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Polling Place: Adding Dentistry to Your Practice

Judi Bonner Leake, DVM

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You have asked ...

How do you recommend building a full-service dentistry complement into an existing practice?

Our Readers Say...

Education, Education, Education
I believe the key to building a full-service dentistry program is education, education, education. First, the doctors must be educated as to the need and value of dentistry. When I was in school over 20 years ago, teeth and teeth cleaning for small animals was mentioned maybe once. There is so much more information on dentistry now, and good continuing education is invaluable.

Once the doctors are convinced, they must educate the staff. Many pharmaceutical companies have great programs to help and, as is true for veterinarians, continuing education is available for technicians at most major meetings. 

With doctors and staff trained, now comes the challenge of educating clients. Again, drug companies have many educational aids, but the key is to examine every patient's teeth, including horse's teeth. Start early, when patients are puppies and kittens. Emphasize that even the pet insurance programs deem that an annual dental cleaning and exam are important. Show your clients any problems and explain the possible consequences. As clients see your concern about dental health, they too become convinced. Most will then demand that you do something. At this point, adding the necessary equipment is only a minor issue.
Vaughn Ray Park, DVM
Provo, Utah

Investing for a Healthy Return
Initially, a little investment in time and money is required to incorporate dentistry into your practice. You need trained staff, educated clients, and new equipment.

The whole staff must know the importance of periodontal disease to sell the concept to clients. To ensure that staff members buy into the concept, recommend dental prophylaxis for staff pets. It is also essential to have technicians trained to do dental prophylaxis. If your staff does not have the necessary training, continuing education is available and there is an American Society of Veterinary Dental Technicians. C.E. is also available for doctors.

Educating clients starts when their pets are puppies and kittens. As part of our initial puppy and kitten exams, we provide complimentary C.E.T. finger toothbrushes and mini tubes of toothpaste. Our technicians then demonstrate how to brush teeth and explain the reasons why it is important. Doctors begin to stress the importance of oral health to clients at annual exams and talk about potential secondary effects of periodontal disease on the heart, liver, kidneys, and lungs. Also, C.E.T. and other companies may offer brochures and other paraphernalia for client education.

Lastly, you need the proper equipment. This entails purchasing equipment for ultrasonic scaling and polishing, hand tools, and a dental x-ray unit.

With minimal investment in time and money, dentistry can generate quite a profit center.
Marty Weber, DVM
Appleton, Wisconsin

Educating Staff & Clients

I would say that the most important action that anyone can take is to educate your entire staff not only on the importance that oral health has on the overall health of a pet, but also on the economics involved in dental cleanings. The number one question that we get from clients when a professional dental cleaning is recommended is, "Why does it cost more to clean my pet's teeth than it costs to have mine cleaned?" I have found that when everyone on the staff can answer this question with confidence, client compliance skyrockets.
Kimberly K. Mercurio, DVM
Woodhaven, Michigan

What the expert says ...

Think & Talk Teeth

Where do you start to build a knowledgeable and lucrative dental practice? How do you avoid feeling foolish explaining the "need" to brush "Little Sergeant Pepper's" teeth? With the demand for a higher level of care from clients, cleaning and polishing teeth is not enough for them, nor is it enough for our patients. Here are 10 simple steps that can help you to fully incorporate principles of quality dental care in your practice.

