Vet Checking Cat's Teeth

I don’t know one veterinarian who went to school to become a dentist, and yet I’ll wager that most of us spend a significant percentage of our working lives practicing dental medicine on our patients.

I got to thinking about this after a particularly harrowing Thursday (my big dentistry day). Exhausted after performing several time-intensive dental procedures, I wondered what percentage of my time I’d been dedicating to dentistry lately.

Though I’ll probably never know exactly, as it happens, I learned that it wasn't too tough to get an estimate. Based on last year’s dental intakes, I was able to establish that almost 12 percent of my income was attributable to dental procedures. Add in the exam room time, pre-anesthetic labwork and peri-procedural medications prescribed, and it becomes clear that at least 15 percent of my income (a rough approximation of how my working life is apportioned) is dedicated to dentistry.

Which shocked me. When exactly did I turn into a dentist?

A Low Priority Two Decades Ago

The truth is that when I graduated from veterinary school back in the mid-’90s, the program I attended at the University of Pennsylvania did not require a clinical rotation in dentistry. Which effectively means that most of us were expected to apply what we’d learned in our core classwork (in anatomy, physiology and pathology, among others) to an area of veterinary medicine we’d never been clinically trained in.

At the time, it was an effective-enough approach. After all, dentistry was the red-headed stepchild of the veterinary world. Back then, it was common for essentially untrained technicians to perform routine dentistry procedures. In fact, I worked at several hospitals where it was standard practice for techs to extract teeth! Why would any self-respecting veterinarian dirty her hands with a procedure her tech could do "perfectly well?" 

Dentistry Gains Momentum

But over the course of my career, I’d seen the writing on the wall: Veterinary dentistry was growing up. Veterinarians began to recognize that proper dental care could prevent pain and help protect pets from the spread of infection to internal organs, including the heart, kidneys and liver. No longer was it good enough for just anyone to “pull” teeth when proper extraction techniques were required.

Sure, technicians were a wonderful adjunct to the team, especially when certified or well-trained via formal coursework in veterinary dental techniques, but things had changed: Digital X-rays were de rigueur, and veterinarians — not technicians — would perform all delicate dental procedures. I mean, you wouldn’t expect your hygienist to supplant your dentist in a surgical situation, would you?

Which explains why most of us not-so-clinically-schooled veterinarians eventually undertook seminars on current techniques in veterinary dentistry and clocked hours in wet labs on radiology, dental pathology, surgical extraction techniques and endodontics, among other areas of dental interest (root canal, anyone?).

The Force Behind the Change

But the question remains of why things changed. How did we get from overseeing our technicians while we performed ostensibly more “complex” medicine to dedicating a full 15 percent of our workdays to dentistry?

Turns out much of it was your fault. Sure, veterinarians campaigned for dental X-rays and thorough cleanings beneath the gumline. But it was you, our progressive pet owners, who clamored for higher standards of care and wouldn’t stand for anything less. You were the ones who didn’t think it was good enough to extract a tooth when we could save it. You wanted root canals and advanced periodontal procedures.

Now, it’s true that not everyone can afford the high level of care most of us now provide. But here’s the thing: At least you know what’s on the menu. And that means that maybe one day (pet insurance in hand, perhaps?) you will start to think of your veterinarian as a dentist, too.

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