.
Kertes has already seen his old and sick animals die on the operating table.
"In general, anesthesia is very dangerous for animals.
"Our goal is to use the minimum dose of anesthetic and cause them the minimum amount of trauma."
He works closely with local veterinarians.
A lot of effort is put into planning the surgery so that the results are as predictable as possible and there is no need for a second examination.
Differences
The first challenge is realizing that the animal needs help in the first place - they can't tell you what's wrong with them or describe their condition.
"Many animals hide pain - they seem to live with it, they don't show it like humans do," says Dr Kertesz.
"Sometimes, however, it can be obvious, such as swelling, suppuration and stopping food."
Often the animal keepers are the first to notice a change in the animal's behavior that can cause a toothache or some other problem.
Most of his work with animals involves tooth extractions, fillings and nerve extractions.
"We never do prosthetics. Some people had prosthetics made for them with disastrous consequences.
"The animals live in protected environments, so we just need to change their diet."
Another challenge is getting the tools he needs for such a wide range of mouths.
"Animals have different jaw structures. This means that I need a variety of equipment to treat them. We had to design it from scratch.
"I talked to experts and had special instruments made for me."
The largest piece of equipment he has is an elephant drill, weighing 32 kilograms.
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Is there doctor favorites?
Kertesz says he doesn't have a favorite animal to treat—each one comes with its own set of challenges, and he'll help any animal that needs help.
"Large carnivores are relatively easy to treat," he says.
"It's easy to put your hand in their mouth - you just need the right instruments and to work fast!"
"The walrus is a very interesting and intelligent animal, I love it very much," he says.
"Unfortunately, in marine parks, they peel their tusks against concrete buildings. As a consequence, the tusks become infected."
He traveled to Russia and South Korea to treat walruses kept in marine animal parks.
His job is usually to remove their tusks.
“It usually takes 25 to 40 minutes to extract each tusk. The whole operation can take two to three hours."
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Saving lives
He is sure that his intervention prevented the premature death of many animals.
"The mouth is the gateway to animal health. A damaged dental structure can represent a perfect entrance for pathogens that enter the body and cause serious consequences.
He rarely visited the same animal twice, while he has been seeing some human patients regularly for 30 to 40 years.
He enjoys that part of the job, but the fact that his time with any animal is limited also makes everything especially difficult.
"We don't have long relationships with animals. The high points are high, the lows are really low," he recalls.
"We never have a dull day with the animals.
"When I do a good job and the animal benefits from it and looks good and healthy, I'm very happy."
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