The Veterinary Dental Patient: A Multidisciplinary Approach. Группа авторов

Products with the VOHC seal are more reliable that those with just a marketing logo. Additionally, there are a growing number of evidence‐based medicine studies evaluating the effectiveness and mechanism of oral hygiene products (See more in Chapter 5).

       Provide information on your website and in your waiting room and reception on standards, safety, and the importance of oral health

       Make dental care part of your prophylacitc/preventative/wellness program, together with vaccination, deworming, senior care, and so on.

1.5 Equipment Considerations

      1.5.1 Waiting Room

Depending on the types of patient you typically see, the waiting area should be arranged in such a way as to handle animals of all different sizes and types at the same time. Regarding dentistry, communication should start with examples of the problems that create pain and infection. Pictures demonstrating procedures and patients should not be too scary or dramatic, however, as children and some other customers may find them upsetting. A TV screen displaying information about the quality of oral hygiene, anesthesia, and surgery provided by the practice is very useful, especially for those clients who have to wait some time for consultation or for discharge of their pet (Figure 1.1). However, too many advertisements may have the effect of alienating customers, so be careful not to overdo it.

      1.5.2 Consulting Room

This is where the examination is performed in the conscious patient, which is a very important part of the dental consultation. In clinics that respect the International Society of Feline Medicine (ISFM) recommendations and standards, it is necessary to have separate rooms for cats where dogs are not allowed to enter (Figure 1.2). This really makes a huge difference in examination comfort, particularly in sensitive cats with a fragile mentality. A list of cat‐friendly clinics is available online.

      The dental consulting room does not have to be large, but the ability to examine the patient in good light is required. For the presentation of radiographs, it is convenient to reduce daylight by closing window blinds.

Space should be available in which to watch the patient's behavior. The examination table should have access to daylight or to a diagnostic lamp that provides near‐natural light. Plaque‐disclosing solution, a toothbrush, and examples of hygienic solutions are very helpful for establishing oral hygiene strategies. Instrumentation should be available to demonstrate additional diagnostic modalities. However, very few patients allow for conscious examination with a periodontal probe or mirror. Having dental models or educational posters and presentations available will be of excellent benefit when explaining what treatments will be performed to the pet owner (Figure 1.3).

It is confusing when the veterinarian must leave the room repeatedly to fetch equipment, so it is wise to store all of the equipment in one place. It is also important to keep the equipment and models clean and sterile (e.g. for toothbrushes or probes).

Figure 1.1 Waiting room TV screen with informational dental presentation.

Figure 1.2 Feline cabinet, following the standards of a cat‐friendly clinic.

Figure 1.3 Dental models and instruments as well as a small whiteboard can be helpful in explaining dental problems to owners.

Even novices should be able to describe the outline of a problem in an understandable way (e.g. brief pathogenesis, diagnostics and the goal of treatment). Education of the pet owner is very helpful when done in an inoffensive way and adapted to the individual. White boards and a set of colors markers will improve the explanation (Figure 1.4). Posters presenting occlusal problems, the importance of radiography, and the most commonly diagnosed problems are available (Figure 1.5). So too are iPad applications containing easy‐to‐follow and customer‐friendly movies on the most common dental problems (Figure 1.6).

      Good‐quality flat‐screen computer monitors are important for the presentation of radiographs and other illustrations during discussion with the client, especially for those who prefer visual communication. Others may prefer logic and quiet verbal communication. Additionally to make important notes withdrawn from the clinical interview a paper and a pen is needed.

As a safety consideration, animals' teeth are a part of their defensive apparatus. A patient may bite as a result of aggression, fear, stress, or frustration, and in most of the cases we cannot blame them for doing so. Before an oral examination in a conscious animal, it is reasonable to ask the owner about its attitude toward strangers. There is a device available that protects the fingers, but in the author's experience it is better to stop an examination rather than force it until the patient begins to fight (Figure 1.7). Depending on local regulations, the veterinarian may be responsible for any injuries that happen to the pet owner within the consulting room, including being bitten by their own pet. Therefore, anesthesia should be performed in any circumstances where the owner cannot assure assistance or where such assistance may create a hazardous situation.

Figure 1.4 White board drawings explaining a crown height‐reduction procedure.

      Finally, here is a list of useful equipment to install in the consulting room:

      1 Dental models of a dog and a cat

      2 Educational posters

      3 Diagnostic flashlight

      4 High‐quality screen or tablet

      5 Paper and pen

      6 Whiteboard and markers (or tablet)

1.6 Dental Operatory

The first step in organizing a dental presence at a practice might be to install a dental corner/table in the preparation room. However, it is much better to have a separate dental operatory (Figure 1.8). During dental procedures, significant contamination will be produced, including of an infectious aerosol. This is a specific situation in dentistry and thus it is important to separate the dental department from the rest of the surgical operatory. At the same time, all procedures will be performed under general anesthesia, so it is mandatory to provide the infrastructure for safe anesthesia (Figure