How to Start a Dental Programme

Training Staff for a Veterinary Dental Programme.

The very first step in implementing a dental programme is for the entire practice to decide to make dentistry important. When everyone is on the same page, owners receive a unified message about dental health. If dentistry is important to only a few staff members, owners often receive mixed messages about their pets’ oral health, which inadvertently sabotages any efforts to grow dental services. The best way to ensure the entire practice is promoting the same message is to have a clear understanding among all staff members about what the message is. This can be accomplished at regular staff meetings and the main points agreed on by the entire staff. Every staff member, from the receptionist to the veterinarian should feel comfortable explaining the practice’s views on oral care and what treatment options it can provide. Receptionists and nurses should understand dentistry services, terminology and products dispensed. Veterinarians need to be trained to “open the mouth,” and discuss the oral health of every patient that walks through the practice door – whether it be for a vaccination, skin, ear or any other presenting problem. It really helps to have a dental ‘champion’ to help drive the program. This may require extra dentistry training in order for them to understand dental anatomy, pathophysiology, radiology and procedures.

Introducing Dentistry to the Veterinary Consultation.

Dental disease must be discussed in detail at the consult and the reasons why even Grade 1 dentals need to be performed. This involves discussing the consequences of periodontal disease with the risk to vital organs, bone infection, tooth loss and excruciating pain etc. Using the vet dental charts to show the owner photos and radiographs of dental pathologies can help with this client education. Taking a close-up photo, will confirm in the client’s mind that you consider their pet’s dental disease to be a real problem that needs care. The picture will also allow the client to see the oral disease without prolonged handling of the pet’s mouth, show other family members at home, remind them of your recommendations, compare photos taken before and after the dental procedure and allow you to permanently document your records. To enforce in the owner’s mind that a dental procedure is necessary, the veterinarian needs to make strong recommendations such as “Fluffy needs to have a dental procedure, and she really needs it now.” Discussions on cost need to be left until the very end, once the client understands the importance of the recommended procedure.

Encourage Immediate Action.

Physically walking the client to reception and saying to the receptionist, “we need to book Fluffy in for some dental work next week, can you please book that in”, will increase your uptake of dental procedures massively. Consider asking non compliant owners to sign a form declining your recommendations for a dental procedure.

Reminder Cards.

When a recommendation is made by the veterinarian that dentistry should be provided, reminder cards should be generated.

Necessary Veterinary Dental Equipment

The business owner must actively contribute towards purchasing proper dental equipment and educating staff to diagnose and perform the procedure. Equipment needs to be modern and in good working order, for staff to remain enthusiastic about promoting dental procedures. As well as an efficient high-speed drill, reliable scaler and polisher, the ability to take dental radiographs is a vital component to make dentistry work. Published studies have shown that without dental x-rays pathology is missed in up to 75% of pets as a significant amount of dental pathology lies underneath the gingival margin and therefore can’t be visualised. It can be utilised to confirm missing teeth; diagnose diseases, such as periodontal and endodontic conditions; and confirm treatment procedures, such as complete tooth extraction. Dr David Clarke recommends, and uses in his own practice the Acteon X-Mind dental generator and the Sopix DR sensor.

Dental Homecare for Pet Owners

The goal of a dental homecare programme is to maintain a healthy oral cavity free from plaque, which in turn prevents gingivitis (and therefore periodontitis and periodontal disease).

It should be started in young pets to prevent periodontal disease and in older pets with existing disease after a professional clean and client education. With adequate homecare and plaque removal, periodontal disease never progresses past a mild gingivitis.

Your clinic dental motto should be ‘to prevent gingivitis’. This is achieved when the entire clinic staff is ‘on board’. One of the key ingredients in the maintenance of periodontal disease is that all staff members are trained and well-versed in the pathophysiology of periodontal disease and home care products available and recommended by your clinic. The MAXI/GUARD® range of products are excellent for owners that may not have the inclination or time to brush their pets teeth and for pets that won’t tolerate teeth brushing. MAXI/GUARD®  is also great to use after a dental procedure, when it isn’t possible to feed a hard diet or brush the teeth, and it is recommended that it be dispensed routinely with every dental.

Effectively Communicating with Clients

Far too often, when a patient’s records are looked at retrospectively, a dental procedure has been recommended repeatedly, without the pet owner taking action until the dental issue has become such a problem that extraction is the only treatment option available. Furthermore, many clients say if they had only known, they would never have let their beloved pet’s mouth get so bad. This would indicate that the current way we communicate with clients is not sending a clear message about the importance of their pet’s oral health nor is it prompting them to take action.

Clients need to be educated on the risks of tartar buildup and gingivitis such as internal organ problems and dental disease with its associated pain and eventual tooth loss. Owners tend to be unaware of their pet’s dental issues because the pet continues to eat. You must convey to them that eating is not an accurate indicator of a pain-free mouth as most patients continue to eat even with severe oral disease. Explain that treating dental disease early, not only prevents unnecessary suffering and extractions, but can avoid a larger bill for a more extensive dental procedure in the future. Having the Vet Dental Charts open on your consult room computer with the dental pathology photos and x-rays readily accessible is helpful in educating clients of the results of not prioritising the oral health of their pet. Showing these photos and radiographs can give you the opportunity to discuss different grades of dental disease, resorptive lesions, periodontal disease, fractured teeth, gingival recession and hyperplasia, retained deciduous teeth and many more. Showing clinical photos that look normal and then showing radiographs that prove otherwise is also helpful in educating owners on the importance of dental x-ray.

From the very first visit, owners need to be taught the importance of daily oral homecare and regular professional cleanings in maintaining their pet’s oral health. Whenever a patient is seen, be it for a vaccination, skin, ear or any other presenting problem, a thorough oral examination should be incorporated into the physical examination. This will not only help in detecting dental disease early, but it will foster a new generation of pet owners who will view dental care as part of good overall care and who will come to expect a report on their pet’s mouth as much as they expect a vaccination. MAXI/GUARD® Oral Cleansing Wipes are a perfect educational aid to use in the consult room. Use one wipe to clean the pet’s mouth and then show it to the client. The client will be amazed at the amount of oral debris present in their pet’s mouth, making it much easier to promote the importance of daily dental homecare.

A nurse or veterinarian should discharge the patient after a dental procedure to discuss everything that was done during the procedure. Using the vet dental charts at this time, allows you to showcase the practice’s quality of care. The owner printouts of pathology and treatment charts, digital photos and radiographs of the pet’s mouth, show the extent and value of what has been done and also gives the owner something to refer to when checking on the pet’s home care progress. Discussing the Vet Dental Charts printable homecare instructions, allows you to outline post procedure care and medications. MAXI/GUARD® is the ideal post procedure medication as it can be used in the days immediately after a dental procedure when brushing is not possible and a soft diet is recommended. Recommendations for developing a long-term home oral care regimen should also be discussed at this time. Presenting discharge information to the pet owner in a professional package such as this is your opportunity to shine and sends a clear message that your practice takes the oral health of their pet seriously.