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Veterinarian Technician June 2008 (Vol 29, No 6)

Brushing Up on Dentistry: Promoting Dentistry in the Veterinary Practice

by Vickie Byard, CVT, VTS (Dentistry)

    According to the American Veteri­­nary Dental Society, an astounding 80% of dogs and 70% of cats over 3 years of age have some degree of periodontal disease. Many pet owners, however, are unaware of the importance of providing oral health care for their pet. They do not realize that dental disease can lead to other health-related problems. For veterinarians and technicians who work in general practice and provide routine dental services, it is important to promote these services while at the same time emphasizing the importance of oral health care to their clients.

    Staff Education

    Before technicians can educate clients, they must have a good understanding of proper dental care, consider dental care a priority, and be knowledgeable about the dental procedures performed in the practice. Technicians should feel comfortable discussing routine dental cleaning with clients as well as any procedures that the veterinarian may recommend. Clients may have concerns, especially regarding their pet's safety during the procedure; therefore, technicians should be prepared to answer any questions. They should also be able to demonstrate toothbrushing techniques so that clients can provide proper at-home oral care.

    There are numerous ways for technicians to advance their dental skills and knowledge. They can attend local, regional, and national conferences that offer dentistry lectures, wet labs, and continuing education opportunities. Reading articles about dentistry in clinical journals can also help technicians to keep abreast of current dentistry information. Having "lunch and learn" sessions in the practice is another way to educate the staff about dental techniques. The practice owner or manager can contact dental product suppliers and have representatives come to the clinic and conduct demonstrations, review techniques, present new information, and answer questions.

    Client Interaction

    Educate the Client

    During every visit, the technician should assess the pet's teeth and discuss the importance of dental care with the client, emphasizing that failing to maintain the pet's oral health could lead to infections, abscesses, and consequent systemic illnesses. Maintaining good oral hygiene should be discussed during the client's initial visit — ideally starting with the first puppy or kitten visit — and during every visit thereafter. Emphasis should be placed on promoting oral care when the patient is young because puppies and kittens will more readily adapt to having their teeth brushed.1 Technicians should inform new puppy and kitten owners that in addition to benefiting from regular oral care at a young age, these pets will often have improved social skills and be easier to handle during veterinary visits.1

    Most clients need to hear oral care recommendations several times before they will act on them. Clients must be given the same consistent message by all team members. Technicians should be able to address the reasons why clients may not comply with recommendations (e.g., they did not "hear" the recommen­dation, they have concerns about anes­thesia), clearly explain the types of procedures recommended (e.g., dental cleaning, periodontal disease treatment), and review at-home oral maintenance techniques (e.g., toothbrushing, giving the pet treats approved by the Veterinary Oral Health Council). Simply giving the client a pamphlet on dental care, a toothpaste sample, and a finger toothbrush is not sufficient to ensure compliance. The client must be shown how to brush the pet's teeth and told how to fit the task into his or her schedule (e.g., brush the pet's teeth at night when the client brushes his or her own teeth). Ultimately, the technician must be passionate about dental care and share this passion with the client.

    Address Barriers to Seeking Dental Care

    There are a number of reasons why clients may not seek dental care for their pets. Veterinary professionals often believe that cost is the main barrier to regular oral care. However, according to an American Animal Hospital Association (AAHA) client compliance survey, prohibitive cost was considered a barrier to dental care by only 7% of respondents. The number one reason why respondents did not seek dental services was that they never "heard" the recommendation from the veterinarian or other clinic staff. The AAHA survey results indicate that even when a recommendation regarding oral care is made, clients may not hear the recommendation or remember it, in part because several topics (e.g., housetraining, vaccination, sterilization) are usually discussed during a typical appointment. Therefore, during checkups, appointment length should be evaluated and time should be allotted to discuss oral care with clients. In addition, the pet's oral score or stage should be noted in the patient's record during every visit, if possible. When a pet presents to the clinic with a serious medical condition, however, staff should recognize that the client's concerns regarding the pet's current condition may make it difficult to conduct an in-depth discussion of preventive oral care; therefore, reminder cards and other tools to increase client compliance (discussed below) can be used to remind the client to schedule dental care once the pet's presenting condition has resolved.

