By Vickie Byard, CVT, VTS (Dentistry), CVJ

Is this a typical record for your clients?


If this would not be the norm in your practice, maybe you should ask the question; “Why?” The clinical presentation is as follows:  This is a challenging Siamese who has not to date allowed his owners to brush his teeth.  Knowing that, our veterinarians know it is important to follow his tartar accumulation closely and to recommend care BEFORE it becomes a problem. Here is the before image:

Thai Right side before

Here is the pet’s after image:


If we look at the medical record, this patient had a COHAT  (Comprehensive Oral Health Assessment and Treatment) in 2013.  That means we thoroughly examined the oral cavity, professionally cleaned the teeth and took full mouth radiographs under general anesthesia.

On the physical examination in 2014, it was determined that this pet had a significant amount of tartar already accumulating.  Since this patient will not allow his parent to brush his teeth, the veterinarian understood the health benefits of cleaning the teeth again.  Since this pet had a recent radiographic survey, we will provide the next dentistry without the expense of radiographs and we charge only for the amount of anesthetic and monitoring time.

We do not reduce the cost of any of our services and we do not reduce the standard of care.  Since the second dentistry only required 20 minutes of anesthetic time, that’s what we charged.  This patient still received a thorough pre-anesthetic exam, a dedicated anesthetist, IV catheter and fluids, and a thorough cleaning.  Charging the client appropriately, allows the pet owner to provide these frequent dentistries, which in turn allows the practice to provide true wellness care.  It is a win-win for everyone.

Consider the cost of a COHAT in your practice. Is the expense of it the reason it is difficult to recommend them frequently?  What if YOU created a Wellness Dentistry? In some practices a Wellness Dentistry would be synonymous with Grade 1 dentistries.  Do you not recommend Grade 1 or Wellness Dentistries on 3 year old Golden Retrievers because there is little to no tartar?  If not, could you have missed the opportunity to provide comfort for this patient?

tooth resorption

Our estimate for a COHAT has a full series of radiographs on the low end and a full series on the high end.  The estimate for a Wellness Dentistry has zero radiographs on the low end and a full mouth series on the high end.  When we perform the admissions intake, a veterinary technician discussed whether or not the owner would like us to take the X-rays on this Wellness Dentistry.

As much as I believe in the benefits of intraoral radiographs, I wonder if we, as veterinary professionals, are shooting ourselves and our patients and clients in the foot by insisting that every dentistry MUST have a full mouth series.  Have we priced our dentistries strategically so that the average client can take advantage of your dentistry services as frequently as they would like?

Just a little food for thought.  So, far, this program has worked well with our clients and they appreciate a program that promotes health at a reasonable cost without compromising standards of care.

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