Bridging the compliance gap: Talk to clients about infection

Bridging the compliance gap: Talk to clients about infection

Feb 01, 2007

Brett Beckman
Quality veterinary dental education for staff, technicians and practitioners is readily available. Many practices take advantage of courses and seminars to increase knowledge and upgrade dental-care equipment.

It's the next step that often brings frustration: Getting clients to comply with your recommendations.

Photo 1A: This patient is missing the first two mandibular left premolars.
The key is good communication – through building trust, education, using digital images, handouts and other means. Communication can make the difference between a pet that receives proper oral care and one that continues to suffer from oral disease.

First establish client trust

Even the best efforts toward dental-treatment compliance will fail unless first you win the client's trust. How can you do that? Here are some suggestions:

  • Walk into the exam room with a smile, shake the client's hand and introduce yourself.
  • Acknowledge the pet verbally and by holding or petting.
  • Remember names. Use the names of the client, the pet and others in the room frequently during the exam. Acknowledge children and compliment them. Most parents will shut out an adult who ignores their children.

Photo 1B: Radiography reveals an unerupted first premolar and a large dentigerous cyst. Removal of the unerupted tooth and the entire cyst is the only treatment.
These simple things, though sometimes ignored, foster a positive relationship and gain the client's trust, after which they will more readily follow your recommendations.

Paradigm shift

Our main selling point for dental procedures until now has been convincing pet owners that the animals' teeth need to be cleaned. Many owners don't lift a pet's lips to observe the teeth. Why assume they would comply with a recommendation that implies a mere cosmetic benefit?

It's time for a paradigm shift – looking at a problem in a different way.

Oral malodor is present in the majority of pets with tartar and inflammation. This malodor results from the mercaptans, sulfides and other noxious substances produced by anaerobes that collect in periodontal pockets.

If there is odor, there has been a shift from the normal gram-positive aerobic environment to a gram-negative anaerobic one. Therefore periodontal infection is present.

Photo 1C: This patient was caught later in life. The cyst expanded to destroy the entire rostral mandible. These images are used to demonstrate the importance of radiographs when evaluating missing teeth.
Are pet owners more likely to agree to treat an infection in their pet's mouths or to clean their teeth?

We need to talk to them about the odor, the infection, the progression, the potential pain and systemic effects and leave the teeth-cleaning concept out of the discussion.

I usually tell pet owners that I don't care if the teeth are cleaned but I do care that the infection is resolved. Infection is resolved only mechanically, not medically. Removal of plaque, tartar, granulation tissue and diseased bone are the only resolution to treating periodontal disease effectively. So let's start talking about infection rather than cleaning, and you're likely to gain more client compliance.