Mary L. Berg
BS, RLATG, RVT, VTS (Dentistry)
Mary Berg is a charter member of the Academy of Veterinary Dental Technicians and received her VTS in Dentistry in June 2006. She received her B.S. in Biology/Microbiology from South Dakota State University, and A.S. in Laboratory Animal Science and A.S. in Veterinary Technology from St. Petersburg College. She is a past president of NAVTA. She continues to work in research, specializing in products aimed at improving oral health of companion animals. She was the practice manager and dental technician specialist at general practice, teaches at a veterinary technology program and is currently the president of Beyond the Crown Veterinary Education, a veterinary dental consulting service.Read Articles Written by Mary L. Berg
Eighty percent of adult dogs and 70 percent of adult cats have some form of oral disease. Dental problems are among the top three concerns raised by dog and cat owners.
Why is the incidence of oral disease so high? Is it due to a lack of compliance or a failure to educate the client about the importance of dentistry? Pets living longer is one reason oral disease is so prevalent. We improve so many aspects of their lives, but dental care seems to be lagging.
Unfortunately, veterinarians and veterinary technicians do not receive much dentistry training while in school. Many practices don’t put enough emphasis on dentistry and the importance of a healthy oral cavity. In some small animal clinics, dentistry accounts for less than 10 percent of gross income. When a proper dental program is in place, dentistry can contribute an additional 25 percent of the overall income. It’s a great way to regain lost business.
Education and Words Matter
Statistics show that 25 percent of clients will accept whatever you say immediately, 60 percent will take time to accept your recommendations and 15 percent will not accept your suggestions.
It is our job as veterinary health professionals to promote dentistry. How can we do this? Early testing, dental report cards, free toothbrushes and sample packets, and marketing are a few ways.
The technician is often responsible for client education. Start the education at the first puppy or kitten visit. Talk about the importance of good oral care by pointing out that the mouth is a mirror to the body. Offer handouts explaining the relationship between oral disease and systemic health.
Using a simple diagnostic test strip at each wellness visit can increase the number of dental procedures performed at the clinic. The test is done in the exam room and detects thiols, the byproducts of the pathogenic bacteria present in periodontal disease. The test can detect a periodontal pocket that would not be visible during a conscious oral examination. Doing the test with the pet owner present changes the conversation from an opinion — yours — to visual proof that infection is present.
Changing the terms used with clients can have a dramatic impact, too. Stop saying, “Your pet should have a dental soon,” and instead say, “Your pet is showing signs of oral infection and needs to have a comprehensive oral health assessment and treatment.” The term “dental” can leave the client wondering if the procedure is needed or just a cosmetic fix. Replacing “should” with “needs” helps the owner understand the importance of the procedure.
How do you convince clients that gingivitis, if left untreated, will progress to periodontal disease and possibly a systemic infection? It’s often said that a picture is worth a thousand words. Use photographs, models and even videos to drive home the point. Photographing a pet’s oral disease will:
- Allow the client to see the oral pathology without the need to focus on a moving target — the mouth.
- Become permanent documentation of the pathology.
- Provide a take-home view that the client can share with family members.
- Serve as a reminder to the client of the need to return for treatment.
- Provide the client with the first of before-and-after photos.
A dental report card is a great way to help a client understand the treatment given to their pet. Include a simplified dental chart on which problem areas are marked or highlighted. A section for diagnosis, treatment, home care, prescriptions and follow-up visits should be included. Keep it simple and use bright, cheerful colors and clip art. Always remind the client to call with any and all questions.
The dental report card, or take-home sheet, is a great tool, but even more important is the need to schedule a follow-up appointment before the client leaves. This shows the client that even though your hospital is busy and hectic at 5 p.m., you think dental issues are important enough to take time to go over the procedure, home-care recommendations and answer questions. This appointment should be done by a technician.
Putting together a dental goody bag is a great way to provide informational handouts and samples. Including food, toothpaste and a toothbrush lets the owners know of the many oral care options.
February is Dental Health Awareness Month, not Dental Discount Month. Take advantage of the annual promotion to educate clients about the importance of good oral care. Discounting procedures often has an adverse effect by subliminally telling clients that the procedure is not necessary or is overpriced. (They might think, “That’s why the clinic can afford to discount it!”) Find another way of rewarding clients.
