Veterinary Medicine - October 2007 - (Page G4)

A DENTAL MISNOMER The term prophy must be eliminated from the vocabulary of everyone who works in a veterinary clinic. Prophy is used in people because you are taking your very clean mouth that you brush twice a day and going to the dentist. The dentist may find a bit of calculus, but in most cases, you don’t have raging periodontal disease. In veterinary medicine, patients are often not seen by the veterinarian until the mouth really smells, which means they have periodontal disease. This is not a prophy because it is not preventing anything. Instead of scheduling patients for prophy visits, I recommend the term Oral ATP: the Oral Assessment, Treatment, and Prevention visit. —Jan Bellows, DVM, DAVDC, DABVP Goldstein: In general, clients are responsive about vaccinating, deworming, and preventing tick exposure, and they are becoming more responsive about preventing obesity. The challenge for clients is to keep their pets as healthy as possible. It is not necessarily our role to be the sole health provider for their pets. Veterinarians are in charge of monitoring them and diagnosing problems, but it is each client’s primary responsibility to keep the pet healthy. If a cat can’t have its teeth brushed, then nutrition or treats can be used. People can try other things that contribute to their pets’ oral health. In geriatric patients with kidney disease, diabetes, or hyperthyroidism, for example, lengthy anesthetic procedures are not good for them. If we can shorten the time the pet is under anesthesia by having a healthier mouth to begin with, that is a huge benefit for the pet. So keeping pets in that first or second tier is a much healthier option than requiring the third tier every year or every six months. financially coming in yearly. The take-home point is that the veterinarian needs to be the pet’s advocate. The dog had to live with that mouth for a long time. When a client tells me, “I’ll speak to my husband” or “I’ll think about it,” which really means no, I put on my animal advocate hat and say, “Just think about it from your dog’s point of view—this mouth hurts!” Scherk: We have to find out what concerns clients have. It’s anesthesia for some and cost for others, especially cat owners. We need to emphasize the subtle signs of sickness and how much disease cats hide. We are not aware of their pain. I ask them to try to stand in the cat’s shoes and tell them, “If your mouth looked like this when you went to the dentist, how do you think it would feel?” I put a little bit of guilt in there—there is nothing wrong with that. It’s not manipulation; it’s teaching them what they should know and helping them choose what they should have all along. Boone: Sometimes veterinarians and staff members prejudge how much the client will pay, but it’s not our position to do this. We need to offer clients the best medical advice for their pets and let them decide. They’ve made an effort to come to the clinic and seek our knowledge, so it’s our job to spend the necessary time to understand and overcome any fears they may have. The fact is very few animals die during anesthesia. Scherk: We have to educate our clients and emphasize the care that we use in monitoring anesthesia. Educational tools Hurley: We mentioned showing clients photos of teeth. What other educational tools do you use? Scherk: Dental models are helpful. You can compare a healthy side to a diseased side. I use one set of images to show the progression of gingivitis to periodontal disease in cats. I don’t use brochures a lot—I think direct, hands-on learning is more valuable for clients. Bellows: We also have to urge clients—even being a little pushy—to get this done. We saw a 12-year-old Yorkshire terrier that fractured its lower jaw because of periodontal disease. The referring veterinarian told me that he had recommended dental care since the dog was 1 year old, but the client was afraid of anesthesia and didn’t want to spend the money each time. We had to extract every tooth in the dog’s mouth. We estimated the cost of annual veterinary visits for 12 years compared with what our procedure cost—the client would have been ahead Goldstein: Cartoons work well to show the bacteria and film that develop in Stage I disease. I explain that the calculus seen is not just a piece of inert rock—it is an active inflammatory process that eats away at the bone and gums in their dog’s mouth. It’s important for clients to understand the disease gets worse every day if we don’t treat it. Hall: I use dental models and radiography books. I also have a tooth collection to show clients. 4

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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