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How to successfully book in that veterinary dental procedure

Posted in Festival of All Things Dental @ Aug 13th 2015 - By Dr Rhys Hayward, Vets First
How To Successfully Book In That Veterinary Dental Procedure

Tips and scripts on how to convince your veterinary clients on the importance of essential dental treatments for their pets.

It’s FatD time and as I contemplated whether or not I have anything to offer this year my mind drifted back to a recent conversation with our vet team. As it turns out I had been managing to book in more dental procedures than some of the other team members.  As vets we very rarely listen in on other vets’ consults so we had a chat about how we discuss dentistry with clients and book their pets in for dental procedures.  It’s a conversation well worth having with your team particularly if there is a stand out performer that you can plagiarise!

So here it is….my step by step guide to booking in a dental procedure.

Disclaimer: My approach may not be for everyone but hopefully you’ll get a tip or 2.

Let’s assume that I am seeing a client (I’ll call her “Judy”) with a small breed dog (“Bob”).  Bob is in for a check-up and vaccination and just happens to have grade 3 dental disease…..

Step 1. Step 1 in the art of veterinary science is to Build Rapport

You know; make a fuss of the dog in the waiting room, call the client by name, ask 3 non-animal related questions before launching in to your exam etc etc.  Let’s just assume we are all good at this and get through the small talk before doing our clinical exam.

Step 2. Clinical Examination

I always start by examining the oral cavity and clearly in this scenario I am going to find a problem.  When I flip the lip of a dog (or cat) with grade 3 dental disease I tend to make a concerned looking face and say something really profound like

“Judy, Bob has some really sore teeth and gums.  Please remind me to talk about how we can help before we finish up.”

I find that this puts the problem in the front of people’s minds and they often will remind you in a few minutes to discuss it….not that I would ever forget!  Showing genuine concern for the patient is paramount.

Step 3. Judy and I have a nice chat while we finish off Bob’s clinical exam (thankfully finding no other problems) and I get him up to date with his vaccinations. 

Now is the time to Discuss Dental Disease.  I put aside a good 5 minutes for this to make sure Judy fully understands the problem and how we are going to fix it.  My spiel goes something like this: 

Every time Bob eats, saliva mixes with bacteria and forms plaque on the teeth (yes, it’s a simplified version of events).  As Bob doesn’t brush his teeth, the plaque eventually turns into tartar which sits on the tooth and starts to cause bad breath (Grade 1 dental disease).  As the tartar expands it grows up the teeth and under the gum line.  This causes the gum to be red and painful (Grade 2 dental disease).  Now Bob has Grade 3 dental disease, which means that this gum disease is widespread and the infection is getting between the teeth and the jawbone, causing the roots of some teeth to be permanently damaged.  This is a painful process.  As for Grade 4 dental disease…well you never want to see that.”

Step 4. Now that Judy understands dental disease a little better, she can understand how to fix the problem, so Discuss the Dental Procedure. 

At this point I always explain that the solution comes in 2 parts; the dental procedure and the ensuing home care and regular checkup/prophylaxis program (a topic for another day).  But here’s how I explain the procedure itself: 

“The first thing Bob needs is a blood test to make sure his organs are functioning well and he can cope with the anaesthetic.  One of our nurses can do that for you now.  On the day of the procedure Bob will come in on an empty stomach and be given a sedation so he can relax in his cage.  He will then be given a full general anaesthetic so we can do the dental work.  In this case the first step will be to x-ray all of his teeth.  Once that’s done I will sit down and evaluate all the x-rays while one of our super dental nurses scales and polishes Bob’s teeth.  I will make up a chart which will show me which teeth I need to remove.  Next I examine and probe around all the teeth to make sure I am not missing anything as the x-rays don’t always give you the full picture.  I will then put in some local anaesthetic and extract the teeth that can’t be saved.  Some teeth are easy to remove while others need oral surgery and sutures. 

