Battling the 'Difficult Sell' of Veterinary Dentistry

Overcome these 3 client misperceptions and get pet owners to say “yes” when it comes to veterinary dental work!

Recommending dental work can be particularly challenging considering that clients frequently experience the following issues:

1. Lack of Understanding About the Oral Cavity
2. Concerns About the Costs for an “Elective” Procedure
3. Fears About the Use of Anesthesia

We'll look at each of these 3 reasons.

1. Lack of Understanding About the Oral Cavity

One way to improve a client’s understanding of the importance of quality professional oral care is to do the following:

(a) Educate the client about how complex the oral cavity is
The use of transparent models, acrylic models, plastic models skulls and radiography is often helpful. However, veterinarians shouldn’t expect a client’s understanding of anatomy to be like that of a veterinarian’s.

Figure 2: Models depicting dental problems often have one side showing the lesion while the other side remains normal for comparison. (www.drshipp.com)

Figure 3: Seeing the nasal cavity and bone structure together can illustrate how difficult a dental extraction can be. (www.drshipp.com)

(b) Emphasize the importance of dental radiography

The importance of dental radiography in appropriate diagnosis and treatment planning is an important tool in client education, and cannot be overemphasized. Radiography offers clues as to the health of the teeth and supporting tissues. Showing your clients radiographic evidence may improve their appreciation for how extensive the diseases may be (see below).

(c) Provide clients with printed copies of radiographs

Receiving printed radiographs allows the client to look at and review their veterinarian’s diagnosis on their own time. Most radiography imaging software programs have a default method for generating printed reports displaying multiple images on each printed page. An example of a printed radiograph is below.

Figure 4: Digital dental radiology of a Yorkshire terrier, courtesy of Brook A. Niemiec, DVM and Matthew Wright, DVM (Clinician’s Brief, January 2011) (www.cliniciansbrief.com/column/diagnostics/digital-dental-radiology)

Resistance to dental treatments often stems from their expense. It is human nature to perceive money spent as valuable when they receive something tangible to show for it.

(d) Use take-home brochures

Take-home brochures explaining the stages of periodontal disease permits clients to consider the given treatment recommendations after they leave the appointment.

Want to know where to easily find some dental brochures?

Historically, various industry companies (pet food and drug companies) have promoted their products through client information brochures on periodontal disease. The presence of these resources typically coincides with Pet Dental Health Month.

Remember, in human medical care, “providing written and verbal health information has shown to be more effective…than providing verbal information alone”.¹ Similar approaches can be taken with veterinary clients by using models and posters.

Tell Your Clients:

“Extracting teeth in animals is a big job. These transparent models demonstrate how large the roots are and how careful we need to be.”

2. Concerns About the Cost for an “Elective” Procedure

(a) Talk with clients about finances

Let clients know they’ll save more money with yearly preventative dental care than by skipping or even completely ignoring dental care for extended periods of time.

Consider dentistry as an opportunity to educate clients about the enormous value to their pet’s general health, and the cost savings over time. We know the immense tolls that chronic pain and infection have on the body—and the high costs of allowing them to get only worse.

Tell Your Clients:

“Once we remove this tartar, we will be able to examine areas below the gum line. If we find periodontal pockets that are too deep, we recommend taking a radiograph like this before extraction. The bone loss in this x-ray is a dramatic example of how the jaw could fracture spontaneously if periodontal disease left untreated.”

Use gingivitis and calculus build-up as a reason to evaluate the animal under general anesthesia. After all, periodontal disease occurs below the gum line, and cleaning the surfaces the client can see enables us to clean the areas we can’t see—which have the biggest impact on the pet’s comfort and health.

Figure 5: Dental digital radiology, courtesy of Snyder and Soukup

3. Fears About the Use of Anesthesia

Concerns about general anesthesia are often used by clients as a reason for avoiding or postponing dental cleanings.

One paper that looked at 3,249 dogs and cats who underwent general anesthesia found that 0.43% of dogs and 0.43% of cats died during the perianesthetic period.² Considering this evaluation was of patients anesthetized at a teaching institution, one could argue that the level of anesthetic risk was much higher in this referral population that may have inflated the number of complications.

On the other hand, dedicated anesthesia staff, specialty anesthesia training and top-of-the-line monitoring may have supported some patients through a procedure that may have had complications otherwise. Preventative professional oral care performed before advanced pathology develops should be viewed as “an ounce of prevention being better than a pound of cure.” No client wants their pet to be the exception to something that should be very safe.

(a) Use polypharmacy to maximize the safety of anesthetic practices.

The use of multiple smaller doses of appropriate drugs helps to reduce the adverse effects associated with any one particular drug. People equate going to the dentist with taking extra time at lunch and resuming work afterwards.
By using premedications, reversible drugs and local anesthesia techniques patients can leave your practice less groggy and more closely resembling how they walked in.

(b) Maintain consistent dental care rather than inconsistent care.

Short yearly professional oral care done safely, and in healthy patients, is a much better scenario than putting off treatment until an animal is geriatric and the procedure is a marathon of extractions!

Tell Your Clients:

“Once we get your pet’s mouth clean and problem areas addressed, daily brushing should help reduce further development and progression of periodontal disease. If you can maintain home care, future procedures should be quicker, require less anesthesia, and be less expensive.”

Practice Tip:

To benefit your practice concerning anesthesia:

It doesn’t all have to be about breaking difficult news to clients—conversations about dental care can be about breaking great news!

Conclusion

Be proactive with the solutions discussed in this article, and be positive about the impact your practice of veterinary dentistry will have on your patients. Your patients and clients will thank you for it!

References:

1. Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home: systemic review. Johnson A, Sandford J. Health Educ Res. 2005; 20(4):423-9

2. Complications and mortality associated with anesthesia in dogs and cats. Gaynor JS, Dunlop CI, Wagner AE et al. J Am Anim Hosp Assoc. 1999; 35(1):13-7