Dental CPD

RE: Dental CPD

Evelyn Barbour-Hill — Fri, 18 Sep 2015 15:43:02 GMT

[quote user="Aine Seavers"] yet there is very little support for doing a dental xray on a foetid mth- sure he is eating Doc, cant be that bad.[/quote]

Ah, that's not a situation I meet very often.

RE: Dental CPD

Aine Seavers — Fri, 18 Sep 2015 02:10:47 GMT

No, not negative at all, I have the problem here in Australia where even 80-90 yr old humans have great teeth and so very few understand what it is like to have a bad tooth- there is simply very little empathy for what these animals are going through- as so many generations here have grown up with superb dental care and the concept of suffering with teeth is alien to them- yet the same animal who suddenly has a sore leg or a skin lesion, well that same animal is presented quickly, everything must be done- I have to talk most of the owners out of having an xray day one of most lameness yet there is very little support for doing a dental xray on a foetid mth- sure he is eating Doc, cant be that bad. So you can explain it so they understand all the terminology but unless they can relate to it it often falls on deaf ears which is probably why the 'routine annual dental under ga' doesnt gain much traction here-yet..

RE: Dental CPD

Evelyn Barbour-Hill — Fri, 18 Sep 2015 01:30:51 GMT

Well, sometimes they have real pyorrhoea, and you can point that out. But every pet has a bacteria-laden mouth, and so do you and I. Personally I think clients, if they are intelligent and educated enough to understand anything beyond "his teeth are utterly awful", should understand what plaque is and the great difference between plaque and pus, if they are to give the dog proper homecare, both preventive and by way of salvage; and if they are to be convinced that the degree of calculus present has very little bearing on the severity of periodontal disease; and if they are to be convinced that Binky needs some dental attention now. Also if they are to refute the suggestion by Cheapo Revenue-Stream Vets down the road that Felix ought to have a "routine annual dental".

Sorry, that probably sounds negative. I can't help it. I'd say it was because I'm "passionate" about dentistry, but that word is so ridiculously overworked now.

RE: Dental CPD

Aine Seavers — Thu, 17 Sep 2015 23:58:28 GMT

in a literal sense yes, but if a lay sense where clients understand pus-the presence of something that is bacteria laden[which plaque is)- then no as its translates the problem into layspeak- now sure if I was talking to a medic I would explain biofilm etc but not to most of the clientele who have allowed the dog to get to such degree of neglect that the mouth is a mass of glowing almost 3 d pink- where they have convinced themselves the pet is eating so Vet is having them on-then they need it explained in a way they can get it, that means something to them that has a direct impact-their pet has a bacteria laden mouth(often with real pyorrhea) then the pet can get the relief.

RE: Dental CPD

Evelyn Barbour-Hill — Thu, 17 Sep 2015 22:56:26 GMT

[quote user="Aine Seavers"]One of her other Hawkism is to use the blue light(often Hills have them as freebies at trade shows) flash that in the pet's mouth and when the pink lights up the teeth- alert the client that is 'pus' [/quote]

Hmmm.... at the risk of being thought negative..... in't it a little naughty to illuminate the plaque in pink and tell the client it's pus?

RE: Dental CPD

Evelyn Barbour-Hill — Thu, 17 Sep 2015 22:18:01 GMT

[quote user="Rob Davis"]

[quote user="Busybee"]Drifting.....http://www.whatprice.co.uk/prices/vet-prices/dental-surgery-dog.html makes for interesting reading, though not sure how trustworthy it all is![/quote]

I wish I hadn't looked at that..... my blood pressure goes up with each comment....

[/quote]

"whatprice.co.uk does not make any representation or warranty, express or implied, as to the completeness, reliability, accuracy or timeliness of the information provided by us. You should not assume that the information provided is error free. "

[quote user="Busybee"] Really? Who would that be then? And would they really come all the way to the south....?[/quote]

You could ask. I guess it would get rather expensive though.

