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The vet, engineer and artisan and some wild elephant dentistry

GERHARD STEENKAMP The first opportunity to extract a tusk from a live elephant occurred in 2010

27th February 2015

By: Irma Venter

Creamer Media Senior Deputy Editor

  

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What do you do when an elephant has a toothache? You call Dr Gerhard Steenkamp from the University of Pretoria’s (UP’s) faculty of veterinary science, Onderstepoort, one of only two elephant ‘dentists’ in the world.

While it may sound like the first few lines of a poor bar room pun, elephants in captivity often suffer from broken or infected tusks.

Tusks are not made of ivory from end to end, explains Steenkamp. Inside the tusk, starting from inside the skull, there is a pulp – consisting of nerve endings and blood vessels – that extends into the visible tusk for quite a few centimetres.

This hidden part of the tusk often exceeds more than 50 cm in grown bulls – which spells a monster tuskache should infection sets in.

One particularly severe case saw an elephant die of sepsis.

Steenkamp, 49, describes himself as a veterinarian, and not a dentist or a maxillofacial surgeon.

“But I have a passion for elephants and animal teeth and tusks. The elephant is the world’s largest land animal. If you can work on an elephant’s tusks, you can do dental work on any animal.”

Steenkamp studied zoology and botany in the 1980s, followed by a stint on Marion Island as a katskieter.

South Africa’s research station in the sub-Antarctic Indian Ocean for decades suffered a mouse infestation, which failed to be resolved by the introduction of five cats in the 1940s.

By the 1970s, the cat population had grown to more than 3 400.

The cats had to be hunted as they were feeding on the island’s natural bird population.

Following his stay on Marion Island, Steenkamp completed his studies in zoology, and proceeded to study veterinary science. After three years in the UK, he returned to South Africa to lecture at the UP’s faculty of veterinary science in 1998.

Tuli Elephants and Root Canals
Steenkamp first started work on elephant tusks when two of the famous Tuli elephants were brought to the Onderstepoort veterinary hospital for treatment.

In 1998, 30 young elephants were captured in Botswana’s Tuli Game Reserve and brought to the North West province, in South Africa, where they were brutally ‘trained’.

Public outrage, coupled with court action, eventually saw the elephants moved to zoos, sanctuaries and wildlife parks.

“Luckily, the two elephants I worked on were still small, but I realised that I needed to develop a protocol, and tools, to work on elephant tusks,” notes Steenkamp.

“I also realised that there was very little literature available to guide me, bar a handful of articles published in the US.”

Steenkamp faced two problems: How to make a filling for an elephant tusk, and how to extract a tusk.

It is preferable to do a root canal on an infected elephant tusk, rather than extract it, as the tusk can continue growing, emphasises Steenkamp.

Tusks are not merely ornamental, but serve as important tools.

“Elephants are right- or left-tusked, just as people are right- or left-handed,” explains Steenkamp.

“Elephants in captivity often injure their tusks as they work to escape. They don’t want to be held in cages. They try to open gates, to push steel bars, and they mainly use their slave tusk to do this. They also fall on the concrete in their cages, breaking their tusks.

“Iron, concrete and tusks do not mix.”

Subsequent to his work on the Tuli elephants, Steenkamp operated on two deceased elephants in an effort to learn more about the dentistry these animals require.

This was followed by an operation on an elephant held in captivity. The bull, kept chained around his leg, broke his slave tusk as a result of numerous attempts to escape.

Steenkamp used an acrylic filling to fix the broken tusk.

Some time later, it was suspected that the elephant had developed an infection, and the Onderstepoort vet had to return to tackle the new problem.

“This is when I contacted Danie Burger, who worked at the UP’s department of mechanical engineering at the time, to help me find a solution. I had to find the tools to improve on the work I had to do,” says Steenkamp.

When Steenkamp took out the acrylic filling (under full anesthetic), he saw that there was no problem with his previous work. However, there were numerous other issues to address, such as the cracks that had appeared in the tusk when he created the hole to insert the filling.

In the end, Steenkamp and Burger drilled a hole into the tusk with a hole saw, connected to a drill. They then threaded it with a tap and inserted a nylon plug, while placing a clamp around the tusk.

Steenkamp says he uses nylon as it withers at the same rate as the tusk. He is also mindful of not using materials that can be sharpened by the elephant, such as steel.

Following this operation, Burger proceeded to make Steenkamp an aluminium conic guide to assist drilling the filling hole straight down the middle of the tusk.

Steenkamp subsequently also completed his master’s degree on the subject of elephant tusks.

Next Challenge: Extraction
“We were happy that the thread idea worked. Now the second question remained – how to extract a tusk,” says Steenkamp.

Extraction is a difficult procedure as such a large part, up to a third, of the tusk is embedded in the skull. The tusk also curves into the head.

Conventional surgical tooth/tusk removal can cause numerous problems.

“You would need to use steel thread stitches, and the elephant would probably rub the wound open as soon as possible,” explains Steenkamp.

In finding a solution to this conundrum, the vet again worked on cadavers, trying to extract the tusks, but with little success.

He realised he required specialised chisels. Again, Burger helped in the development of these instruments.

In 2010, Steenkamp had his first opportunity to extract a tusk from a live elephant.

The animal in question was used for elephant-back safaris in Zimbabwe.

The idea was to drill a hole all the way into the broken tusk, and to then collapse the ivory into the hole through the use of chisels placed between the ligaments and the tusk.

Steenkamp managed to extract the tusk, under full anesthesia, but found that he struggled to create a deep enough hole. This problem recurred during a 2012 trip to Poland, when he tried to extract the 13-cm-diameter tusk of a five-ton elephant bull named Ninio.

“My instruments were not sufficient to extract that large a tusk,” he states.

By this time Burger had left the university, and Steenkamp turned to SOMTA Tools, a Pietermaritzburg-based designer and manufacturer of standard and custom tools.

SOMTA made a set of stainless-steel cutters and drill bits for Steenkamp, which enabled him to hollow out elephant tusks.

Louis le Grange, MD at Hentiq 1536 and an artisan by training, designed and made a set of curved chisels for Steenkamp, also at no charge.

Le Grange’s son and wife are both veterinarians.

“I never had to look for answers abroad. Nobody ever asked me for a cent. We managed to find an African solution to a particular problem the African elephant faces. I could not have done it without the help of Danie, SOMTA or Louis,” says a grateful Steenkamp.

80 kg of Luggage
Steenkamp again travelled to Poland in 2013, this time with his new instruments, weighing in at 80 kg.

He finally managed to extract Ninio’s offending tusk, revealing chronic infection.

While his new instruments – continuously refined and upgraded – work perfectly, Steenkamp has one more wish: coating all of his instruments in nickel titanium.

“This will ensure they do not rust. I’m more than willing to pay if someone in the engineering community is willing and able to assist.”

Steenkamp returned to Poland in January this year to again work on Ninio, who had since fractured his other tusk.

Steenkamp was aided by the Peter Emily International Veterinary Dental Foundation, based in the US.

His elephant expertise has seen him travel to a number of countries, including Zambia, Zimbabwe, Egypt, Poland and China.

“I also consult widely.”

Steenkamp would like to expand his ‘dental’ practice to include the walrus.

“Walruses are often held in captivity. As they use their tusks to pull their bodies along, being held in concrete spaces means the tusks often break, or become infected. And make no mistake, a broken tusk causes incredible pain.”

The first prize, though, says Steenkamp, is for zoos and other places that hold wild animals to ensure their environments and enclosures are as natural and spacious as possible.

Edited by Martin Zhuwakinyu
Creamer Media Senior Deputy Editor

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