Veterinary Medicine - October 2007 - (Page G6)

BRUSHING: A STEP-BY-STEP PROCESS When educating clients about how to properly brush their pet’s teeth, break it down into steps so clients are not overwhelmed with information. Clients should spend at least 10 to 15 seconds multiple times a day performing each of the following steps, and they should only proceed to the next step when their pet accepts the previous step. 1. Spend time desensitizing the pet to having its face and lips touched. 2. Lift the pet’s lips. 3. Open the pet’s mouth. ent (CET HEXtra chews—Virbac) can be effective if the dogs actually chew—not gulp—the rawhide. We also prescribe Greenies (S&M NuTec) daily to practically every patient we see. Clients with cats get a bag of Feline Greenies. We vaccinate every one of our canine patients with Pfizer’s periodontal vaccine. I don’t feel it is a panacea against periodontal disease, but reasonable research shows it will be effective in controlling one of the major pathogens.7 However, it’s important to realize that other pathogens exist. Clients can’t think that if their pet gets this vaccine they don’t have to do anything else for dental health. 4. Brush the pet’s teeth with your finger, paying close attention to the area where the gum and teeth come together. 5. Put toothpaste on your finger and use that to brush the pet’s teeth. 6. Begin using an appropriately sized, bristled toothbrush. Bristles are important because of the gingival sulcus, which is less than 1 mm in cats and 2 to 3 mm in dogs. That’s where the plaque, calculus, and bacteria accumulate. —Barron Hall, DVM FAVD, DAVDC the tooth-gum interface to decrease plaque in that area. Scherk: There also needs to be positive reinforcement for the client, or the behavior will not be repeated. We also ask them to come back 10 days later, and when we show them the mouth, they are pleased with how much it’s improved. That alone is reinforcing. Boone: A simple tip that I give clients is to have them elevate their pets to exam table height. For example, they can put them on top of the clothes dryer, which is a perfect level. They can clean ears, brush teeth, check feet and nails, and brush hair. It is easy on owner’s backs, and it gets the animal out of its natural territory. It also gives them much more control over the pet’s movements. Scherk: Clients may need to do several things, one of which is altering their pet’s diet. Some patients need a diet other than a dental diet for health reasons. That is why we need to look at what is appropriate for individual patients. Hurley: What do you recommend, Dr. Hall? Hall: Brushing is the “gold standard.” It’s important to talk clients through this process. I say, “You can’t expect to brush their teeth right away. You need to take it step by step, and each step has to be done with positive reinforcement.” We must give clients a step-by-step approach (see Brushing: A step-by-step process). Depending on the pet’s temperament and age, each step may take days to weeks to accomplish. Again, not every animal will allow brushing. Educating veterinarians and technicians Hurley: We touched on dentistry in the veterinary curriculum. How well educated do you think veterinarians and staff members are? Hall: When I lecture to veterinarians and technicians, I give a one-page quiz that asks about basic dentistry and how much dental education they had in school. It’s usually very minimal. Lectures are good, but I recommend that they attend wet labs. Bellows: We ask clients to come back two weeks after the Oral ATP visit. We then show them how to clean the teeth first with a wipe and then apply OraVet (Merial). Each one of our patients receives OraVet gel, which attaches to Bellows: Veterinarians need to understand that periodontal disease is complex. There are four stages, and each stage is treated differently. Only during the last two stages do you even consider extractions. During the first two 6

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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