The Veterinary Dental Patient - A Multidisciplinary Approach

A professional dental cleaningincludes a thorough examination in both the conscious and the sedated patient, radiography (preferably intraoral), a dental exam including periodontal probing and dental charting, supragingival and subgingival deposit removal with the use of mechanical scalers and hand instruments, polishing, and gingival sulcus lavage. An important part of prophylaxis is the establishment of homecare, composed of both active and passive methods: toothbrushing, diet, supplements, dental chews, and toys. To properly perform dentistry in a clinic, it is necessary to carry out all these tasks at a standardized level.

The provision of dental services in private practice should include all necessary parts of the business plan. For most such plans, it is useful to follow the “SMART” acronym:

Specific:Specify what exactly is needed. Dentistry is a large subject, and for novices it can be quite confusing. Election of a range of dental procedures to implement at the outset is necessary to the design of a good plan. In addition to equipment investments, the education required to utilize them should also be considered.

Measurable:Plan expenses on an appropriate level. Consummate with the local market, select prices that will provide a relatively quick recoup of expenses without driving away clients. At the same time, the quality of purchased equipment must be high. Skimping on quality, warranty, or durability often works out to be more expensive in the long run.

Achievable:There are no limits to possible expenses, so it is important at the outset to establish the minimum amount of money that it will be necessary to invest according to local prices and stock.

Realistic:Buy what is necessary according to the skills available at the practice, its specific features, human resources, and the practice's general business plan.

Time‐bound:Be realistic. Plan timing and deadlines, then make them real. Use promotion. If possible, plan future development and evaluate its results.

The educational opportunities listed in this section may not be available in every country, but e‐learning is becoming ever easier to access, and its quality is steadily increasing. Teaching dentistry is the subject of Chapter 3, so here we will only emphasize the critical need for education prior to establishing a dental presence and the importance of continuous further development.

Dental Program During Veterinary School:See Chapter 3

Self‐Education:This can include books, articles, journals, training, and cooperation with a referral vet. Despite there being just one journal dedicated to veterinary dentistry – the Journal of Veterinary Dentistry ( https://journals.sagepub.com/home/jov)– dental articles can be found frequently in Journal of American Veterinary Medical Association (JAVMA), Journal of Small Animal Practitioner (JSAP), European Journal of Companion Animal Practitioners (EJCAP), Journal of Feline Medicine and Surgery (JFMS), Frontiers in Veterinary Science and its section: Veterinary Dentistryand Oromaxillofacial Surgery and other publications. Textbooks are available both from traditional publishers and from smaller, independent ones, or in e‐formats like those offered by the International Veterinary Information Service (IVIS). Finally, the Dental Guidelines of the World Small Animal Veterinary Association (WSAVA) offer a comprehensive overview of the veterinary dentistry field.

Associations:The European Veterinary Dental Society ( https://www.evds.org), Foundation for Veterinary Dentistry ( https://veterinarydentistry.org), and British Veterinary Dental Association ( https://www.bvda.co.uk) offer many educational opportunities via their websites, publications, and conferences.

Continuing Education:Courses organized and tutored by specialists are often available. The really good ones combine a practical component with theoretical prerequisites. Additionally, dentistry streams are offered by the WSAVA and Federation of European Companion Animals Veterinary Associations (FECAVA), and during national congresses, seminars, and conferences dedicated to dentistry.

Continuing Professional Development (CPD) Courses:These are offered by pre‐congress wetlabs, the European School for Advanced Veterinary Studies (ESAVS) or Accesia Academy, and training centers (e.g. the San Diego Veterinary Dental Training Center).

Certifications and Specializations:These are offered by the European Veterinary Dental College (EVDC), American Veterinary Dental College (AVDC), and Australian and New Zealand College of Veterinary Scientists (ANZCVS).

Nursing:Lack of nurse education may be a major limitation in dental service development. However, there are an increasing number of CPD events dedicated to nurses, and Accreditation Committee for Veterinary Nurse Education (ACOVENE)‐accredited nursing schools provide dentistry‐oriented profiles.

Although important, promotion may not be seen as such by the public or the veterinary community. It is performed differently in Europe, where many countries have specific regulations on advertising veterinary services, than in the North America. Marketing will be the subject of Chapter 2; our purpose here is only to highlight the importance of certain policy related to promotional efforts.

Should we promote the various services we offer? Should the major goal of marketing be focused on making customer say “Yes,” or should it present the benefits of oral health and of releasing the patient from pain and infection? Both aspects are important, and a balance is required.

The follow techniques are worth considering.

Participate in educational events like National Pet Dental Health Month and the Pet Smile Campaign.

Make use of oral care products and merchandising provided by pet food companies: models, posters, leaflets, brochures, and so on. It is not easy to select high‐quality dental hygienic products based exclusively on manufacturer information, so turn to institutions like the Veterinary Oral Health Council (VOHC) http://www.vohc.org for information. Products with the VOHC seal are more reliable that those with just a marketing logo. Additionally, there are a growing number of evidence‐based medicine studies evaluating the effectiveness and mechanism of oral hygiene products (See more in Chapter 5).

Provide information on your website and in your waiting room and reception on standards, safety, and the importance of oral health

Make dental care part of your prophylacitc/preventative/wellness program, together with vaccination, deworming, senior care, and so on.

Depending on the types of patient you typically see, the waiting area should be arranged in such a way as to handle animals of all different sizes and types at the same time. Regarding dentistry, communication should start with examples of the problems that create pain and infection. Pictures demonstrating procedures and patients should not be too scary or dramatic, however, as children and some other customers may find them upsetting. A TV screen displaying information about the quality of oral hygiene, anesthesia, and surgery provided by the practice is very useful, especially for those clients who have to wait some time for consultation or for discharge of their pet ( Figure 1.1). However, too many advertisements may have the effect of alienating customers, so be careful not to overdo it.