Once we are done we will wake Bob up, make sure he has enough pain killers on board and get him home to you that afternoon with a few days pain relief.  Really importantly, we get you back 10 days later to make sure that everything is ok, all wounds are healed and get you started on a long term prevention program so Bob never has to have pain in his mouth again.  You only ever want to do major dentistry once…”

Notice there are no options and I use words like “need” rather than “recommend”

Step 5. Only once Judy is fully informed do I Discuss Cost. 

In this case I explain that the likely range for this procedure is $585-1250 and that it’s only once we have done the x-rays that we know how many teeth need to be removed.

Step 6. BOOK IT IN. 

Everyone has their own technique but this is a step that is often missed.  I like to walk the client to the front desk and say

Angela, can you please book in Bob for a Grade 3 dental next week”. 

This reinforces how important it is to me that we get this procedure done.  Others like to book in while still in the consult room which I think is also a good idea.

Step 7. Smile in the Satisfaction that you have done the right thing by Judy and Bob and started them on a program which will make sure Bob continues to have a pain-free mouth.

So there it is – a sequence of events that works well for me. I realise that there is no formula that works for every vet and that different clients require different communication styles.  But hopefully you have gained something out of this to help you book in more dentals.  I would also love to hear any comments or tips from others that help to increase dental book-in rates.

Until next year…

About Rhys

Rhys graduted in 2001 and started at Strathalbyn and Riverport in May 2005. Rhys’ main interests include small animal surgery and emergency medicine.  He was admitted to the Australian College of Veterinary Surgeons in the field of Small Animal Surgery in 2010.  He is also a chartered member of the Australian Veterinary Association.  Rhys loves a challenging surgical case!

In his spare time Rhys enjoys cycling, golf and surfing. He enjoys following the Aussie cricket team and the Adelaide Crows.

You can read Rhys' Blog here: Vets First Blog  |  Click here to visit 'Vets First Riverport & Victor Central' on Facebook  |  Click here to follow 'Vets First' on Twitter


Liz @ Aug 14th 2015 9:33am
Great tips Rhys. What is your response to when they say "but they are eating fine" or "they are not in pain".
Sanjay @ Aug 14th 2015 12:28pm
Thanks for the tips Rhys. Good questions above. I would also like to ask what your response is when clients balk at the cost.
Rhys Hayward @ Aug 14th 2015 5:05pm
Hi Liz. That's a common response and it depends on the client a little but I'll explain how it's their survival instinct not to show pain as if they were in a pack they would be left behind or preyed upon for showing any signs of weakness. If it feels right I'll explain how for a cat or dog to stop eating they have made a conscious decision that they would rather starve to death than put up with the pain (I think I heard that one from Christine Hawke). For most people just explaining that the red gum is a sign of inflammation and therefore pain, and also that the bad breath is from pus, seems to be adequate. Finally I find that asking the client if they have ever had a sore tooth hits home in many occasions, as you can multiply that pain by however many teeth are affected to make the point.
Rhys Hayward @ Aug 14th 2015 5:11pm
Hi Sanjay. Many clients baulk at the cost but it is almost irrelevant what that cost actually is. To explain a little better it is natural to baulk when given a cost for a major procedure initially, but the response is likely to be the same whether that cost is $500 or $1000 so I try to overestimate and then come in under most of the time. However, when you take the time to fully educate the client on the disease process and the extent of procedures required you would be surprised how often they think it's worth a lot more than the figure you give them. In the case where they truly can't afford the treatment we will discuss a payment plan but I don't reduce the quality of treatment. Very occasionally they will then go elsewhere for a scale and polish with no x-Rays etc but I can only think of a couple of times where that has happened. Hope that helps! Rhys
Judy @ Aug 15th 2015 2:54pm
Hi Liz, I've got my 'pet owner's' hat on and I know when I first started reading about dental health for pets and realised that my girls could be hiding so much pain I was horrified - and to be honest - a little upset that in my mind this hadn't been explained to me before. I really had no idea that it was part of an animal's instinct to hide pain. This is part of the reason I started FatD as I wanted ALL pet owners to also understand this.

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