How veterinarians can ease common roadblocks to dental care

Many companion animal veterinary practices want to improve dental compliance. Yet, veterinary dentistry suffers from both terminology and perception problems. Until people really comprehend the risks of untreated dental disease and what they can easily do to avoid or fix dental problems, dental care will continue to feel optional.

Finding the right language to talk about pet oral health

Vocabulary challenges confound veterinary teams’ efforts to improve adherence to recommendations for lifelong oral health strategies.

The most recent AAHA Dental Care Guidelines for Dogs and Cats suggest using the broader term “oral health” to bolster compliance efforts.1 The guide encourages veterinarians to discuss oral health as a fundamental part of veterinary medicine for companion animals — not something extra that only certain patients need.

The American Veterinary Dental College (AVDC) advocacy committee explains: “Dental disease should be a topic that is broached early and often in a patient’s life. Conversations puppy visits. Provide handouts and videos to owners to describe the importance of toothbrushing and preventative at-home dental care for pets.”

Client education through automated and targeted client communication can also feature:

• How common periodontal disease, fractured teeth, and tooth resorption are in pets
• What indirect indications of dental pain might look like, including changes in eating habits/weight loss, chattering teeth, or changes in engagement with people in the home
• Why anesthesia-free dental care is “purely cosmetic and ineffective to treat disease,” according to the AAHA dental guidelines
• How intraoral radiographs uncover problems, even in teeth that look normal to the naked eye
• Every step veterinary teams take when providing dental care — from anesthesia safety protocols through pain control and post-op planning

Getting clients to understand the components of dental care

According to the AAHA guidelines, foundational dental care includes:

• Regular consultation and evaluation by veterinary professionals, starting with pets’ first visits and continuing throughout their lives
• Recommendations for at-home oral hygiene (including specific products) and dental disease prevention strategies tailored to what’s logistically possible for specific pets and even breed- or size-specific risks
• Regular conscious and unconscious oral evaluations (including intraoral radiography) that provide objective information needed for diagnosis and treatment plans and maximize the benefits of dental care that can only be given to anesthetized patients
• Diagnosis of conditions, diseases, and disorders of the entire oral cavity and maxillofacial area
• Treatment of diagnosed issues

All members of the veterinary care team should emphasize the importance of preventative anesthetized dental cleanings. Early intervention brings three benefits:

1. It helps prevent pain and suffering.
2. It increases the chances of reversing gingivitis.
3. It likely costs clients less than waiting for severe dental disease stages and states to take hold.

Common reasons for poor dental compliance

Common struggles at home also nix the best intentions for sticking to at-home dental hygiene routines. People often feel busy and exhausted from other demands on their time and energy. Sometimes, that means frequent, consistent at-home dental care such as brushing their pet’s teeth or using dental wipes does not happen.

Patient noncompliance remains another big issue, even with more veterinarians working on cooperative care training. Maria Soltero-Rivera, DVM, DAVDC, based at UC Davis in California, chairs the AVDC advocacy committee, which includes five specialists in practice. The committee members worked together to recap roadblocks that prevent clients from scheduling and keeping dental care appointments, saying:

“Clients often don’t notice that their pet has a dental problem. Animals are famous for concealing the severity of their dental disease, so owners don’t schedule appointments because they don’t see that anything is wrong.

“When the veterinarian identifies disease on a conscious oral examination, the owner will typically need to schedule a follow-up appointment for an anesthetized procedure. This can be challenging for many reasons: owners’ busy schedules, veterinary scheduling, cost of the procedure, and concerns about the procedure itself.” 

As for those procedure concerns, AAHA’s dental guidelines report that clients’ “fear of anesthesia is the most common cause of clients’ decision to forego dental procedures for their pets.” This is particularly true for people with older or otherwise compromised pets, including those with cardiac diseases or seizure disorders.

Improving rates of pet oral health starts with staff

The process of normalizing pet oral health and improving adherence takes everyone moving and communicating in the same direction.

AVDC advocacy committee members explain, “Compliance can be improved in several ways. Education of the whole veterinary care team is one of the most critical factors. Everyone from the doctor to the receptionist and technician needs to understand and appreciate the importance of dental care. If a part of the care team is being left out of this education, the client will not receive the same message from everyone.”

AVDC and other organizations offer continuing education for veterinary teams to learn more about the clinical side of pet dentistry and make recommendations and care more accessible and understandable for clients.

The AVDC committee also says that “another critically important strategy is for the doctors to develop a good, comprehensive, efficient conscious oral examination. Since most patients don’t develop symptoms of oral disease until it is very advanced, it’s important to be able to recognize it in its early stage.”

Including dental care in preventive care plans offers another way to normalize oral health as a foundational element in pets’ lifelong comfort and wellness. Plus, it helps address cost and family budget concerns.

Erin Altman of Louisville, Kentucky appreciates having dental care included in her pets’ care plans. “We always get our professional cleanings and X-rays done. Having it included in our care plan is a big help since the cost is spread out over the year.”

In all communications about oral health for pets, convey the importance of prevention and treatment. Make oral health messaging a foundational part of client education, engagement, and retention efforts so that every team member at every point of contact knows if a pet is due/ overdue for dental services.

Otherwise, as the authors of AAHA’s guidelines write, “Without the pet owner’s understanding and acceptance of the veterinarian’s oral health recommendations, the decision to pursue dental cleaning, oral evaluation, and treatment will seem optional.”

Take a little time, especially with new pet parents to help them understand prevention is worth its weight in gold for the pet. Keeping dental health conversations at the top of the list can improve compliance, allowing you to spend less time on intensive procedures trying to fix or reverse dental disease.

Reference

1. 2019 AAHA Dental Care Guidelines for Dogs and Cats. AAHA. Accessed 1 October 2021. Available online at: https://www.aaha.org/aaha-guidelines/dental-care/dental-care-home/