Getting your clients to follow medical instructions and adhere to at-home care is always tough, but there is perhaps no bigger struggle than convincing clients to brush their pets’ teeth daily. “Within my personal experience, it’s a losing battle on increasing compliance for home care, but we shouldn’t give up—I haven’t given up,” said John Huff, DVM, FAVD, Dipl. AVDC, a board-certified veterinary dentist at VCA Alameda East Veterinary Hospital in Denver, Colo. “I have owners who use electric toothbrushes, I have owners who can floss,” Dr. Huff said. “Now that I’m boarded, I cater to a clientele that does those things, but I think they would have done it on their own because they already understand the importance. I still want people to know that brushing is the gold standard, but for the average client, increasing compliance is really difficult.” Bridging the Gaps Huff believes the biggest reasons clients don’t brush their pets’ teeth at home are lack of cooperation from the pet, lack of time on the part of the owner and a lack of understanding of the importance of brushing. He uses photographs to try to overcome the latter. “Most owners don’t really know what’s happening under their pet’s lips,” he said. “If you take a picture, when they see it, I think that motivates them more to do something for their animal’s health.” According to Heather Loenser, DVM, veterinary advisor, professional and public affairs for the American Animal Hospital Association, the biggest barriers to owner follow-through also include the owner’s anticipation that their pet won’t like having its teeth brushed (even if that is not the reality), as well as a lack of understanding about how easy it is to train a pet to enjoy (or at least endure) teeth brushing. “Ideally, our veterinary teams would include training on how to brush a pet’s teeth at every puppy/kitten visit and reinforce this message during annual/biannual wellness examinations,” said Dr. Loenser. Teaching Moments As is often the case, education is the key to getting your clients to see the light when it comes to brushing their pets’ teeth. “The veterinarian’s role in the education process is absolutely critical, and I think that’s mainly understanding periodontal disease, trying to convey the importance of brushing and trying to discuss with the owner the consequences of not doing it,” Huff said. “I still use a lot of human comparisons. I don’t know that it actually increases compliance, but the owners who get it, they just kind of get it. We brush our teeth twice a day, floss once a day and use an oral rinse, and I go to the dentist every six months. So why aren’t we doing that for dogs and cats?” A Whole-Team Approach Nancy Kelso, DVM, medical director of VCA Columbia Animal Hospital at Hickory Ridge in Maryland, said education should come not only from the veterinarian, but also from the entire veterinary team. “The entire staff needs to be on board and understand why we make our recommendations and how it improves the pet’s quality of life and health,” she said. “Taking the time to discuss all the benefits of oral health from quality of life, preventing pain, good breath and improving whole body health allows the owner to understand the benefits. Not every client will commit to all our recommendations, but anything they are willing to do at home can benefit the pet.” Show Them How Anything foreign can be intimidating to pet owners. For those clients who have never brushed a pet’s teeth before, hands-on demonstrations can go a long way toward overcoming their hesitation. “The owner’s perception that home brushing and dental care is too difficult and time consuming can be addressed,” Dr. Kelso said. “When we take time to show the owner how to brush and simplify the processes into steps, it’s amazing how many people will comply. It’s especially effective when started during their puppy or kitten visits.” One tactic that should be avoided is trying to guilt a client into brushing. “I don’t think shaming a client is an effective way to build trust between the practice and the client,” said Loenser, who also is an associate veterinarian at Bridgewater Veterinary Hospital in Bridgewater, N.J. “Encouraging small achievements and educating pet owners on the multiple ways they can care for their pets’ teeth is far more effective.” Loenser sees rays of hope for widespread compliance of home dental care. “I am constantly amazed by the dedication of pet owners,” she said. “There absolutely is a segment of the pet-owning population that will care for their pet’s teeth daily, especially if we, as their trusted health team, educate them on the benefits and empower them to do so.” Fun Habits Can Yield Results Mary Jane “MJ” Redman, DVM, Dipl. AVDC, a board-certified veterinary dentist from Compassion-First’s Mission Veterinary Specialists & Emergency, suggests sharing the following tips with clients for improving at-home dental care. Make it fun and enjoyable, said Dr. Redman, who ensures her dogs love their toothpaste so it's a special treat. Make it a habit. When Redman brushes her teeth, her dogs’ teeth get brushed, too. “The routine helps them tremendously, and when I don’t brush my teeth, they follow me around the house, like I have forgotten to do something important. “Another key benefit for pet owners in brushing is that they get to see the inside of the mouth more often,” she said. “Think about it. We don’t see the inside of our pets’ mouths unless they yawn. By brushing, owners can see whether there is bleeding, a strong odor or even if there is a growth.” More Than Just Brushing: VOHC-Certified Products Brushing at home is considered the gold standard, but 98 percent of your clients aren’t going to brush their pets’ teeth,” Huff said. He recommends steering clients toward the plethora of dental care products listed on the Veterinary Oral Health Council website (vohc.org). “We know those products have been through double-blinded studies that show that they do work. When we say ‘work,’ it’s a 15 to 25 percent reduction in plaque or tartar or both.” Huff carries some of these products in his clinic. Two of his personal favorites are Healthy Mouth, a water additive, and Sanos, a dental sealant. “Those two things are the simplest things you can do,” he said. “Healthy Mouth is a water additive. [Dogs] simply drink the water, and there’s a reduction in plaque and tartar. Sanos is applied to pets’ teeth while they are under anesthesia. It’s almost like an acrylic nail polish of sorts. It allows the surface of the tooth and the gingival-tooth interface—that’s the critical part—to shed off the plaque easier.” Kelso educates her clients that dental home care is not limited to brushing. “Spending time to discuss dental diets, dental chews, water additives, oral products, wipes and professional cleaning includes the pet parent in the process,” she said. “Dental diets (Hill’s Science Diet and Royal Canin) and dental chews (CET rawhide, CET Veggiedent and Greenies) have been hugely successful for home care. Although these products are available elsewhere, having them at our clinic is important to start home care immediately. We also carry wipes, water additives, paste, OraVet and rinses. We encourage VOHC products.” Originally published in the May 2017 issue of Veterinary Practice News. Did you enjoy this article? Then subscribe today!
