We all know the elephant in the exam room has always been the awful breath pets have. It is the one thing we veterinarians and pet owners address every time, then let fall down the priority list until "next February." We hear the echo of our clients saying, "I know his teeth are awful and we need to get them cleaned, but we use those dental chews. Are they effective?" It is a nice way of leading into the conversation stating yes, we are aware; and no, we do not really want to do anything right now about it. Especially since you will give us a deal in February, right?
As life happens to all of us, clients get busy, February comes and goes without addressing their pet's oral needs and the years pass waiting until "next February" for dental month. Next thing you know, Muffin is 14 years old with a gutter mouth.
We created "Dental Month" to help compensate for our anticipated financial slump when things have been historically slower. Times have changed, and oral pet care thankfully has changed as well.
Now or never
Some of us may have mistakenly created a tolerance for oral disease when we do not strongly advocate for our pets' current needs. We schedule that cruciate tear ASAP, don't we? Sure, it is easy to tell owners to brush their dogs' teeth, use oral rinses, wipes, etc., which some of them do; however, we all know most of our patients need professional cleaning and evaluation. It is our job to impart to owners that we need to act now—not next month and certainly not next February.
I am guilty of this myself, when I listen to the client's financial plight precluding any exam. I hear their message loud and clear and say, "Well, keep up the good work with your home oral care regimen, as it is slowing down the tartar accumulation, and let's get those teeth assessed in the next few months when life settles down." I effectively gave that client a pat on the back and pass for doing something right now. We do not want to discourage owners from doing some at-home oral care but being more direct motivates clients to act sooner.
Show the clients those teeth! Do not simply breeze over the oral cavity and say, "Muffin could use a dental." Find a relatively normal looking tooth or use a chart for comparison. Let them know what abnormal looks like, then show them the gum recession, tartar accumulation, the tooth mobility, etc. Show clients how their pet reacts to a gentle nudge of that loose tooth. Let them see yes there is disease and use that word. "Yes, that hurts, and it hurts right now not in February."
Seeing is believing
Help clients relate to what their pet feels when their gums are bleeding upon being touched, or their jaw jerks away when you touch that suspicious feline oral resorptive lesion (FORL). It is obvious to us what pathology looks like, but seeing that knee jerk and painful reaction from their pets can be motivating.
Seeing is believing, and nothing motivates clients more than showing them the obvious pain that lurks in the shadows! Sharing with them a dental chart of a dog or cat with stage 4 periodontal disease just shows them what that dog has, not theirs. Make the demonstration personal.
It starts with the first puppy visit. Identify those malocclusions and retained teeth early to let owners know treatment is needed to prevent further damage or to at least start saving for possible surgical needs. Get them prepared in advance. As a matter of fact, some of those young pets that are mouthy or head shy may have active pathology.
Almost every one of us has either had a not-so-comfortable dental experience or knows somebody who had. I often ask clients that very question to help them relate to what that person experienced. Have you ever had a toothache yourself? If they have the response is typically a quick, "Yes I have, and it was awful." I have been blessed and not encountered any such pain; however, I draw experience from my family and friends. Oral pain is very real, and people need to know simply because a pet is still eating does not excuse the need to prevent and treat oral disease now, not next February.
Discourage excuses
We have done our pets a disservice for years making excuses for them to avoid continued care. We hear it all the time: "Doc Jones said she is too old to undergo anesthesia. It is just too risky." Or if a pet has a heart murmur, it is used as a crutch to avoid anesthesia. Certainly, if there are underlying concurrent disease or unmanaged endocrine diseases, that is one thing. Being old, in my opinion, is not a disease nor an excuse. We can properly educate our clients about the risk of hearing loss, advanced cognitive dysfunction, etc. when undergoing any general anesthetic event.
Yes, Muffin has a murmur. Yes, Muffin is 10 years old. However, Muffin will likely live until she is 14 and that is four more years we do not want Muffin suffering from oral disease. Remind them our pets are living longer lives and we want to responsibly plan for that. More importantly, let's take advantage of a "younger and healthier" pet before they get that heart murmur or renal failure.
I tell owners all the time: When I'm 75, if I make it that long, I will still want to have my teeth cleaned and treated for any disease. Give them examples of those geriatric patients that underwent the dreaded extract-athon and lived their best life after removing all the infection from their mouth. As a matter of fact, they typically are chewing bones again and playing with their chew toys!
Education is key
Educate clients on how advanced our medicine and anesthesia are now compared to 30 years ago. Clients will emotionally latch on to a story of a pet unexpectedly passing under anesthesia, and that fear is sure to stop them dead in their tracks.
We take it for granted that we perform general anesthesia daily on numerous patients with a variety of needs, so we become desensitized to this fear clients have. That fear is very real, and it is important to let them know we properly prepare an anesthesia plan specifically for their patient. We check blood work to ensure proper organ function, we offer EKGs, thoracic radiographs, etc. More importantly, we monitor like we never have before. I remember many years ago only seeing an esophageal stethoscopes monitoring being the only device used for general anesthesia procedures.
Clients may not always understand the standard of medicine has rapidly advanced to meet our patient's needs. I believe explaining all our planning, tailored anesthesia protocols, and monitoring really helps remove some of their hesitation toward general anesthesia.
If clients are very fearful, simply let them know we can avoid a lot of surprises with thorough presurgical screening. I understand not every client will want to pay for a full chemistry panel, chest rads, or EKG prior to performing a dental assessment; however, it is important to offer those if concerns are the one thing prohibiting us from helping their pet.
Discourage alternative treatments
I am not saying there is zero merit in a "non-anesthetic" dental cleaning. However, we all know that safe evaluation and treatment of periodontal disease requires general anesthesia. Let owners know clean teeth are great, but painful disease below the gums is not. We do not know until we look, thoroughly and safely.
Be sure to thoroughly explain the value in what your skilled hands and eyes are looking at. Clients see what they want to its human nature. They know they can get Muffin's teeth cleaned for $70 and not spend "all that unnecessary money with lab work, anesthesia, etc." and come out with the same result. It is our job to let them know the difference between that $70 treatment plan and the one we offer.
At the end of the day, it is the client's decision to pull the trigger. It is our duty to assess and safely recommend what we feel is the best thing for the patient. Let them see the disease and encourage them to act in place of waiting. Maybe stop offering the dental discounts one month out of the year and offer a discount if they schedule within the next two weeks. Maybe remove all discounts to send the message that oral care is important every day, every month, and not just "next February."
Marshall Beggs, DVM, is a small animal veterinarian with a passion for dentistry. Dr. Beggs has previously authored articles for San Antonio's Texas Dogs and Cats magazine, drawing attention to pet dentistry. Beggs graduated from Ross University of Veterinary Medicine and is the proud owner of Houston Pet Dental, which opened in 2022.
