7 ways to promote dental care compliance

When it comes to dentistry, without great communication there will not be effective compliance. Without compliance, the patient, client and practice lose. This is our daily reality. It's a shame our patients can't make treatment decisions for themselves. In the real world, we need the client to say "yes" to recommended therapy plans. When a client doesn't comply with our treatment or prevention recommendations, we often chalk it up to unavailable finances, but is that the real reason?

Compliance seems to depend on what and, more important, how treatment recommendations are presented. The University of California Los Angeles conducted a study on communication, which revealed that the actual words spoken contribute only seven percent to a person's decision. How the words are said and the body language and gestures that are used comprise 93 percent of the influence in the decision-making process. Veterinarians need to improve their overall presentation of treatment and management recommendations if they hope to influence their clients' decisions.

When it comes to dental care, client compliance is everything. Convincing pet owners of the value of daily teeth brushing, regular oral examinations and dental cleanings (requiring the dreaded general anesthesia) can mean the difference in a patient's overall health and well-being. Easing client confusion, frustration and genuine concerns regarding home care and dental procedures is the key to solidifying client trust and compliance. Here are some communication ideas that will improve your clients' understanding and increase your dental treatment plan's acceptance.

Show

Photo 1: A veterinary assistant takes a picture of teeth, which in seconds broadcasts to the television screen.

A picture often speaks a thousand words. Pictures and videos let clients see what is involved in the oral assessment, treatment and prevention of dental disease. It is now possible to take a picture in the exam room that is instantly enlarged on the computer screen. An Eye-Fi (Eye-Fi, Inc.) card placed in a digital camera, coupled with a wireless network, makes instant viewing available to all (Photo 1).

Give

When oral pathology is identified and a picture is taken, a handout that corresponds to the patient's condition can be given to the client (Photo 2). The handout may be from a published article, veterinary textbook or credible information pamphlet. It should include pictures and be easy to read and follow. This step adds credibility to your advice and gives clients a way to refer back to the information given during the visit.

Clients will often try to address treatment costs at this stage. It is important to let them know that you will cover that in detail, answering all of their questions, but prefer to focus on discussing their pets' problems and what options for treatment or management you recommend.

Photo 2: Use a handout and picture to explain disease to a client.

Tell

Your voice tone, pitch and speed will greatly influence a client's decision. Speak calmly as you would to a good friend, so that clients are able to see their pets' oral disease as you do—a real problem necessitating intervention. Emphasizing the pain and discomfort associated with oral disease is a good place to start. Clients report to us daily on the difference dentistry has made in their pets' lives.

Gestures and facial expressions are powerful tools, conveying the magnitude of oral examination findings and need for treatment. Clients need to know the significance of their pets' problems before they can attach a value to treatment. If during an oral examination, you find advanced periodontal disease or discover a fractured tooth with pulp exposure, your facial expression is likely to give away the severity of the condition (Photo 3). Your clients' decisions are likely to be based largely on emotion, so avoid downplaying more minor conditions, and don't hold back on expressing the significance of advanced dental disease.

Photo 3: Concerned facial expressions during an oral exam emphasize the importance of the pathology.

Eliminate distractions

Children, other pets and cell phones are common exam-room distractions. Being aware of disruptions and having a plan on how to handle them are musts to gain compliance. To control distractions:

• Don't let the patient be the distraction. There are several ways to prevent pets from jumping or playing while you are explaining the dental problem and treatment recommendations. You may choose to hold the pet so the client can concentrate on the matter at hand or have a technician hold the pet so that the client can focus on you. Smaller pets may do best back in their carriers while the details are discussed. Separating the pet from the client is another effective method if the patient is too large to hold or is excitable.

• Cell phones are harder to control than bouncy pets. Having a clearly posted cell phone policy in your waiting area and exam rooms may help. Clients can also be politely reminded that calls may be made or received outside before entering the exam room.

• Use toys to control spirited kids. If you don't have the luxury of having a kiddy corner in your practice, have age-appropriate toys available such as crayons and coloring books. At the beginning of the exam, ask the child to draw a picture of the family and pets.

Overcome objections

Client objections often stand in the way of performing needed care. If finances are the impediment, then third-party organizations and creative payment plans can help. When anesthesia complications are the main concern, explain that choosing the proper protocol and monitoring for each patient allows the safest anesthesia possible. The need for treatment can be put into perspective by relating the severe pain and progression of disease associated with leaving dental conditions untreated as compared with the small risk of complications associated with anesthesia.

Occasionally, clients do not want to face a pet problem at the time of a visit because of other events in their lives (e.g., car repair, vacation, family, roof leak). If this appears to be the situation, offer to set up another appointment at a more convenient time to address the oral problem. This emphasizes your concern regarding the oral disease, as well your understanding of life's many complications.

Call to action

You must take time to discuss the precise procedures you are recommending. This needs to include what the procedure is, how long the treatment will take, what the expected outcome and anticipated follow-up are, as well as the cost. You also need to outline the ongoing care required to prevent future disease and the commitment and any associated cost. By providing clear and direct information, your client can ask appropriate questions and have any concerns addressed.

Stop talking

During every oral assessment, treatment and prevention visit there comes a time when you have explained everything and the client needs time to process the information. While the client is making a decision, the silence can be deafening. Some of us find it hard to keep quiet at these times, and the urge to continue making the case can be irresistible. I count to 20 to myself to keep from interrupting my client's thoughts. This gives clients time to digest what has been presented. Silence is golden after showing and explaining pathology.

Overview

In the medical sense, compliance is a patient's adherence to a recommended course of treatment. By adhering to the tips above, compliance to your dental recommendations will improve, allowing you to provide your client and patient the best care possible.

Dr. Bellows owns Hometown Animal Hospital and Dental Clinic in Weston, Fla. He is a diplomate of the American Veterinary Dental College and the American Board of Veterinary Practitioners. Camilo is the hospital administrator for All Pets Dental in Weston, Fla.

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