Ever since I graduated from veterinary school in 1987, the importance of oral health has grown as we learned more about the incidence and significance of periodontal disease. We rarely cleaned pet teeth in veterinary school, and I don’t recall an actual lecture or lab devoted to the topic.
In people, periodontal disease, causing systemic infection, has been linked to osteoporosis, diabetes, heart disease, respiratory disease, chronic obstructive pulmonary disease, pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome, adverse pregnancy outcomes and even cancer! A similar effect in our animal patients is likely.
Therefore, it’s imperative that we detect and treat periodontal disease in our patients. Failing to do so is, in my opinion, malpractice because it’s one of the easiest diseases to detect and treat. And because pet owners are familiar with their own dental care, getting a client to say “yes” to a dental cleaning is a pretty easy sell if done correctly.
Have a Game Plan
First and foremost, I believe we must be careful in our choice of words. Referring to a professional cleaning — a term human dentists use — as a “dental” undermines the true value of our service. While “cleaning the pet’s teeth” is acceptable, we need to make sure to explain everything a “cleaning” encompasses and why the associated charges are appropriate.
While a dental cleaning is rarely an emergency, I know some colleagues try to schedule the procedure for the same day as the annual visit. Once the periodontal infection is shown to the client, these veterinarians suggest that since the pet is already in the office, it would be convenient for the client to leave the animal and “finish the work.”
Another tip I love to use to get a client to say “yes” to any of my recommendations for better pet care is to encourage the client to ask for the service herself. The easiest way to do that is by having the client fill out a questionnaire before the doctor enters the exam room. The veterinarian can then review the questionnaire alongside the client. One of the questions refers to whether the pet has bad breath or teeth discoloration.
Once the client indicates that the pet does, in fact, have a problem in the oral cavity, encouraging the owner to allow you to TREAT the DENTAL INFECTION becomes easier. (I emphasize those words to relay the seriousness of dental disease.)
Charge for All You Do
Don’t forget to charge for procedures that should accompany the cleaning. Prior to sedating the pet for a cleaning, we run an EKG to assess cardiac health and provide a baseline for monitoring during the procedure. We also charge for tech time, cardiac monitoring (especially important for cardiac patients that require a dental cleaning), bonding gel application, dental radiographs, ClindaCure administration, lidocaine gel applied topically to the gingiva after the cleaning, prescribed supplies to continue periodontal care at home, and administered fluids.
The invoice also includes a no-charge item we call “oral cancer screening,” something my dentist puts on my invoice. We include this item so that the owner understands the extra value of a professional cleaning. The screening does not occur during anesthesia-free dentals because a thorough examination of the oral cavity is impossible at that time.
Show and Tell
To help educate clients, prepare handouts that discuss periodontal disease, and quote some of the science behind the problems associated with periodontal neglect. Doing this reinforces your message. I also suggest leaving space at the bottom of the handout so that you can personalize your “prescribed,” not “recommended,” treatment. For example, the handout might include a place where you can circle the periodontal disease grade, on a scale of 1 to 4, and list what might be done when the pet is treated, such as radiographs, anesthesia, extractions and polishing.
I find that clients who leave the practice with a personalized handout place a higher importance and urgency on performing the prescribed treatment.
Showing clients what periodontal disease looks like is very helpful. Whether using before-and-after photos or dental models, your clients are more likely to understand periodontal disease if they can see what it looks like.
Consider Timely Discounts
I suggest offering a discount during Dental Health Month. Even though February is traditionally dental month, I typically offer a special in August and December to be different from all the other veterinarians and to make sure those two months stay busy. Discounting is up to you, but be aware that your colleagues typically offer some sort of special.
Another idea is to inform clients, maybe on the handout they take home, that if they schedule the dental cleaning within two weeks of the visit they will save a certain amount of money. Specials that expire often result in a high acceptance rate by clients.
We also tell clients that if another medical procedure, such as radiography or a tumor removal, occurs during the dental cleaning, the cleaning itself is discounted at least 50% and the pet will need only one anesthesia. An extra tip I’ll share is to offer other services that can be done while the pet is sedated for a cleaning, such as a nail trim, ear flush or anal sac expression. We offer these services at half off to encourage clients to say “yes” and because the services are easier to do when the pet is asleep.
Be an Advocate
The most important tip I can give is to believe in the value of dental cleanings. If you don’t believe in a procedure, you’ll have difficulty persuading others of the need for it.
When I first started my practice, I had a hard time getting clients to agree to periodontal treatment via a regular dental cleaning. No matter what I tried, I couldn’t persuade most pet owners. Then it hit me: I didn’t understand the health risks associated with dirty teeth and smelly breath. I simply thought of a dental cleaning as a cosmetic procedure.
That thinking changed when I attended a cardiology meeting and the speaker stated, ”The most important thing you can do for a pet with heart disease is clean its teeth!” That simple statement convinced me that I had to change the way I approached the topic. No longer was I treating “dirty teeth and bad breath.” Instead, I was curing an infection and likely prolonging the pet’s life by preventing more serious problems.
Finally, don’t forget the very real, but ignorant, fear that most clients have about anesthetizing older pets. You will have to spend time explaining your anesthesia procedure, how you make it safe for older pets, and how the pets are screened before anesthesia to ensure their safety.
The advice I’ve shared should improve the percentage of clients who agree to treat their pets’ periodontal disease. If you have other tips that work for you, please email me at shawnvet@sbcglobal.net.