    Even when clients acknowledge that they have received oral care recommendations from the veterinary staff, they may be reluctant to schedule a dental procedure because they are concerned about the risks of anesthesia, especially for older pets. The technician should educate the client about the types of anesthetics available and help alleviate the client's fears by explaining that the pet will undergo a preanesthetic evaluation and will be monitored continuously during the dental procedure. Clients may also be hesitant to schedule a dental procedure because they do not understand the importance of the procedure; therefore, technicians must emphasize that good dental health is essential to the pet's overall health and well-being. Technicians should explain that pets can mask pain extremely well; therefore, many owners are often unaware that their pet has a serious dental problem.

    Use Proper Terminology

    When educating the client about the importance of regular dental care, the technician should use proper terminology. The technician should ensure that the client understands the necessity of regular dental prophylaxis (i.e., cleaning and polishing), which is sometimes incorrectly referred to as "a dental" or "a prophy." A patient undergoing dental prophylaxis receives a comprehensive oral health assessment, scaling below the gum line, fluoride treatment, and professional teeth cleaning under general anesthesia. In addition, oral radiographs are often obtained. The technician should explain that prophylaxis is intended to prevent — but not treat — periodontal disease.2 If peri­odontal disease has already occurred, the pet will require more extensive dental care. If serious oral problems are observed, the pet may have to be referred to a veterinary dentist for treatment.

    Demonstrate Toothbrushing Techniques

    Technicians have an opportunity to discuss oral health care with clients during wellness visits and regular checkups; however, theoretical education alone cannot ensure client compliance with recommendations, particularly those involving at-home oral hygiene, which is necessary to maintain a pet's dental health. In addition to giving clients pet toothbrushes and toothpaste, technicians should demonstrate how to use these products. Technicians who routinely brush their own pet's teeth will feel more comfortable demonstrating toothbrushing skills on a client's pet.

    Technicians should be able to demonstrate these skills using either a dog or a cat. If the pet is uncooperative, the technician should be able to instruct the owner on steps (e.g., put toothpaste on a finger and let the pet lick the toothpaste, use a finger toothbrush) that can be taken to acclimate the pet to the toothpaste and the toothbrush. Toothbrushing sessions can be videotaped and uploaded to a desktop computer in the clinic to assist with the demonstration. To increase compliance with toothbrushing recommendations, it may be helpful to give clients a handout with photos or illustrations, step-by-step instructions, and tips.

    Promoting Dental Services

    Internal Marketing

    To promote the practice's dental services and encourage client compliance with dental care recommendations, it is essential to develop a marketing strategy. All staff should participate in marketing efforts targeted to both existing clients as well as potential new clients in the community.

    Before a practice can market dentistry ser­vices to its clients, management must first market these services to the staff. Providing dentistry education in the clinic is one way to emphasize the importance of these services so that team members can reinforce any dental recommendations made by the veterinarian.

    Several methods can be used to promote dental services to existing clients. A message about the clinic's oral health care services can be played when clients who call the clinic are put on hold. In the waiting area, posters advertising National Pet Dental Health Month (February) or other special dentistry-awareness events can be displayed. Dental models can be placed in the examination rooms to help initiate discussions about oral care. Dental health brochures or handouts can be provided to clients, and picture books showing photos of patients' teeth "before" and "after" dental procedures can be made available.

    The practice can also promote its dental services to clients by including a recommendation on the patient invoice regarding dental procedures, by sending reminder cards, by including information on dental health topics in clinic-generated newsletters mailed to clients, and by offering free educational seminars on dental care, which can also be open to the public.

    External Marketing

    In addition to offering free seminars to help attract potential new clients, the practice can promote its dental services in local newspapers, on bulletin boards in pet care supply stores, through direct mail advertising, and on its Web site. The practice also can generate community interest by holding an open-house event and inviting the media. Tours can be given of the hospital, dental kits can be distributed, and proper toothbrushing techniques can be demonstrated. In order to obtain referrals, the practice can market its dental services to other practices that do not perform dental procedures.

    Conclusion

    With the increased emphasis on wellness care for pets, it is important that the entire team promote regular dental care, just as they promote regular vaccination. By actively marketing its dentistry services, a practice can increase its revenue and opportunities for growth while improving the quality of life for its patients.

    1. Myers WS: Best practices: How to promote dentistry year-round. Atlantic Coast Vet Conf 2005.

    2. Holmstrom SE, Bellows J, Colmery B, et al: AAHA Dental Care Guidelines for Dogs and Cats. Accessed May 2008 at www.aahanet.org/PublicDocuments/Dental_Care_Guidelines.pdf.

    References »

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