Dental care from top to bottom

Dental care from top to bottom

Everything you ever wanted to know about building a successful dental program but were afraid to ask.
Jan 01, 2005

Ernest E. Ward Jr., DVM
What's the No. 1 disease seen in general veterinary practice? What's the most underdiagnosed and undertreated disease seen in veterinary medicine? The answer to both questions is periodontal disease. Periodontal disease affects nearly 80% of all dogs and cats older than 3, according to the American Veterinary Dental Society. Yet only about 3% of affected dogs and 1% of affected cats receive proper dental care, according to the 2003 AAHA Compliance Study. How can you fight these trends and ensure your patients receive the care they need? To help answer this question, let's take a look at the parts, procedures, and people that make up a successful veterinary dental program.

The parts Perhaps the easiest aspect of developing a successful dental program is assembling the equipment you'll need. The basic ingredients include diagnostic equipment and supplies, operatory tools, patient anesthesia and monitoring equipment, and well-trained staff members.

Creating the dental experience
Diagnostic equipment In the exam room you'll need an illuminating device to show clients those decaying fourth upper premolars. This can be a simple halogen pen light or a more sophisticated transillumination device. To reinforce your message, use a lighted projectable videoscope to show owners images of their pets' teeth and gums. A plaque-disclosing agent can also prove that even the cleanest-looking teeth may hide a dirty secret. Remember, most clients won't appreciate the seriousness of periodontal disease until they see it. Don't be afraid to lift the lips and reveal the disease that's easily ignored yet affecting most of our patients.

Once you've shown the client the damage above and below the gum line, take a look at where the real harm takes placeā€”the tooth roots. Dental radiography is a relatively inexpensive service we often overlook in busy general practice. With just a few thousand dollars, the proper safety equipment, and some simple training, you can generate a new revenue stream in no time.

People are accustomed to having their teeth radiographed when their teeth are cleaned, so it's easy to apply this same rule to pets for every routine dental prophylaxis. Radiographs will help you discover damage you didn't detect during the exam. Use a portable viewing box and "hot-spot" light to review dental radiographs with clients.

Dental facts your team should know
Basic dental operatory equipment You have almost limitless choices for dental scaling and polishing equipment. Choose a system that meets your needs and budget and allows you to expand as your dental skills improve. I recommend adjustable-speed handpieces for polishing, drilling and burring, or cutting. When working on that fourth upper premolar or canine tooth, you'll want contra angles, which are specifically designed for this application. Don't forget basic burs and cutting discs. You may need to replace these pieces often, so you don't get caught with a dull bur. You'll also need an assortment of probes and explorers, so pick up a basic pack. Too often we forget to use an autoclave to sterilize dental equipment between patients. So when you schedule dental appointments, factor in time to sterilize your equipment. This has only recently become an American Animal Hospital Association accreditation standard. Finally, a magnifying loupe and a good light source will help with the detailed work you'll perform.