Promoting dentistry through client education (Proceedings)

Oral disease is one of the most prevalent diseases in dogs and cats. 80% of adult dogs and 70% of adult cats have some form of oral disease. Dental problems are among the top three pet owners concerns in dogs and cats. Calculus and gingivitis are the most common conditions diagnosed by veterinarians in all ages of animals.

Why is the incidence of dental disease so high? Is it due to lack of compliance or the lack of educating the client about the importance of dentistry? Pet's living longer lives, is one reason that oral disease is more prevalent. We are already improving so many aspects of their lives, but dental care seems to still be lagging behind.

Unfortunately, veterinarians and veterinary technicians do not receive much training in dentistry while in school. Many practices don't put enough emphasis on dentistry and the importance of a healthy oral cavity. In many small animal practices, dentistry accounts for less than 10% of the gross income. When a proper dental program is in place, dentistry can contribute to an additional 40% of the overall income.

Companion animals have become an important part of our lives. Many people consider the pet a part of their family. This bond has been important to the veterinarian and his staff because clients are more readily interested in seeking care for their pets. It is essential that communication remains open between all parties. All members of the veterinary team must be excited and motivated and thus project that enthusiasm to the client. The veterinarian and his staff must educate the client about the need for dentistry and convince them of its importance. Statistics show that 25 percent of your clients will accept whatever you say immediately; another 60 percent will take a little time to accept your recommendations; the remaining 15 percent will not accept your suggestions.

As veterinary health professionals, it is our job to promote dentistry. How can we do this? Provide quality services and educating the client on the importance by advertising, dental report cards following examinations, giving out toothbrushes and sample packets The technician should be responsible for client education start this education process at the first puppy or kitten visit. Talk with them about the importance of good oral care by expressing the fact that the "mouth is a mirror" to the body. Give handouts explaining the relationship between oral disease and systemic health.

Many clients may be reluctant to have the dental procedure done for a variety of reasons. How do you convince them that if left untreated, gingivitis will progress to periodontal disease and possible systemic infection? It's often said that a picture is worth a thousand words. Use photographs, models and even videos to drive home the point. Taking a photo of the oral disease in their pet and showing it to the client can help them visualize the severity of the pathology. The advent of digital technology has given us another great tool in the promotion of dentistry. A digital photo can be a powerful tool. The picture will:

• Allow the client to see oral pathology without the need to focus on a moving target!

• Be a permanent document of the pathology

• Provide a take home view that your client can share with family

• Be a reminder for the client to return for treatment

• Provide your client with the before and after photos

• Become part of a bulletin board, display or notebook on oral pathology for use with future

• clients

You can also place digital radiographs and photos on a CD and send home with the client as memento of the procedure.

The use of a dental report card is a great way to help the client understand the treatment that was given to their animal. Include a simplified dental chart on which problem areas can be marked or highlighted. A section for diagnosis, treatment, home care, prescriptions and follow-up visits should be included on this report card. Keep it simple and use bright, cheerful colors with clipart. This is a fun way to give the client important information, a reminder of home care, dosages for prescriptions and the date of a follow-up visit. Always give the client your card and remind them to call with any and all questions.

The dental report card or take home sheet is an important tool but even more important is the need to schedule a go home appointment prior to sending the animal home. This shows the client that even though the clinic may be busy and hectic at 5 pm, you think dentistry is important enough to take the time to go over the procedure, home care recommendations and answer their questions. This appointment should be done by a technician.

Putting together a dental "goody" bag for clients is a great way to provide information, handouts, FAQ's and samples. Including a sample of diets, toothpaste and a toothbrush let the owners know that there are many options available to aid in oral care.

February is Dental Health Month. Take advantage of the promotions and use the provided materials to promote dentistry in your clinic. Offer a discount that month or give a small bag of t/d to each patient that month. Many practices take it a step farther by offering a discount if the client schedules the procedure the day that the recommendation was given. Find some way of rewarding your clients in you practice.

February is also Dental Health Month for people. Take time to write an article for the local newspaper, be on a radio talk show to volunteer to give presentations to local school children. When promoting prevention of dental disease, a great tool that can be used to help promote dentistry is to get the children involved. As we teach children to brush their own teeth, we can teach them to brush the pet's teeth. This helps build the bond between the child and the dog and can teach the child responsibility. When advising your clients to brush their pet's teeth, point out that this activity can help build the bond between the pet and the owner.

