How to Compete With Nonanesthetic Dentistry

I’ve never been a fan of the dentist. The poking and prodding, my mouth forced wide open, the cold air on my sensitive teeth. None of it is fun. But I know I need to go to the dentist every six months for a cleaning so my teeth stay healthy. Just like eating right, exercising and going to the doctor, visiting the dentist is necessary for my overall wellness.

You know that pets need regular dental care, too. However, we can’t explain to them why it’s important to their health. We can’t ask them to sit back, close their eyes, open wide and relax while we scrape the tartar off their teeth.

If going to the dentist can be uncomfortable for humans, it can be downright terrifying and painful for animals. That’s one of several reasons organizations like the American Veterinary Medical Association, the American Veterinary Dental College and the American Animal Hospital Association oppose nonanesthetic dentistry in pets. The dental college’s position statement on “Companion Animal Dental Scaling Without Anesthesia” dates to 2004.

Despite the veterinary industry’s opposition, companies offering anesthesia-free dental cleanings are common, and their marketing tactics effectively draw in pet owners.

For example, HealthySmiles, with locations in Florida and Illinois, claims, “We deep-clean your pet’s teeth safely, without anesthesia.” According to its website: “First, we gently swaddle your pet to ensure it feels safe. Then, we begin the dental cleaning by removing the plaque and calculus on your pet’s teeth. We further clean the bacteria under the gumline and finish by polishing, wiping and rinsing the mouth.”

It goes on: “Our nonanesthetic dentals help reduce the risk of bacterial infections such as periodontal disease, which adversely affects your pet’s overall health, causing chronic pain, gum inflammation and, in severe cases, bone loss and organ failure. To avoid these health risks, your pet should have a deep dental cleaning every six months.”

The HealthySmiles website includes a chart comparing nonanesthetic and anesthetic dentals, touting the former’s shorter procedure time, lack of medications and lab tests, and a less-expensive price tag. In addition, the company shows compelling before-and-after photos. Its workers even will come to you — no need to leave the house to get a safe, effective, thorough and inexpensive dental cleaning for your pet.

For the average pet owner, that all sounds pretty good, right? Why pay two or three times as much and put Bella or Max at risk with anesthesia?

“I’ve seen many pet owners who have been doing anesthesia-free dental cleanings for years, and I’ve had to pull many teeth due to abscesses for every one of these patients,” said Monique Weldon, DVM, the owner of Animal Dental Clinic in Aurora, Colorado. “Cleaning under the gumline is the most important part of the cleaning, and it’s impossible to do that effectively when a pet isn’t sedated.”

But do pet owners know that fact? How can veterinary practices compete with the providers of nonanesthetic dental cleanings?

Here are eight recommendations.

1. Build Trust With Clients

Mitchell Bruckert, DVM, who purchased Wales Animal Clinic in suburban Milwaukee in 2021, doesn’t think every pet requires a full dental cleaning annually.

“I recommend once-yearly exams, and then I go from there,” Dr. Bruckert said. “Most of our bigger dogs don’t have severe dental disease, but a lot of the smaller patients do, so for them, I typically recommend yearly dentals.

“Would it be awesome to do a dental on every patient every year? Yes. From a business perspective, that would be great. But ultimately, is it best for the patient? Sometimes not really.”

Dr. Bruckert found that being open with clients and tailoring his approach based on each pet’s unique needs rather than sticking to a rigid protocol increases the likelihood that his clients will trust him and agree to his recommendations.

2. Stress Preventive Dental Care

Dr. Bruckert talks with his clients about preventive care, teeth brushing and Veterinary Oral Health Council standards.

“But I’m realistic with them,” he said. “For some dogs, you can’t brush their teeth every day. So, it’s about what kinds of other strategies we can use to allow them to get proper dental care.”

Dr. Bruckert’s dog, a 15-year-old miniature poodle, won’t let him brush her teeth. Instead, she eats dental chews, and Dr. Bruckert does his best to mitigate the tartar. But it still builds quickly, so he professionally cleans her teeth every six to 12 months. He’s removed a few of her teeth and said her condition would be worse if he weren’t doing as much home care as possible.

“During one week recently, I had to remove about 80 teeth from three patients because the disease was so bad,” Dr. Bruckert said. “I’ll tell clients about that week, as well as my own dog, in the exam room. Hearing real-life stories helps them understand the importance of preventive care.”