RE: Dental CPD

Busybee — Thu, 17 Sep 2015 21:19:16 GMT

[quote user="Evelyn Barbour-Hill"]There is a reason for that: cat cadavers are very difficult to practise on. Something happens to the periodontal tissues.[/quote] That would explain it, frustrating though.

[quote user="Evelyn Barbour-Hill"]I also know this really cool bloke in North Wales who will come to your practice and tutor on your own equipment if you wish.[/quote] Really? Who would that be then? And would they really come all the way to the south....?

[quote user="Rob Davis"]I wish I hadn't looked at that..... my blood pressure goes up with each comment....[/quote]

I know, mine too

RE: Dental CPD

Rob Davis — Thu, 17 Sep 2015 10:03:14 GMT

[quote user="Busybee"]Drifting.....http://www.whatprice.co.uk/prices/vet-prices/dental-surgery-dog.html makes for interesting reading, though not sure how trustworthy it all is![/quote]

I wish I hadn't looked at that..... my blood pressure goes up with each comment....

RE: Dental CPD

Aine Seavers — Thu, 17 Sep 2015 08:18:16 GMT

I couldn't find a way to post without replying to a thread so apologies Busybee but your one was the least controversial to tag back a reply. I cant help re the cat thing but tx to Mr Evelyn I know now why cat pms an issue. That aside I had a Eureka moment for dentistry about 4 years ago at a conference during a lecture I attended by accident- on dentistry- and the specialist speaker Christina Hawke transformed my approach to dentistry. We now live by her Hawkisms-and they are driven by pain relief- as dental pain in dogs- unlike corneal pain- is much much worse in dogs-something to do with % of dentine tubules-Evelyn can probably tell us exactly. Christine reminds us that our pets have no choice but to eat through the pain- its either that or starve- and so they eat until that pain overwhelms starvation pain- and so they stop eating- She suggests we ask our clients- do you want to get to the point where that is the choice your beloved pet faces every morning? To eat in pain or is today the day to starve? Most clients get it and book the dog in for a dental examination and surgery customised for that dog. One of her other Hawkism is to use the blue light(often Hills have them as freebies at trade shows) flash that in the pet's mouth and when the pink lights up the teeth- alert the client that is 'pus' the yuck factor that is on them when licked by them, and swallowed by their pet countless times a day. the yuck factor has saved many a heart and kidney from further bacteraemic/septicaemic assault. And boy are animals happier. We are so driven by pre-emptive pain for surgery and pain relief for appendicular pain but we forget- to the animal's detriment- the role of dental pain in their daily lives. So now dentistry really does fascinate me and by secondary happenstance also helps keep the bank manager happy.

RE: Dental CPD

Evelyn Barbour-Hill — Wed, 16 Sep 2015 22:03:46 GMT

[quote user="Stephen Courtney"]you tend to come across negatively when others on here get excited about dentistry,[/quote]

I do?

I'm sorry then.

Dentistry is one of the few things that excites me.

RE: Dental CPD

Stephen Courtney — Wed, 16 Sep 2015 21:59:45 GMT

^^ OK fair enough - but you tend to come across negatively when others on here get excited about dentistry, perhaps/probably I'm oversensitive

RE: Dental CPD

Evelyn Barbour-Hill — Wed, 16 Sep 2015 21:55:15 GMT

[quote user="Stephen Courtney"]

[quote user="Evelyn Barbour-Hill"]

Sure.

But you can't learn it from lectures.

[/quote]

That's a very negative and unhelpful comment - what's the point of any lectures then? it's a place to start, surely, or do you feel things are OK as they are?

[/quote]

Not intended to be unhelpful, on the contrary intended to be helpful. Of course it's a start. The lectures will not be wasted. I should have said, you need more than lectures to learn it.

[quote user="Busybee"]However, the practical side of the course only concentrated on canine (as in dog!) dentistry[/quote] There is a reason for that: cat cadavers are very difficult to practise on. Something happens to the periodontal tissues.

Alex does feline courses from time to time, and so do the BVDA course organisers.

