Once early, moderate or advanced periodontal disease is present, removal of deposits on the teeth is no longer a preventive service, according to Jan Bellows, DVM, Dipl. AVDC, ABVP ALL PETS DENTAL, Weston, Fla. In the presence of periodontal disease, more than a prophylaxis is needed.
CO: To help educate the client about this different process, the terminology COPAT (comprehensive oral prevention, assessment and treatment) can be used to explain there are three distinct processes required for total patient dental care, Dr. Bellows says.
P: Prevention oral care involves the removal of plaque and calculus from the accessible surfaces of the teeth using hand and mechanical instrumentation accompanied by appropriate oral hygiene instruction. The veterinary dental visit is not complete until a discussion has been had with the client detailing how to keep the pet’s mouth clean and how to minimize recurrence of disease.
A: Assessment is the collection and analysis of data to identify patient needs. There are four parts of the assessment:
- history-taking by asking the owner direct questions;
- examination of the conscious patient’s mouth;
- examination of the whole patient as an anesthetic candidate to assess risks and formulate an anesthetic protocol;
- a tooth-by-tooth evaluation under general anesthesia including probing and full mouth intraoral radiography.
T: Treatment is the care recommended, performed or declined based on the under-anesthesia tooth-by-tooth and oral cavity examination. The client’s role is important in tailoring individual treatment plans based on the exam findings, financial ability, willingness to provide home care, and the inclination of the patient to accept prevention.
“After the COPAT visit, progress visits are scheduled weekly until the owner is comfortable with the home care process, then every 3-6 months,” Dr. Bellows says. “What owners need to understand is that they are an integral part of the equation and a COPAT partnership between the veterinarian and client will result in smiles all around.”