Communication Strategies for Dental Procedures in Pets

Implementing communication strategies for dental procedures in pets can be a challenge. The hurdles to overcome include a lack of understanding of the significance of dental disease, fear of anesthesia, and the potentially high cost. All of these must be addressed to gain client acceptance and enable you to benefit the pet.

Lack of understanding:

• Educate clients

• Explain the potential systemic health impacts of untreated periodontal disease

• Explain all that is involved in a COHAT and how this differs from “anesthetic-free dentistry”

• Fear of anesthesia

• Explain benefit:risk assessment

• Explain the safety measures utilized

• Advise clients of the increased risks of delaying dental procedures

Cost Concerns

• Explain the reasons for the charges

• Make payment plans available

• Client communication for dental procedures in pets is essential before, during and after dental procedures

1. Lack of understanding: Educate pet owners

   
   

   This requires a team approach where everyone, including receptionists, technicians and veterinarians must deliver a consistent message.

   
   

   Speak with confidence and make your approach conversational by asking questions that make the client feel involved and empowered. For example, you might say, “Mrs. Smith I know how much you love Fluffy. Would you like me to explain to you how we can help her live longer, be healthier, and pain-free?” OR “Can you imagine what it would be like if you never brushed your teeth and only saw the dentist every 14 years or so?”

   
   

   Explain periodontal disease in layman’s terms stressing the potentially severe consequences of leaving it untreated. For example, “Dental procedures are not done to improve the pet’s breath or the cosmetic appearance of the teeth, although these are bonus results. Dental disease occurs when plaque bacteria under the gum line cause inflammation of the gums, or gingivitis. Gingivitis is a reversible condition with proper dental care, but left untreated it worsens and becomes periodontitis which involves damage to the bone and other tissues that support the teeth. The eventual result is loss of bone and tooth attachment ultimately leading to pain, tooth loss and even possible jaw fractures.“

   
   

   Use visual aids to improve the clients’ understanding of dental disease. Before-and-after pictures are impactful, as are radiographs. Stress the importance of full mouth radiographs to examine the two-thirds of the tooth that lies below the gingival margin. It is also helpful to use a clear dental model to demonstrate how much of the tooth is hidden.

   
   

   If possible, show clients their pet’s mouth and explain the implications of any pathology you may detect (ex: halitosis, extra/retained teeth, missing teeth, gingivitis, tooth resorption, discolored teeth, fractured teeth, malocclusion, masses, swelling).

   
   

   Explain potential systemic health impacts. Most clients are unaware that dental disease impacts more than just the mouth and can have serious implications for the pet’s general health. To address this, you might say, “Did you know that untreated dental disease can harm Fluffy’s overall health? Harmful bacteria can move from diseased gums into the bloodstream, travel throughout the body, and cause infection in multiple organs including the heart, kidneys, liver and lungs. The worse the dental disease, the more severe the damage to these organs! This damage can be permanent, so prevention with regular dental care is crucial.”

   
   

   Explain all that “dental” entails. The term COHAT (comprehensive oral health assessment and treatment) can be confusing but explain to the client that unlike a so-called anesthetic-free dentistry, a proper dental procedure goes way beyond simply cleaning the teeth; A COHAT, in contrast, includes a full pre-operative exam, general anesthesia, complete oral exam, dental x-rays and interpretation, probing pockets and charting the results, cleaning the crown of the tooth as well as root planing to remove debris from the pockets between the gums and the tooth, treatment (which might involve extractions, open flap debridement, gingivectomy, etc), polishing the teeth, pain medications if indicated, and the use of adjuvants such as PerioVive to increase the rate and quality of tissue healing while providing additional pain control.

2. Fear of Anesthesia: Benefit:Risk Analysis

   
   

   Don’t dismiss the client’s fear with a brief “she’ll be okay.” Instead, acknowledge it and ask, “What scares you about anesthesia and what can I do to allay those concerns? Then, explain that “No medical procedure is completely without risk, but we always conduct a benefit:risk analysis, or in other words is the benefit of the procedure worth the potential risk? Fluffy is young and healthy so her risk from the anesthesia is very low but the benefit of treating her dental disease is very high.”