I also know this really cool bloke in North Wales who will come to your practice and tutor on your own equipment if you wish.

RE: Dental CPD

Stephen Courtney — Wed, 16 Sep 2015 21:08:11 GMT

[quote user="Evelyn Barbour-Hill"]

Sure.

But you can't learn it from lectures.

[/quote]

That's a very negative and unhelpful comment - what's the point of any lectures then? it's a place to start, surely, or do you feel things are OK as they are?

RE: Dental CPD

Busybee — Wed, 16 Sep 2015 20:21:39 GMT

I did a really good weekend dentistry CPD course - lectures and practical - four years ago which I found very useful, particularly after a distinct lack of dentistry teaching at uni....

However, the practical side of the course only concentrated on canine (as in dog!) dentistry so I would be very keen on a practical feline dentistry course if anyone knows of any!

Drifting.....http://www.whatprice.co.uk/prices/vet-prices/dental-surgery-dog.html makes for interesting reading, though not sure how trustworthy it all is!

RE: Dental CPD

Evelyn Barbour-Hill — Wed, 16 Sep 2015 19:05:17 GMT

[quote user="Stephen Courtney"]

There is a really good Dental Stream at next year's BSAVA congress, starting with the basics of how to do a proper scale and polish, how to chart the mouth, dental radiography - both how-to and interpretation, as well as more complicated stuff like oral pathology, surgical extraction techniques, feline dentistry and also a lecture on holistic rabbit dentistry, and a very interesting lecture on Compliance Theory which relates to more than just dentistry. The speakers lined up are excellent and this series of lectures should suit anyone who 'does dentals' and would like to do better work.

Just sayin...!

[/quote]

Sure.

But you can't learn it from lectures.

RE: Dental CPD

Stephen Courtney — Wed, 16 Sep 2015 17:48:22 GMT

Just sayin...!

RE: Dental CPD

Rob Davis — Wed, 16 Sep 2015 15:00:16 GMT

I believe CPD solutions still do some courses taught by Alex Smithson. I went on one of these several years ago and it was an excellent starting point.

[quote user="Evelyn Barbour-Hill"]Keep an eye on Accesia, their courses are the very best:[/quote]

Totally agree with this. I have spent three weeks at Accesia over a three year period and cannot rate it highly enough. At the time it was the Dentistry I, II and III courses run by ESAVS, but they fell out with Accesia over delegate numbers (Accesia wanted fewer for better quality teaching, ESAVS wanted more for more revenue....) and the ESAVS courses are now run elsewhere. Accesia hower run their own courses and are briliant. PM me if you want any further info on them.

RE: Dental CPD

Braden Collins — Sat, 12 Sep 2015 02:03:47 GMT

[quote user="Martin Atkinson"]

[quote user="Braden Collins"]A simple "scale and polish" would cost $410 (around 200 pounds), which would include having the pet on IV fluids during the procedure.[/quote]So how much do you charge for £5-10 worth of fluid, giving set and IV cannula given that 99% of cases don't need IV fluids Braden? Fair enough in a uraemic old cat but it sounds a bit like cynical profiteering to me!

[/quote]

$78 for IV fluids during the procedure. Of course there is the disposables, but also the pumps (we have a fluid pump for every animal on a drip - at over $1000 each they need paying for. Plus staff time, etc. We make very little extra profit from our decision to put all animals on IV fluids when undergoing GA. We have seen a huge imrpovement in how fast/well animals recover from anaesthetic though. No more dogs looking unsteady as they walk out the door.

the ecconomy is also a bit differnet here, wherre most things cost more and wages are much higher if we look at a direct conversion. For example, our nurses are on around $24/hour (15 pounds/hour), and our vets on around $95000pa (around 55000 pounds), so we need relatively higher prices.

RE: Dental CPD

Evelyn Barbour-Hill — Fri, 11 Sep 2015 22:45:33 GMT

[quote user="GrooveJet"]As for cost, I struggle to keep things below £200... and with IVF and extensive surgical extractions, am usually around £350. Which I honestly believe is amazingly cheap coz it's a lot harder than removing a wee dermal lump or even a goitre![/quote]

Absolutely. (Must stop saying that, it's as bad as "basically" or "amazing" ).

