An Asian elephant (Elephas maximus) suffering from dental malocclusion was anaesthetised for dental treatment using etorphine. The main risks of the procedure were trauma, associated with falls during sedation, and malpositioning, preventing access to the oral cavity. To reduce these risks the elephant was trained, using operant conditioning, to lie down in the required position and accept hand injections. Induction was straightforward and no repositioning was required under anaesthesia. One molar was extracted and another reshaped to improve occlusion and prevent soft tissue trauma. The anaesthetic was reversed within two hours of induction, and the elephant was manually assisted by the keepers to stand up. Operant conditioning proved invaluable during this procedure by improving staff and animal safety by enabling controlled hand injection of potent opioids instead of remote injection; allowing correct positioning prior to induction, greatly reducing anaesthetic time; and allowing a swift-assisted recovery post reversal.