The Oral Gap in Pet Health

Oral health care is a critical component of overall pet health management and well-being, yet most practices only get a small percentage of their revenue from dentistry.

By the time you read this column, my dog should have a healthy mouth full of sparkling clean teeth from her early November dental cleaning. No doubt I will be fulfilling my resolution to keep those chompers plaque-and tartar-free with daily dental care and regular brushing, right?

The road to the clinic for this pricey procedure was paved with good intentions. I have a shelf full of pastes, gels, wipes, toothbrushes, water additives and dental treats, but have still failed miserably when it comes to keeping my dog’s teeth clean enough to avoid a dental. The sad fact is, I’ve still done better than the 98% of pet owners who statistics show never brush their pet’s teeth – the gold standard for preventing plaque and tartar.

Oral health care is a critical component of overall pet health management and well-being – right up there with good nutrition, vaccines, and flea, tick, and heartworm prevention – yet national averages show that most practices get only about 4% of their revenue from dentistry. This is a serious gap both in pet wellness and lost clinic revenue, considering that periodontal disease is the most prevalent disease in both dogs and cats. Nearly 80% of dogs and 70% of cats over the age of three have some form of periodontal disease, according to the American Veterinary Dental Society. Left untreated, periodontal disease causes not just bad breath, but pain and discomfort, and can also lead to infection and bone loss, and even damage the heart, liver and kidneys. Every pet owner needs to hear not just a “dental message” but an “oral health” message from the entire veterinary team beginning with the first puppy or kitten exam.

Convey the importance

An effective way your clinics can convey the importance of regular oral health exams is to replace “dental” discussions with COHAT conversations. COHAT, or Comprehensive Oral Health Assessment and Treatment, covers the entire process of oral care that involves much more than just the basic scaling and polishing many pet owners assume are all that’s involved in a “dental.” Veterinarians should check the mouth, teeth, and gums as much as the pet will allow during each wellness exam, or whenever there is a suspected problem like excessive salivation, loss of appetite, or dropping food. Using a diagnostic product like C.E.T. Orastrips during every wellness visit can show pet owners when a periodontal infection is present. The test strips detect thiols produced by bacteria present in periodontal pockets below the gum line and provide visual proof of the need for treatment.

Anesthetizing the pet is necessary for a thorough dental examination and cleaning, so pets that will benefit from the procedure should have preoperative blood work to make sure they can safely undergo anesthesia or possibly require IV fluids during the procedure. Some dental disease can only be found below the gumline, so dental radiographs are necessary to show any issues in the jaw or roots of the teeth. A complete COHAT procedure will likely include supragingival (tooth surface) and subgingival (below the gumline) scaling and polishing, probing and charting of each tooth, any necessary extractions, applying a tooth sealant, monitoring vitals and anesthetic recovery, pain management, and any necessary pre- or post-procedure antibiotics.

Every species that has teeth should have those teeth regularly checked by a veterinarian. Rodents and rabbits have teeth that grow continuously, so occlusion – or contact between the teeth – is more of a concern than gum or periodontal disease. The upper teeth need to meet the lower teeth to maintain proper wearing of the tooth surfaces and prevent overgrowth. When they don’t meet and wear at the same rate, trimming or filing the teeth is necessary.

In-home importance

Stressing the importance of in-home dental care to pet owners should be a priority for your customers, since the success of a dental procedure depends on how well the client can control plaque between veterinary visits. Plaque can start to reaccumulate almost from the time the animal gets home. It can attach to clean teeth within 24 hours, start to form tartar after just three days, and gingivitis can start to develop after only two weeks. Sharing those facts with customers illustrates why consistent daily dental care is so important. Since brushing is at the top of the noncompliance list, it’s important for veterinary staff to demonstrate how easy it can be to train a pet to tolerate (or even enjoy) tooth brushing and that just a couple of minutes a day is all that’s needed.

The OTC consumer market for oral care products has continued to grow. Are your veterinary clinics stocking and recommending any of the variety of products? Be prepared to discuss the items you carry, help them source samples and educational materials and discuss home delivery options that can help your practices improve owner compliance and increase revenue. VOHC-Certified products carry the seal of the Veterinary Oral Health Council and have passed double-blind studies showing a 15% to 25% reduction in plaque, tartar, or both. The complete list is at vohc.org. There are lots of user-friendly options such as water additives, oral gels and sprays, tooth and gum wipes, enzymatic chews and dental treats that give good results for those owners that just won’t brush.

I happened across an article the other day about how devoted people are when it comes to their animals. It quoted a survey conducted by OnePoll where three out of five pet owners who responded said they’d run into a building burning or fight another person to save their pet. Over 80% said they wouldn’t think twice before saving their pet from immediate danger. I have no doubt this is true, so why are only about 2% of these owners brushing their pet’s teeth? Pet owners truly want what’s best for their animals, but simply don’t understand how critical dental care is to the overall health and wellbeing of their pet and that it shouldn’t be an option. As animal health professionals, it’s up to us to tell them.

Photo credit: istockphoto.com/bluegame