It is necessary to communicate the importance of dental treatment and oral care in many ways. It should become as commonplace as vaccinations and heartworm testing in your clinics. Each annual visit should be an opportunity for a dental evaluation and care recommendation. Soon the clients will understand the need for regular dental exams and cleanings.

Every member of the staff must be a part of the dental team because dentistry begins with the phone call taken by the receptionist. The technician meets the client in the exam room has another opportunity to speak the client about dental care. The kennel staff handle the pet prior to and following the dental procedures. The veterinarian then diagnoses and treats the dental problems. Each team member's role is important. The understanding and performance of their role is critical to a successful dental practice. The receptionist must project a positive attitude regarding dentistry and home care. How your receptionist handles the phone shoppers is equally important. When asked how much a practice charges for a dental procedure, the answer must be "It depends upon the degree of oral disease present." The receptionist should avoid quoting prices over the phone. It is best to explain that it is difficult to determine the true extent of the oral disease by having a dental technician or doctor examine the patient and create an estimate which can them be discussed with the client.

A script that can be used by receptionist for phone shoppers, "We can't give you an accurate estimate for a dental treatment over the phone as the cost depends upon the degree of treatment necessary to give your pet the very best care possible. It is essential that we exam your pet to give you a more accurate idea of the cost."

The technicians are essential members of the dental team. To have a successful dental practice it is critical to have one technician whose main focus is dentistry. The technician should be able to concentrate on emphasizing home care, client education, follow up visits. The technician's examination, communication and therapy skills are vital for a successful practice. Their responsibilities should include; prophylaxis procedures, dental procedure assisting, oral radiography, charting, giving post operative instructions, and maintenance of equipment as well as keeping the dental operatory well stocked. They should also keep the staff education up to date on oral hygiene products.

Practices that offer boarding for clients should train their kennel staff or technicians to exam the pet's teeth at admittance. They should show the owner the degree of oral disease and ask if they would like to have the pet's teeth cleaned while boarding. The importance of oral care must be demonstrated to the client. If they don't bring a toothbrush, offer to supply one for use while the pet is boarding and incorporate daily brushing into the practices boarding services. This simple procedure helps emphasize the importance of oral care to the client.

The veterinarian should be the team leader. They must believe that dentistry will help the pet live longer, healthier lives. The veterinarian should be comfortable recommending dental procedures to clients. They should also schedule dental education training and be supportive of continuing education opportunities for themselves and staff.

The decision has been made to make dentistry a priority in your clinic. How do you get the word out? Advertising, word of mouth, client recommendations to friends are all ways to get additional clients but don't forget your current clients. Perform an oral exam on each and every animal that comes to your clinic. Recommend dental cleanings to animals in the early stages of oral disease don't just treat the advanced cases. When performing a dental cleaning, look at each tooth individually, take radiographs and look closely at the pathology happening below the gum line. Approximately 42 percent of pathology happens below the gum line.

Marketing your dental practice to your clients is important. Handouts on oral care, plaque prevention, FORL's, periodontal disease and other dental problems should be made available to your clients. A brochure with frequently asked questions is another good way to answer those questions clients might have but are not sure how to ask. Many people learn visually, include photos of pathology in the brochures.

Continue to communicate with the client after the animal goes home. Call for a follow up in the next day or two. A reminder letter can be a courteous reminder to client of the need for post dental cleaning or post surgical appointment. This can be sent after treatment related to periodontal disease or post surgical that explains the need for a follow-up visit. Emphasis the need to evaluate healing and to evaluate home care effectiveness to ensure the continued prevention of disease progression and possibility of systemic disease should be addressed. Ask the client to call the office to schedule a follow up exam. Many clinics include the cost of the follow up visit in the initial service fees unless additional sedation or anesthesia is required.

Be creative, have fun with it. Have a contest with in your practice to come up with new and exciting ways to promote dentistry!

References

Bellow, J., The Practice of Veterinary Dentistry; A Team Effort. Iowa State Press, 1999.

Harvey, CE, Emily, PP: Periodontal Disease. In Harvey, CE, Emily, PP: Small Animal Dentistry. St. Louis:Mosby, 1993; 89-144.

Gorrel, C: Preventive Dentistry, In Gorrel, C: Veterinary Dentistry for the General Practitioner. Saunders, 2004; 111-118

Logan, EI, Berg, ML, Coffman, L, Hefferren JJ.: Scientific Basis for Prevention. Proceedings of the 14th Veterinary Dental Forum 2000; 261-264