Veterinary Medicine - October 2007 - (Page G3)

Scherk: The veterinary profession can support periodontal wellness by increasing client awareness. Hall: I agree. If clients see commercials or read about dentistry in pets, when the veterinarian talks to them about dental health, eventually it will sink in. Many clients think that if pets are eating, they are fine and are not in pain. That is one of the biggest myths. If they are not eating, then they are pretty darn sick. We tell clients that pets need an Oral ATP visit at least once a year. Just like with people, they need to have their teeth cleaned on a regular basis. We have a Polaroid camera in each exam room. We take a picture, show it to clients, and say, “Put this on your refrigerator, and when your schedule will allow it, please let us clean these teeth and do the Oral ATP.” That picture motivates them because now the oral disease is in front of their nose. Nobody wants a sick pet. Boone: Don’t be discouraged if the first time you mention oral health, clients aren’t receptive. You need to be persistent. If you just keep educating clients, they will usually comply with your recommendations. Hurley: It’s best to start when the animal is young. When you examine a puppy or kitten, tell the owner about preventive oral health care. Attitudes have changed, and people are treating their pets as family. Veterinarians are shifting from just a disease focus towards a prevention focus. Hall: Without intraoral radiography, a thorough assessment is not possible. The assessment also requires a dental chart. Without adequate documentation to refer to when you see the patient again, you are basically starting from scratch. Client compliance obstacles Hurley: So what are the obstacles to this plan? Do your clients come back every six months? Bellows: You will have attitudes at either end of the The Oral ATP Hurley: Take us through your ideal preventive plan. Bellows: First, the word prophy has to be eliminated from everybody’s vocabulary (see A dental misnomer, page 4). Instead, we should say Oral ATP: the Oral Assessment, Treatment, and Prevention visit. Oral ATP covers the three steps of comprehensive oral health (see The Oral ATP visit, page 5). It starts when a client calls the office asking for a teeth cleaning. At that time, the receptionist explains what the client should expect. The client often asks about the cost, but you can’t give an estimate because you don’t know what is going on in the pet’s mouth. It’s impossible to know without a tooth-by-tooth exam with intraoral films under general anesthesia. In our practice, we give clients a list of all of our fees beforehand. We do not hide anything. Unfortunately we cannot tell them the exact fee until we have the opportunity to perform a thorough examination. The first part of Oral ATP is the assessment under anesthetic. Some teeth are in great shape and some need to be extracted, but most are somewhere in between. Some have gingivitis and can be cleaned and do well. Some have small pockets in which we place Doxirobe (Pfizer) gel. Others require mucogingival surgery. Clients are given a second treatment plan and estimate of care once the exam is done and their pet is still anesthetized. Once we get an agreement from the client, then we perform the treatment. The third part of this comprehensive program is prevention. Each part is equally important. spectrum. Some folks would like to have their pet’s teeth cleaned every three to four months, and some folks don’t believe in this at all. When I advise some clients that their pet’s periodontal disease is getting worse, they don’t want to hear about it and actually get upset about my constant pestering. I write down my findings on the medical record and type an alert, “Do not mention the teeth.” I have no idea what is in that client’s head, but I don’t want to alienate them. On the flipside, the people who accept our dental care recommendations are so proud of their decision. The effect is amazing when the clients expend effort on their pet’s teeth and gums. We have scores of patients that are 8 or 9 years old and their teeth look like they are 1 year old. Scherk: It’s good to start providing oral care for puppies and kittens, but the majority of patients I see for the first time are not puppies or kittens. I agree that lifting that lip and showing clients the condition of their pet’s teeth is a process of self-discovery. When clients aren’t emotionally or financially prepared to proceed at that time, the next year we need to say, “I noticed grade I or II dental disease last year. Chances are it has not gotten better on its own, so let’s have a look and see where it’s at now.” But keep it light rather than punitive. In my practice, a good motivator for clients to proceed with assessment under anesthesia is our three-tiered dental system. Tier I is when we predict, based on a comprehensive physical examination, that there is minimal disease. In Tier I the cost will be less and the anesthetic will be shorter. Tier II is more advanced, and tier III is yet more advanced. 3

Table of Contents Feed for the Digital Edition of Veterinary Medicine - October 2007

Veterinary Medicine - October 2007 Contents Leading Off The Veterinary Medicine Interview: Dr. Kevin Fitzgerald Toxicology Brief Idea Exchange Animal Sheltering in the United States: Yesterday, Today, and Tomorrow The Euthanasia Problem Offer Basic Behavior Counseling for Every Pet at Every Visit Promote and Perform Early Spaying and Neutering Assist Owners in Selecting the Best Pets for their Lifestyles Champion Animal Welfare in Your Community CE Form Product Review Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - October 2007

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