3. Show the Value

“If I see significant dental pathology on my physical exam, I’ll show the client in the exam room,” Dr. Bruckert said. “I saw a patient this week who was only eating on one side of the mouth because of a fractured tooth. I was able to show the pet owner the difference between one side of the mouth, which looked pretty healthy, and the other side of the mouth, which had a lot of dental tartar, so the pet owner was able to see that the dog was selectively chewing. Having the ability to show them right there helps to convince them.”

But don’t stop there. After you’ve convinced the client and performed the professional cleaning, reveal the differences.

“We need to be sure we’re showing the value in our services by providing pictures and explanations of dental treatments when we discharge patients,” Dr. Weldon said.

4. Competitively Price Procedures

While professional dental cleanings cost more than anesthesia-free dentals, veterinary practices should price their cleanings as competitively as possible and be sure clients understand how the lack of recommended care today might affect their pocketbook in the future.

“The level of care the patient is getting versus sedation-free dentals is better. And in the long term, clients will save money,” Dr. Bruckert said. “If the pet’s teeth are really that bad, they’re going to have gingivitis and periodontal disease. And at some point, the rooster’s going to come home and we’ll have to approach those dentals with extractions and endodontics, which will cost the client a lot more money.”

5. Explain How You Mitigate the Risk

When a client expresses concern about anesthesia, Dr. Bruckert responds with how he and his team keep dental patients safe, including with pre-anesthetic bloodwork and thorough monitoring.

“The good thing about a dental is if we encounter a problem during the procedure, we can wake the patient very easily,” he said. “We’re not in their abdomen; we’re just in their mouth.”

6. Thoroughly Train Your Staff

Client education shouldn’t fall squarely on the shoulders of the veterinarian. According to Dr. Weldon, the more thoroughly trained the support staff members are, the better they’ll be able to educate clients and the more efficient they’ll be during the procedure.

7. Educate Outside the Exam Room

Client education doesn’t need to stay within the practice’s four walls. Instead, invest in educational handouts and write blogs and social media posts explaining the differences between professional cleanings and anesthesia-free cleanings, along with the associated risks. Also, link to your posts from client emails, text messages and your e-newsletter.

8. Explain the Patient’s Perspective

“Most of our patients are already filled with a little bit of fear, some of them more than others,” Dr. Bruckert said. “When you do anesthesia-free dentistry, if you slip, if you cause an injury, that’s going to increase the fear for that pet.

“When we’re doing all our work, yes, they’re going under anesthesia, and they may be waking up with pain, but we do everything we can to mitigate the pain. From the patient’s perspective, that’s less stressful and painful than someone poking around in your mouth with a metal object, scaping your teeth and hitting your gums. It’s unpleasant, even for us humans, and we understand why we’re going to the dentist. Pets don’t understand.”

Dr. Bruckert continued: “We’re in this business for the patient, and we have to think of their experience as they come into our clinic. Sedation-free dentals are ultimately not going to be a good experience for most pets.”

A BITE OF LEGAL INFORMATION

Can anesthesia-free dental cleanings be performed legally in every state? And who can perform these procedures?

According to Kendall MacGregor, a research specialist with Animal Policy Group, veterinary practice acts do not mention anesthesia-free dental cleanings, but they specify that animal dentistry must be completed by a licensed veterinarian or by a veterinary technician under the supervision of a licensed veterinarian.

The following states permit veterinary technicians or assistants to perform dental work under the supervision of a licensed veterinarian:

• Alabama
• Arkansas
• California
• Delaware
• Georgia
• Hawaii
• Idaho
• Illinois
• Missouri
• Nebraska
• North Dakota
• Ohio
• Oklahoma
• Oregon
• Pennsylvania
• South Carolina
• Texas
• Washington
• West Virginia
• Wisconsin

As for groomers and other nonprofessionals, they can perform basic teeth brushing, which is not considered a dental treatment.

When it comes to legal cases, one stands out in California. Canine Care Inc., a provider of anesthesia-free dental cleanings, was ordered to pay $150,000 in 2014 for the unlicensed practice of veterinary medicine. According to the California Department of Consumer Affairs, an investigation revealed that the company was illegally advertising and performing anesthesia-free procedures using scalers.

“Further investigation determined their operation was widespread throughout the state,” the agency stated. “Performing anesthesia-free teeth cleaning using any instrument, device or scaler is illegal unless the individual is licensed by the California Veterinary Medical Board.”

LEARN MORE

A position statement released by the American Veterinary Dental College explained why nonprofessional dental scaling on an unanesthetized pet is inappropriate. Read it at bit.ly/3eAHKOb.