February is also Dental Health Month for people. Take time to write an article for the local newspaper, appear on a radio talk show to talk about pet oral care, or volunteer to give presentations to schoolchildren. When promoting dental care, a great tool is to get the children involved. As we teach children to brush their teeth, we can teach them to brush their pet’s teeth. This helps build the human-animal bond and can teach responsibility. When advising clients to brush their pet’s teeth, point out that the activity can help build the bond between them.
Communicating the importance of dental treatment and oral care should become as commonplace as doing vaccinations and heartworm testing. Each annual visit should be an opportunity for a dental evaluation and care recommendation. Clients soon will understand the need for regular dental exams and cleanings.
Every team member must be a part of the strategy. Dentistry begins with the telephone call to the receptionist. The technician who meets the client in the exam room has another opportunity to talk about dental care. A kennel staff member who handles a boarded pet can point out obvious problems. The veterinarian diagnoses and treats the animal. Each team member’s role is critical to a successful dental practice. Let’s explore each one.
1. The receptionist must project a positive attitude regarding dentistry and home care. How a receptionist handles telephone shoppers is equally important. When asked how much a practice charges for a dental procedure, the answer must be, “It depends upon the degree of oral disease present.” The receptionist should avoid quoting prices over the phone. What is best is to explain the difficulty of determining the true extent of oral disease until each tooth has been evaluated under anesthesia and radiographs have been evaluated. At that point, a treatment plan can be formulated and fees calculated.
The receptionist can tell telephone shoppers this: “We can’t give you an accurate estimate for a dental treatment over the phone as the cost depends upon the degree of treatment necessary to give your pet the very best care possible. It is essential that we examine your pet to give you a more accurate idea of the cost.”
2. Credentialed veterinary technicians are eager to become empowered, and dentistry is one area of the practice where they can be fully utilized. Remember that technicians can do everything but diagnose conditions, prescribe medications and perform surgery. Empowering a technician to become the practice’s dental guru allows for both professional growth and pride in their chosen job as well as an increase in dental revenue at the practice. The dental guru can be the go-to person for all things dental and can train the entire staff so that everyone understands the importance of good oral health.
The technician should concentrate on emphasizing home care, client education and follow-up visits. The technician’s examination, communication and therapy skills are vital to a successful practice. Their responsibilities include prophylaxis procedures, dental procedure assistance, oral radiography, charting, postoperative instructions, equipment maintenance and keeping the dental operatory well stocked.
3. In practices that board pets, kennel staff members should be trained to examine the pet’s teeth when the client drops off the animal. They should show the owner the degree of oral disease present and ask whether they would like the pet’s teeth cleaned during the boarding. The importance of oral care must be demonstrated to the client. If the client doesn’t pack a toothbrush, offer one for use while the pet is boarding and incorporate daily brushings into the boarding services. This simple step helps emphasize the importance of oral care.
4. The veterinarian is the team leader. She must believe that dentistry will help the pet live longer, healthier lives. The veterinarian should be comfortable recommending dental procedures to clients. She also should schedule dental education training and support continuing education opportunities for the team.
The decision has been made to make dentistry a priority in your clinic. How do you get the word out? Advertising and client recommendations to friends are just two ways to acquire additional clients, but don’t forget your current pet owners. Perform an oral exam on each and every animal that comes to your clinic. Don’t treat just the obvious conditions. Check each tooth visually, take radiographs and look closely at what’s happening below the gum line. About 42 percent of the pathology happens there.
Marketing your dental practice to current clients is important. Handouts on oral care, plaque prevention, tooth resorption, periodontal disease and other dental problems should be made available to clients. A brochure filled with frequently asked questions is a good way to address concerns that a client might have but is not sure how to ask. Many people learn visually, so include pathology photos.
Continue to communicate with the client after the animal goes home. Call for a follow-up in the next day or two. A letter or text message also can serve as a reminder of the need for a follow-up visit. Try to schedule the follow-up exam before the pet leaves the practice. Pre-booked appointments are more likely. Many clinics include the cost of the follow-up visit, excluding any needed sedation or anesthesia, in the initial service fees.
Finally, use social media platforms such as Facebook or Twitter to promote your dental practice.
Be creative and have fun with it. Start a contest and challenge the team to come up with new and exciting ways to promote dentistry.