Questions from the dental trenches: The practical side of veterinary dentistry

Questions from the dental trenches: The practical side of veterinary dentistry

Common inquiries from lectures about marketing, client compliance and much more.

Over the years I've given a lot of lectures on veterinary dentistry at continuing education conferences and sponsored symposia. And I've gotten to where I can almost perfectly predict what the audience's top questions will be at the end of my sessions.

I'm assuming that you might have some of these same questions, so I'm kicking off a three-part series of "dental FAQs" to provide answers to some of the more practical concerns when it comes to veterinary dentistry. If you have a question you'd like to see answered in the next two installments, send an e-mail to

Q. On dental day, we perform six to eight prophys, but we would like to perform more. How do we bring in more patients?

>>> Figure 1: This patient had a dental cleaning a month before presentation but still exhibited odor and oral discomfort. Radiography revealed multiple areas of marked periodontal bone destruction necessitating multiple extractions.
A. The first thing to realize is that there is practically no such thing as a "routine prophy." Patients that have been anesthetized for a "prophy" have visible calculus and gingivitis or they would likely not have had the "prophy" scheduled to begin with. Cleaning without evaluating the patient radiographically is of little to no benefit. And with radiographs, almost all of those "30-minute prophys" are really 60- to 120-minute or longer oral surgical procedures involving periodontal regenerative procedures, plus or minus surgical flaps and extractions (Figure 1). The problem is not the number of patients being low; the problem is not doing a thorough job on the patients we have.

Q. Our clients will not opt for expensive dental services. It is hard enough to get them to agree to a prophy. How can we make sure they agree to needed dental work?

A. Vilfredo Pareto, an Italian engineer working in France in the late 1800s noticed that 80 percent of the land was owned by 20 percent of the population. From that observation grew the Pareto principle, or the "80-20 rule." It holds true for a multitude of real-life examples, veterinary practice dynamics being one of them.

You are correct in assuming that most of your clients will not take your recommendations regarding any high-end service. Eighty percent will say no to plating for a limb fracture, a complete workup for an acute vomiting patient, a cardiac evaluation, an ultrasonographic examination—and the list goes on. It is the 20 percent who will opt for dental radiography and will pay for the therapy required uncovered by this invaluable standard of care tool that you should focus your efforts on.

Q. We have dental radiographic equipment, but it would take us 45 minutes to an hour to take full-mouth radiographs in a large dog. How can we become more efficient?

A. Many practices feel the same way. The answer is practice. Practice on cadaver head specimens, not skulls. Cadaver specimens are the closest equivalent to a live patient and are the only way to become proficient before providing this service to a live anesthetized patient. Proper guidance in positioning and software template setup is essential and can be obtained at Reachable full-mouth radiographic time goals are 20 minutes or less on a large dog and eight minutes or less on a cat or small dog.