Sharon L. Campbell, DVM, MS, DACVIM

The fear, stress and anxiety (FAS) our patients experience when arriving at our clinic is something we have been striving to reduce for several years. Many of the resources we have available focus on the veterinary appointment. More recent resources have focused on how to manage the FAS in the hospitalized or emergent patient. But what about the FAS our clients experience, specifically regarding dental procedures?

Owners’ FAS may stem from a general lack of understanding of consequences of poor dental care for their pets, a misconception of the risk associated with anesthesia, apprehension about how the procedure will affect their pet and finally, worry about the cost of the procedures. All of these concerns can be addressed with an empathetic yet emphatic conversation.

We know from various studies that periodontal disease is the most common infectious disease in dogs and cats, affecting 78% of dogs < 4 years of age and 73% of cats > 4 years of age.^1-4 Therefore, every patient and every visit is an opportunity to provide education on dental health.

Getting pet owners to say “yes” to a dental procedure starts with communicating the signs of dental disease and the impact it can have on their pet. Pet owners may or may not have noticed the signs of dental disease such as halitosis, dropping food, etc. and if they did, they may not have associated it with dental disease. By explaining that these signs are indicative of dental disease, which is progressive and not only affects the teeth, causing significant pain and distress, but can affect the kidneys, liver, lungs and heart,^5-7 owners can begin to understand the necessity of the procedure.

Addressing pet owners’ concerns about general anesthesia starts by emphasizing that general anesthesia is safe and keeps their pet safe and comfortable by providing analgesia, reducing anxiety, keeping the pet still, helping protect the airways, and allowing for a thorough exam and complete procedure. Assuring the owner that their pet will be closely monitored during the procedure can also help relieve their concerns. Discussing that antibiotics and analgesics used appropriately before, during, and/or after the procedures can prevent complications and allow the pet to continue their normal routine when they return home can ease their concerns about the outcome of the procedure.

A discussion on the increased risk from waiting until the pet has advanced dental disease can help owners realize the benefits of early intervention. Since advanced dental disease results in a both lengthier and more invasive procedure, this can be avoided if their pet undergoes treatment in the early stages of the disease. Using photos to show the various stages of dental disease is effective in gaining owner understanding.

Finally, the cost of a simple dental cleaning, scaling, and polishing ranges between $250-500. Here again is another reason for early intervention, as the cost for more advanced disease can be 2.5 times more expensive.⁸ Taking photos of the pet’s mouth before and after the procedure, showing these along with radiographs, and explaining what occurred during the dental procedure can help pet owners appreciate the value of what they have paid for.

Getting pet owners to say “yes” to a dental procedure not only involves ensuring that their pet will be handled in a Fear Free manner, but overcoming their own FAS. Once the owner understands the needs and you address their concerns, more pets can receive timely dental care.

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References

1. 1. Wiggs RB, Lobprise HB Veterinary dentistry-principles and practice. Philadelphia: Lippincott-Raven Publishers, 1997: 186-231.

1. 2. Harvey CE Periodontal disease in dogs. Etiopathogenesis, prevalence, and significance. Vet Clin North Am Small Anim Pract 1998; 28: 1111-1128.

1. 3. Lund EM, Armstrong PJ, Kirk CA, et al. Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. JAVMA 1999; 214:1336-1341.

1. 4. Gengler, W.; Dubielzig, R.; Ramer, J. Physical examination and radiographic analysis to detect dental and mandibular bone resorption in cats: a study of 81 cases from necropsy. J Vet Dentistry. 1995: 12 (3): 97-100.

1. 5. Pavlica Z, Petelin M, Juntes P, et al. Periodontal disease burden and pathological changes in the organs of dogs. J Vet Dent 2008; 25:97-108.

1. 6. Debowes LJ, Mosier D, Logan E, et al. Association of periodontal disease and histologic lesions in multiple organs from 45 dogs. J Vet Dent 1996; 13:57-60.

1. 7. Glickman LT, Glickman NW, Moore GE, et al. Evaluation of the risk of endocarditis and other cardiovascular events on the basis of the severity of periodontal disease in dogs. JAVMA 2009; 234:486-494.

1. 8. American Veterinary Dental College (AVDC). Information for owners. http://avdc.org/ownersinfo.html. Accessed December 17, 2013.