Above is just one view of a cat that was taken advantage of by a veterinarian who offered cheap dental work, which came back to haunt several cat owners. Dental radiography has taken the world by storm as a revolutionary diagnostic for cats impacted by dental disease or periodontal disease. I am hoping that this post will encourage more veterinarians to incorporate dental radiography with the dental procedures that they routinely offer if they wish to improve their reputation. I feel that dental radiography will significantly improve compliance with dental procedures and trust with your clinic if you describe the benefits of this dental radiography service rather than taking the easy way out and not taking the risk of making a change.
Without dental radiography, you only get half of the tooth to evaluate and half of an ideal treatment plan. Hundreds, if not thousands of veterinary clinics, have decided to purchase a dental radiography unit in 2019 to improve the quality of patient care for years to come. I firmly believe every patient, every time deserves the best care that there is to offer, within reason. The veterinary clinics that are not going to upgrade their diagnostics to stay competitive will likely start to lose money once more owners start to identify mouth pain as a result of the teeth being incorrectly removed or not completely taken out. Multiple veterinary clinics have already made their money back by offering this additional service to their clients for a slightly larger price tag.
I first encountered the magic of dental radiography in the middle of 2019 when I allowed a veterinarian to perform a dental procedure without dental radiography on a cat by the name of Hershey. Their cost for the teeth extraction was 1/5 of the price that my primary veterinarian was going to charge, so I gave it a go, expecting that nothing could possibly go wrong with extracting teeth. The veterinarian ensured me that every tooth root was successfully removed, as evidenced by the radiograph he took on his traditional radiograph machine. The cat ended up with mouth pain two months after the procedure, so I took the cat to our primary veterinarian for additional evaluation. My primary veterinarian works in an AAHA accredited veterinary clinic and is always upgrading his skills so knew he could find out what was wrong.
Our primary veterinarian snapped a quick dental radiograph of our cat to send off to a dental specialist for evaluation since you could not tell from the prior veterinarian’s film if there was or was not roots left in his mouth. The dental specialist found that the previous veterinarian performed a crown amputation and intentionally left the roots in just over half of the teeth, especially on the bottom. The teeth had no evidence of resorption, so there was no practical reason for performing this procedure instead of taking the time to remove each root. The veterinarian could say with 99% certainly that the tooth roots were not taken out to save time and money.
Hershey is far from being the only cat that this has happened to over the years, I can guarantee that for certain after I have talked to multiple shelters who have had the same trouble with their shelter veterinarian. Dental radiography will likely discover more cats who were taken advantage of for the sake of higher profit margins and less time spent on any single veterinary procedure in the following years. It is appalling that a veterinarian would try to take advantage of a cat, thinking that he would never be exposed. The average consumer will trust their veterinarian blindly and never question their work, especially if they have to pay another veterinarian to take a radiograph of their cat to verify if a previous procedure was done right.
I know one shelter who had 30 cats that had roots left in their mouth, which was only discovered after their veterinarian left the shelter and went to jail for some type of veterinary malpractice. It started with one cat, which then escalated from there when they decided to take a dental radiograph of every cat their previous veterinarian worked on. The suspicion that the prior veterinarian performed shoddy dental work was brought about when the first cat started displaying signs of inflammation and pain in the mouth even though every tooth was supposedly removed in full.
The veterinarian’s only defense for the shoddy work performed on Hershey is that she did not want to purchase a dental radiography machine due to cost restraints. The shenanigans ended up costing $1000 for us to fix at the dental specialist in Saint Louis, Missouri. At the end of the day, our rescue had to pay the price of her failure to upgrade her diagnostics, which isn’t fair to our small rescue. I feel bad for any other cat owners who have to pay that same price. All a veterinarian would have to do is increase the dental procedure price by $50 to $200 once a year to make it worth the investment for every individual.
I do not fault a veterinarian who had trouble removing a root or several roots when dental radiography was not available to the public, and you had no way to verify you removed them. Teeth broken off are the most difficult to remove properly. My primary veterinarian has admitted to leaving a tooth root or two in the past for particularly hard cases where it is hard to tell if you got the whole tooth or not, but that is an entirely different situation than most owners or shelter directors find themselves in. There is no viable excuse in a situation where you can implement quality control at an affordable price.