1. Continuing education is a given. NAVC and other national meetings offer excellent opportunities. I also recommend the annual Veterinary Dental Forum. A membership to the American Veterinary Dental Society includes a subscription to The Journal of Veterinary Dentistry as well as discount registration to the forum.
2. A sound dental library is a necessity. (See Aids & Resources, back page, for a list of recommended texts and contact information for other material and agencies discussed in this article.)
3. Connect with a mentor. This has been the most significant factor in the growth of my dental practice. At this time, there are 69 board-certified veterinary dentists worldwide. Many are willing to answer your questions and help with cases if you are genuinely interested. Employing a boarded dentist to see patients several times a year will offer you valuable information, allow your patients the highest level of care, and is a huge motivator for your technical staff.
4. Obtain dental specialty certification by AAHA. Several years ago, AAHA began offering specialty certifications in several areas, including dentistry. AAHA requires the medical director of the dental specialty to be a board-certified veterinary dentist. It is not necessary for the dental specialty director to be a full-time staff veterinarian.
5. Talk teeth. Talk teeth to your staff, to your clients, even to your friends. The more you talk teeth, the more comfortable you will feel recommending daily brushing, dental cleanings every 3 to 6 months, or special dental chews for cats and dogs. Talk teeth to the owner of the diabetic cat predisposed to developing periodontal disease, to the owner of the dog hit by a car that has a fractured femur as well as fractured teeth, and the owner of the puppy that is chewing on everything in sight.
6. Purchase the proper dental equipment. High-quality dental equipment can be expensive, but the return on the investment can be dramatic and the equipment can be used daily. I highly recommend that you purchase a dental machine with air-driven handpieces and radiographic equipment specifically used for taking dental films. There is a definite learning curve, but the skills are easily conquerable with a true focus.
7. Incorporate dentistry early and consistently. Begin talking about dental homecare during puppy- and kittenhood. Send home dental homecare packs during the last puppy and kitten wellness visit. If done sooner, the client may be overwhelmed with information and forget the "oh-so-important" tooth brushing! A dental recheck should be scheduled at 7 to 8 months to look for retained deciduous teeth, proper occlusion, and other dental problems. This is a good time to reemphasize the importance of brushing and dental homecare. The best way to "walk the talk" is to make sure you are providing your own pets with the care you are recommending. If you can't do it yourself, how can you expect your clients to follow through?
8. Market your interest. If you do not let your clients and colleagues know of your special interest in dentistry, clients will not walk through the door. Include a dental column in each of your client newsletters that is informative as well as fun. Clients love reading about the Jack Russell that now has four new stainless steel crowns placed by the dental specialist. Create an additional dentistry newsletter for your colleagues. Include descriptions of recent dental cases and educate these colleagues on your dental capabilities. We all have to design Yellow Page ads. Include your "special interest" in veterinary dentistry in the text. Be sure to include a special section on veterinary dentistry if you choose to construct a Web site as part of your hospital marketing plan. When targeting your clients, don't be too scientific. Several drug companies offer excellent handouts, posters, pins, and other marketing tools concerning dentistry. Feline and canine dental models are worth their weight in gold for explaining procedures to clients.
9. Generate recalls, rechecks, and reminders. The day following a dental procedure, even a grade-1 prophylaxis, a phone call should be made to see how the patient is doing. If you have performed extractions or need to implement a homecare program, be sure to do a recheck in 7 days. It is critical to every dental practice to send reminders for the next dental procedure, whether it is a routine cleaning in a year or an advanced periodontal procedure in a month. Being diligent with reminders is good business.
10. Offer the highest level of dental care you can provide and charge appropriate fees. Human dental care is expensive, and most clients will not be surprised. Discuss all dental procedures in detail with your clients, and give estimates with an eye toward possible unexpected findings before scheduling. Clients also know that dental procedures hurt, so be sure to include pain medications in the estimate.


For Your Library
Atlas of Canine and Feline Radiology. Williams CA, Mulligan TW, Aller SA. Yardley, PA: Veterinary Learning Systems, 1998.
An Atlas of Veterinary Dental Radiology. DeForge DH, Colmery BH. Ames, IA: Iowa State University Press, 2000.
Small Animal Dentistry: The Practical Veterinarian Series. Mitchell PQ. Woburn, MA: Butterworth Heineman, 2002.
Veterinarian's Companion for Common Dental Procedures. Wiggs RB, Lobprise HB. Lakewood, CO: AAHA Press, 2000.
Veterinary Dentistry: Principles and Practices. Wiggs RB, Lobprise HB. Philadelphia: Lippincott-Raven, 1998.
Waltham Video: Canine Dentistry for Veterinary Staff. Hawkins J. Yardley, PA: Veterinary Learning Systems, 1998.
Waltham Video: Feline Dentistry for Veterinary Staff. Hawkins J. Yardley, PA: Veterinary Learning Systems, 1998.

Web Sites
Academy of Veterinary Dentistry.
American Veterinary Dental College.
American Veterinary Dental Society.
Journal of Veterinary Dentistry.

Dental Models
Dr. Shipp's Laboratory, 315 North Foothills Dr., Beverly Hills, CA 90210;
Henry Schein, 135 Duryea Rd., Melville, NY 11747; 800-442-0107.

Client Handouts
Addison Biological Laboratories, 507 North Cleveland Ave., Fayette, MO 65248.
Eukanuba, Iams, 7250 Poe Ave., Dayton, OH 45413; 800-535-8387.
Greenies, S&M Nu-Tec LLC, 1 Design Dr., North Kansas City, MO 64116;
Hills, PO Box 148, Topeka, KS 66601-0148; 800-255-0449.
Pfizer Animal Health, 150 East 42nd St., New York, NY 10017; 800-733-5500.
Virbac Laboratories, 3200 Meacham Blvd., Ft. Worth, TX 76137; 800-338-3569 or call your local Pfizer representative.

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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