Year-Round Veterinary Dentistry

Why Dr. Jan Bellows believes an emphasis on dental health shouldn’t be reserved for just one month on the calendar.

Every February, the veterinary industry ramps up its messaging on the importance of oral health for Pet Dental Month. While the intent is sincere from clinicians and stakeholders, Jan Bellows, DVM, DAVDC, AVDC, ABVP, said the way it is implemented at most veterinary clinics is a missed opportunity.

Many veterinarians discount dental care for February, hoping it will influence client behavior and get them accustomed to requesting dental services that month, he said. The problem becomes volume. If the veterinary clinic, on average, does five to seven dental procedures a week in a regular month, in February, that could shoot up to 20 a week. That means less time for each animal that comes in overall, whether it’s for dental, preventive care, or an illness.

“It’s shortsighted to just focus on February for Pet Dental Month,” he said. “It brings attention, yes, but it’s not good for the clients, patients, or the hospital.”

Dr. Bellows is spreading that message in talks, podcasts, and RACE-approved CE he helped develop for Dechra called “12 Months of Dentistry.” The title fits perfectly with Dr. Bellows’ focus on the importance of year-round dentistry for veterinary practices. Periodontal disease is too persistent in animals to ignore or leave to one jam-packed month of care for the veterinary clinic, he said.

Plaque is constantly growing in a pet’s mouth, leading to an infection underneath the gum line, “yet practically no one is brushing their dog’s teeth regularly. So, there’s a great need out there,” he said. “It’s a problem that the veterinarian can solve, but it’s not a one-time deal.” The leading cause of animal deaths is kidney disease and heart disease, he said, and both can be mitigated or at least delayed through great dental care all year round.

There are many effective preventive products available that work, but the veterinarian must educate the client to know they’re out there. Dr. Bellows cited an industry study years ago that asked a thousand pet owners whether they thought their dog had oral disease. While the actual percentage is 80-90% in dogs and cats over the age of 3, only 20% of respondents thought their pet had it. “That means 60% to 70% of our clients are missing that their animal has active dental disease.”

What’s worse, Dr. Bellows said, the second question posed to pet owners was, ‘What are you going to do about oral disease?’ The No. 1 response was they would go to the pet store and buy a product. “Anything can be put on a product label except a claim that the product cures periodontal disease,” he said. “But the pet store product could say it freshens breath, whitens teeth, has no GMO, no grain, and is made in the USA. They can say all these things and put a smile on the package, and people will buy it – whether they know it works or not.”

Veterinarians can provide an invaluable service by recommending pet owners research the products they will buy through the Veterinary Oral Health Council’s (VOHC) website. The VOHC does not test products itself. Its mission is to review products for the VOHC’s standards for effective plaque and tartar control in animals when used as directed. The Council reviews the submitted data to ensure it meets the clinical requirements to receive the Seal of Acceptance. When a product demonstrates dental efficacy, the VOHC Seal of Acceptance is awarded. The seal can be for plaque, calculus, or both.

Every tooth, every visit

Dr. Bellows believes every patient should have their mouth examined each time they come into the veterinary practice. For instance, if they are brought in for a skin problem, the veterinarian should still look at the mouth and check for gum disease. If it’s an ear problem, the mouth still gets an examination.

Dr. Bellows also suggests that a pet’s teeth should be professionally scaled and polished when necessary, which may be more than once a year – especially for smaller dogs. Usually, pet owners will get an annual postcard or a text that it is time for teeth cleaning. “The owner would think, sure, their dog’s breath smells a little, so they bring their pet in. The veterinarian cleans the teeth, then the pet owner goes home and doesn’t do anything for a year,” Dr. Bellows said. “You could imagine how bad it would be if you didn’t clean or brush your teeth for a year. That’s the state we used to be in, but fortunately, it’s changing.”

Now, veterinary teams are embracing prevention. The clinics actively promote dental health and have an eye on clients as soon as a pet walks into their office, from the front desk staff to the technician in the exam room. The first step is to use an oral strip to visually show pet owners whether their pet has bad bacteria in their mouth. When the client sees a dental problem, they are more likely to comply with the veterinarian’s recommendations for treating it.

Next, every patient must get an anesthetized tooth-by-tooth evaluation and full mouth X-rays. “Some veterinarians just take X-rays of the teeth that look bad. In one peer-reviewed study of patients with normal clinical findings, 43% had found additional problems once full mouth X-rays were examined,” Dr. Bellows said. “For patients with one problem in the mouth diagnosed, when full mouth X-rays were performed, 75% of those patients had more dental problems that needed immediate care.”

Dr. Bellows does not recommend veterinary practices give quotes for dental procedures over the phone. When a dental procedure is quoted without seeing the patient, often the client does not realize that the price can quickly go up if the veterinarian finds advanced periodontal disease or complicated fractured teeth that need to be removed. Instead, veterinary teams should communicate with the client that dental care is a two-step procedure. “The first step is the same as if you would go into your dentist,” he said. “You would get evaluated, cleaned, and have X-rays. The second step is to care for what’s causing the bad breath (halitosis) and other issues discovered during the tooth-by-tooth examination. Often the cause of halitosis is periodontal pockets where food and oral debris sits. The client can return later to take care of the problems or have them performed while the animal is still anesthetized if time permits, but in the meantime the veterinarian provides home care solutions.”

Opportunities to enhance care

Distributor reps can serve as a valuable resource for veterinary clinics looking to enhance their dentistry services by connecting them with key manufacturers who offer education and training for the veterinary team. Dr. Bellows partners with several manufacturers to develop educational materials through videos and podcasts. He also hosts wet labs sponsored by manufacturers where visiting veterinarians receive instruction and hands-on training at his practice, All Pets Dental, in Weston, Florida.

A study done several years ago by the American Pet Products Association indicated that nearly 50 million dogs in the U.S. never receive proper dental care. For veterinarians willing to put in the work and necessary investments for excellent dental care, the payoff is well worth the effort for the pets they serve and their practice’s bottom line. “It’s important that the veterinarian embraces dentistry for their patients, their hospital, and themselves,” Dr. Bellows said.

Jan Bellows, DVM, DAVDC, DABVP (Canine & Feline), is owner of All Pets Dental in Weston, Florida. He is past president of the American Veterinary Dental College, The Foundation for Veterinary Dentistry and The Veterinary Dental Forum. He is a charter consultant of Veterinary Information Network’s (VIN) dental board. He received his DVM from Auburn University and completed a small animal internship at The Animal Medical Center in New York City.

Photo credits:

istockphoto.com/Chalirmpoj Pimpisarn

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