Diagnosing dental disease

RE: Diagnosing dental disease

Ben Ogden — Fri, 22 Dec 2017 14:49:48 GMT

This may spark a comeback, but it's all in the wording. Instead of saying 'this/your dog has dental disease', have you considered:

"hmm, there is a tartar build up here (indicate), gum recession (here), the gums are inflamed and this root is exposed, these are the hallmarks/symptoms of periodontal disease"

"whats periodontal disease you say? Well........................"

"The practice recommends the following treatment options concerning periodontal disease, they are...................."

"The next step would be to book in with your Veterinary Surgeon for an examination............." You get the point.

You might call it leading the consult, I call it 'say what you see'

I second all the comments about post dental aftercare etc, the dental clinic's role is to promote good oral hygiene to prevent periodontal disease, if your clinic works well and your clients follow advice given, you shouldn't need to worry about not diagnosing dental disease

RE: Diagnosing dental disease

Karen Carver — Thu, 21 Dec 2017 16:48:13 GMT

Don't let it get you down. There's still lots you can discuss in a nurse dental clinic.

The most you can do is advise they are booked in for a dental under GA, as you cannot diagnose dental disease without dental probing/dental xrays.

As for the clinics there is massive scope for nurses running more dental clinics (even if you can't diagnose)

- Advising on daily toothbrushing and teaching technique

- using plaque disclosing solution to show owners where they're missing

- Advising on safe toys/chews

- Advising on dental diets

- Types of toothpaste (Chlorhexadine/Fluoride/Enzymatic) - how they're used and what they're used for.

- Also gives you an opportunity to view any abnormal findings such as fractured teeth, non vital teeth, oral masses etc that you could then adv for a vet check.

You could try iM3 dental, Virbac or Henry Schein Dental for any promo material.

Hope that's helpful!

Karen x

RE: Diagnosing dental disease

bumble bee — Wed, 20 Dec 2017 13:07:11 GMT

You can still see them in your clinics post operatively prehaps to demonstrate brushing of teeth & oral care. Most of our ops are vet checked for free prior to surgery and vet checked on the morning of surgery if not regular client (charity neuters) by the operating vet.

RE: Diagnosing dental disease

apache — Fri, 15 Dec 2017 00:11:44 GMT

[quote user="Josephine "]However, my current boss doesn't want me to do this as I'm not a vet and not qualified to make that decision. He says if I feel the animal needs a dental I should book them in to see the vet just for them to say "yes, Fifi has dental disease and needs dental surgery". The owner would be charged a consult fee to see the vet. There's also no point of my nurse clinics if the ultimate decision is with the vet![/quote]

I agree there is no point in you running the clinic if this is the case. On the other hand I do think there is a way you can make this work. It would be technically wrong for you to 'diagnose' an animal with disease, but its widely recognised that without a GA, scale, probing, (+/- radiographs depending on the practice) you cannot really decide what treatment is really necessary. You should be able to recognise whether the teeth are normal, require monitoring (come back to see me in 6 months), or require treatment.

There is no reason a RVN cannot discuss likely treatment options and explain what happens when an animal comes in for a 'dental'. We would always give rather broad estimates for dental work to cover the unknown nature of this. I would hope a RVN could distinguish between mild/moderate/severe and give an acceptable estimate. The vet involved in the procedure would then make the necessary clinical decisions at the time.

RE: Diagnosing dental disease

Nicola Smith — Thu, 14 Dec 2017 20:01:14 GMT

I do dental clinics and if I feel treatment may be needed get vet to come in and check, give estimate if needed and check if ok for ga. Clients don't get charged for vet coming in. I go through procedure of what we will do e.g. probing, xrays etc and talk about progression if treatment not carried out, and care after procedure. I feel my clinics are very worthwhile and it doesn' take much of the vets time to pop in and may mean they are happier to come to us as no charge for initial check but also as everything explained. Many people have been to neighbouring practice who have offered no explanation - just it needs a dental- whereas if you can talk through surgical extraction techniques and exactly what will happen they feel happier but can also understand the costs involved better.

RE: Diagnosing dental disease

Kirsty RVN — Thu, 14 Dec 2017 18:37:27 GMT

Yeah unfortunately that's the case

The patient would need to be referred to a vet and are the only ones that can make that decision and recommend treatments

Even for fleas and worms they have to see a vet first!

The most we can do in terms of dentistry is advise the client once they have seen a vet on dental hygiene even if we have additional certificates in this area