You can no longer tell yourself a story about how it was an accident that dental roots were left behind on a routine dental procedure now that every veterinarian has the opportunity to train themselves and their staff on dental radiography by online courses or by bringing in an experienced trainer. Technology advancements do no good if you do not evolve with the times and harness the power of those advancements. Maybe you could have fabricated an excuse when the dental radiograph machines first came out, but definitely not now. It will soon be malpractice that a dental procedure is performed without dental radiography.
I practiced dental radiography during my college years at the Vet Tech Institute and found the technology easy to use and interpret. Some of the shots were a bit difficult, but training for any new procedure is expected. Most dental radiograph machines are digital, which will allow for rapid and accurate imaging. You can even edit and send off copies for analysis by a dental specialist. We learned in school that dental radiography should be performed before and after every single dental procedure. Taking the time to learn and apply the magic of dental radiography in your veterinary practice can become invaluable.
My veterinarian told me that radiation exposure is less with a dental radiography machine than with traditional radiography. Overall, you can supercharge a dental treatment plan and tailor it to an individual cat as you monitor progress down the road with additional imaging procedures.
Dental radiography can aid with the identification of periodontal pockets due to a narrow pocket width. Clinically healthy teeth with a hidden infection may be identified, which can prevent unwelcoming pain in the future. Part of the mission in veterinary medicine is to prevent pain and alleviate suffering, and this technology goes a long way toward achieving that goal.
As an example, my Siamese constantly hid in the litter box at the animal shelter and hissed at every person that walked by. I noticed on a Sunday that she was drooling and spitting out her food, which was not normal for her at all. She had eaten less for the previous few days, but I thought nothing of it because of her adjustment to the house. Our primary veterinarian identified three resorptive lesions with digital radiography, which were extremely painful when he poked them under anesthesia.
My Siamese cat was in tremendous pain, but the teeth were clinically healthy on the outside of the tooth and might have gone under the radar. I had another cat that had a recent dental extraction before being surrendered to us by a veterinarian we did not work with. A dental radiograph identified that prior dental extraction caused an adjacent tooth to become fractured underneath the surface. The poor cat would not eat any kind of food I put out, which made sense after having this procedure performed.
I think the decision to upgrade or not upgrade is based on your values as a veterinarian, and the way you treat your customers. I would definitely tell people who want a full mouth extraction that you do not have dental radiography at your disposal so that they do not have a perception that it will be done without any roots being left behind.
I have found through personal experience that the veterinarians who do not have a dental radiography machine tend to make mistakes in a variety of other areas as it relates to veterinary medicine. I have been witness to poor quality control in so many veterinary clinics that would rather purchase new vehicles for themselves rather than upgrade the clinic. I tend to see this problem in more rural areas where there are more old school doctors.
Some veterinarians you meet in life will have more of a desire to pinch their pennies rather than abiding by the veterinary oath. Most veterinary clinics that are like this are based in rural areas and are businesses that have not kept up to date with recent literature. A deep search into the skills of a veterinarian that would intentionally take an easy way out on a dental procedure would probably reveal a poor understanding of veterinary medicine. I always ask a plethora of questions when I work with any veterinarian that is not my primary from now on, understanding every single step they take in ensuring the work is top-notch
I am known for recommending AAHA accredited veterinary hospitals as they are renowned for incorporating the highest standards of care. AAHA accredited hospitals are inspected yearly on a large list of requirements and recommendations which they must abide by to pass. This group of hospitals does end up more expensive, but you almost always get what you pay for. Low prices at the clinic usually equate to quick and sloppy work. Most veterinarians without the AAHA accreditation are highly skilled. Still, I encourage everyone never to assume the way a procedure is carried out just because the textbook says it should be done that way. Always ask questions and never go home feeling like you do not have the peace of mind that every cat owner should have when consenting to a surgical procedure.
You do not have to purchase every bell and whistle that comes out, but purchasing a dental radiography machine is kind of a golden ticket to performing consistently great dental procedures. Do not be afraid to charge more for a service you know is going to be worth the additional amount of money. Doing a full mouth extraction and not knowing if you left tooth roots in by taking a dental radiograph even though you could prevent future pain sends a strong message. Taking the extra time to snap a before and after digital radiograph of their entire mouth sends an entirely different message across the board.