dvm360s top veterinary dentistry tips from 2017
On a scale from Just cutting your teeth to Long in the tooth, how would you rate your veterinary dentistry skills and expertise? Regardless of where you land, were willing to bet theres a tip on this list thatll benefit you and your patients.
We've probed dvm360.com's content to find our favorite veterinary dentistry tips from the past year. Brush up on your knowledge below and on the pages ahead.
A thiol strip being used to demonstrate the presence of plaque. (Courtesy of Dr. Barden Greenfield)Periodontal disease
A visual is worth a thousand words in the exam room. Use thiol strips to demonstrate the presence of plaque to clients in a quick, compelling way.
To determine the amount of bone loss, use a probe to measure periodontal pocket depths. Radiographs can't detect cortical bone loss until it reaches 40%, so it's possible to have significant bone loss before it shows up on a radiograph. Trust those probes!
Read more to fill in the gaps:
A postoperative radiograph confirming complete extractions of the affected teeth. The third premolar appears normal. (Courtesy of Dr. Jan Bellows)Tooth extraction and radiography
Trying to determine if a tooth has died? Keep in mind that pulp matures as a pet ages, so the narrower the dentin wall and the wider the pulp cavity, the younger the pet. “One way to assess the vitality of a tooth is to radiograph the contralateral tooth to assess pulp cavity width,” says Barden Greenfield, DVM, DAVDC. “Premature maturation, or tooth death, results in a static pulp canal width.”
If you need to extract a tooth, obtain radiographs before and after. “As a radiograph is a legal document, this is the only confirmation that the procedure you charged for was done to completion,” says Dr. Greenfield. “Tooth root fragments and remnants are quite commonly left in the mouth with extractions.”
Assemble your radiographs in a way that mimics the natural way the teeth fall in the mouth. This helps you localize any problems.
Charge more for your three-rooted teeth extractions because they're more work! Also, make sure you section these teeth prior to extraction, giving yourself three one-rooted extractions.
Don't charge per radiograph; charge for a full-mouth set, including all postop images, says Dr. Greenfield. If you line-item each image, you might start thinking, “Gosh, we took 15 images and it's going to be such-and-such price.” Just make it a full-mouth set. Dog, cat, big, whatever-it all comes out in the laundry.
After an extraction, prescribe anti-inflammatory drugs, but there's no need for antibiotics. “If you ask 100 veterinary dentists, you'll get 100 people telling you, do not use them,” says Dr. Greenfield. “There's no need. If you've done a good surgical procedure, flushed the alveolus out with some saline, good tension-free closure, you're done.”
Extract more advice:
Since you typically do a thorough dental examination just once a year, enlist your clients in keeping watch for odd growths as well. “The earlier we can catch oral tumors, the better the chance of us having a good result,” says Heidi Lobprise, DVM, DAVDC. “It's really important to get the owners aware of oral tumors and for us to do a good exam to make sure we can catch them.”
No need to search for articles on oral tumors:
The VOHC seal of acceptance. (Courtesy of Dr. Jan Bellows)Product recommendations
Get familiar with products accepted by the Veterinary Oral Health Council (VOHC) so you can be ready when the client questions come (because they will come). Why does the VOHC seal matter? It's only given to products that decrease plaque, calculus accumulation, or both by at least 20%.
Articles about VOHC-accepted products that have the dvm360 seal of approval:
Stop using the word “dental” for your routine oral health procedure (which, as you know, is rarely “routine”). Dr. Greenfield calls it a “complete periodontal exam and therapy.” It's also known in veterinary dental circles as “oral ATP” (assessment, treatment, prevention), “COHAT” (comprehensive oral health assessment and treatment), and even more recently, “COPAT” (comprehensive oral prevention, assessment and treatment).
Before-and-after photos are one of the most powerful compliance tools you possess, so if a patient has had a measurable improvement in its quality of life after a dental treatment, ask the owners if you can share the pet's story-with images-to help other animals.
Instead of playing smooth, sleepy jazz for pet owners while they're on hold, record a message that opens the door to a dental care conversation in the future. Here's an idea from Dr. Greenfield: “Did you know that the majority of dogs and cats over the age of 3 have periodontal disease? Please talk to one of our trained technicians about your pet's oral care.”
Read more about tooth talk:
Become friendly with your local veterinary dentist. It's a great way to learn by observing, especially when you accompany the patients you refer. Search avdc.org to find a veterinary dentist in your area.
Get in-person training from a veterinary dentistry expert at a Fetch dvm360 conference this year. Visit fetchdvm360.com to learn more and to register.
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