   
   

   Explain the safety measures utilized. Inform the owner of your anesthetic protocol in layman’s terms. For example, “Mrs. Smith we use most of the same equipment and protocols used in human hospitals to make anesthesia as safe as possible. This includes: a pre-anesthesia physical exam, bloodwork, IV catheter placement and fluid support, anesthetic monitoring both mechanical (ECG, O2, CO2, BP) and by a trained technician, an endotracheal tube to protect the pet’s airways and deliver a gas anesthetic, local pain blocks to reduce the level of general anesthesia required, and warmers to keep Fluffy’s body temperature stable.”

   
   

   Advise clients of the increased risks of delaying dentistry. For example, “Mrs. Smith, what do you think will happen if we delay Fluffy’s dental treatment? This can increase the risk as she will be older, might develop other health conditions, and the dental disease will continue to progress which will necessitate longer anesthetic time, more extensive treatment and more pain. So do you agree that it is best for Fluffy if we treat her dental disease now?”

3. Cost Concerns: Explain the reasons for the cost

   
   

   Jimmy Dean when asked about his sausage costing more than competing brands famously said “I’d a whole lot rather explain the price than apologize for the quality.” Embrace this attitude and don’t apologize for your charges.

   
   

   A technician should review an estimate with the client and explain the reason for each charge and ask if there are any questions or concerns. Have them be prepared for statements including “my own dental visits don’t cost that much!” They might reply, “Yes but you brush your teeth multiple times a day, get your teeth cleaned every 6 months, and you’re not under general anesthesia, right?” OR “My groomer only charges $250 to clean Fluffy’s teeth” You might reply, “Anesthetic-free dentistry is a misnomer and is merely cosmetic as only the part of the tooth above the gum line and the outer sides of the teeth are cleaned. Scraping teeth without polishing leaves scratches that attract plaque and accelerate the progression of periodontitis. And remember, most of dental disease is under the gum line and can’t be seen without x-rays or treated without Fluffy being under anesthesia.”

   
   

   Make payment plans available if possible. Care Credit or other plans might be an option

4. Client communication is essential before, during and after dentistry

   
   

   The most important part of communicating with the client about dental care starts long before the need for care arises and extends beyond the procedure. Discuss dental care at all visits, starting from the initial puppy/kitten exam. At this point many of you are thinking “I don’t have the time to do this with every patient.” Of course you don’t, so use a whole team approach and allow the technicians to do the bulk of the educating.

   
   

   A consistent message is needed to ensure clients will be motivated to have routine dental procedures performed. On discharge the veterinarian should review the radiographs and any treatments. The technician should then show pre and post dental photographs, review discharge instructions, stress the importance of a follow-up exam, and provide a home care kit with a toothbrush and paste or dental wipes, and possibly PerioPearls, a hyaluronic acid water treatment dissolved in the water daily to help treat and prevent periodontal disease. The technician or doctor should call the client the next day. Avoid asking “How is Fluffy doing?” A better approach is to ask more specific questions. For example: “Is Fluffy eating and drinking normally? Are you leaving the Elizabethan collar on and not giving her anything hard to chew on? Does she seem comfortable? Are you having any trouble giving her the medications? Is there any odor to her mouth? Do you have any concerns?” Conclude with, “It’s so awesome that you’re taking such great care of Fluffy!”

   
   

   Don’t forget about the receptionists or CSRs. On check out, the receptionist should never say, “Wow, that’s expensive,” or “Are you ready?” before giving a total with a sympathetic look on their face. My best receptionist used to gush over what a great pet parent the owner was for having a dental procedure done. For example: “Fluffy is so lucky to have you for her owner Mrs. Smith. I know how much you love her and she is going to be so much healthier and happier after having her teeth taken care of. I can’t wait to see her back in a week for her recheck exam.”

Finally, we all understand the importance of regular professional dental care for our patients, and it is essential that we effectively communicate with our clients about dental procedures so the pets can get the care they deserve. The use of PerioVive, a hyaluronic acid gel, following dental procedures can double the rate and quality of oral tissue regeneration and repair and can dramatically decrease the progression of periodontal disease and associated organ damage.