Once extractions start to get surgical (let us leave aside the pedantic truth that all extractions are surgical ) then things get more expensive.

Mr. Collins charges a lot more than I do, though.

RE: Dental CPD

Miriam Lodewyks — Fri, 11 Sep 2015 18:02:48 GMT

Thanks for clearing that up, Evelyn. I quite agree: having all the gear but no idea doesn't help our patients one bit!

The last CPD I went to was opened with a very important statement that I have taken to heart and try very hard to always live up to: " your aim, with any oral procedure, is ultimately to reduce your patient's pain levels". So leaving a tooth with a tiny little RL, or a bit of root fragment... probably won't significantly help that patient.

I still find it a challenging area (especially since I don't have dental radiography available) but I try to be thorough and patient. Always.

As for cost, I struggle to keep things below £200... and with IVF and extensive surgical extractions, am usually around £350. Which I honestly believe is amazingly cheap coz it's a lot harder than removing a wee dermal lump or even a goitre!

RE: Dental CPD

Luca Poddighe — Fri, 11 Sep 2015 16:22:00 GMT

[quote user="Evelyn Barbour-Hill"]And also Alex Smithson's courses at Myerscough College.[/quote]

I'm very fond of him too... I did a CPD with him now my dental are much less stressful (even if not necessary better) and at least I know when I'm doing a mistake.

RE: Dental CPD

Martin Atkinson — Fri, 11 Sep 2015 15:45:08 GMT

RE: Dental CPD

Braden Collins — Fri, 11 Sep 2015 04:30:12 GMT

I think this is an interesting question Groovejet, and I think one worth a few of us answering so we can see the variation and what might be included.

For us to do as you describe there, I would expect the charge to be up around $1000-1200 (around 550 pounds) total assuming they are surgical extractions, including all drugs, GA, IV fluids, nerve blocks, etc. We tend to charge dental procedures in much the same way we do any surgical procedure, so charging on a time basis for surgical extractions, etc. I would expect a 45-60 minute soft tissue surgery to cost around this, so it makes sense that a dental procedure should cost around the same if it takes the same amount of time.

We are very careful about how we discuss dental procedures with clients. There is no such thing as a "dental" in our clinics. there is a "scale and polish plus dental assessment", and there is "oral surgery". We want to make sure the clients realise that what we do is highly skilled and they should value the work we do appropriately.

A simple "scale and polish" would cost $410 (around 200 pounds), which would include having the pet on IV fluids during the procedure.

Dental xrays are still in the future for us, but hopefully not too far off.

RE: Dental CPD

Evelyn Barbour-Hill — Fri, 11 Sep 2015 00:38:54 GMT

Anyway, back to your original post.

Keep an eye on Accesia, their courses are the very best:

http://accesia.se/?lang=en

And also Alex Smithson's courses at Myerscough College.

And join BVDA, it's worth it for journal of Veterinary Dentistry alone.

RE: Dental CPD

Evelyn Barbour-Hill — Fri, 11 Sep 2015 00:22:05 GMT

[quote user="GrooveJet"]Are you suggesting that £200 for a "proper" dental assessment and treatment is an unacceptable revenue stream?[/quote]

No. I'm suggesting that £200 for the poorly performed and anyway probably unnecessary "routine annual dental" is a rip-off.

My point was that it's not surprising that the charge goes up from £75 when the sort of boss who sees everything in terms of "revenue stream" (what a ghastly phrase ) suddenly realises that with the acquisition of some bog-standard machinery (described on the practice website as "the latest dental equipment" ) he or she can charge lots lots lots more. Doesn't even have to hire any more veterinary manpower, "the nurses can do it".

[quote user="GrooveJet"] Or is the £75 all inclusive "scale 'n crack the crown off" unacceptable?[/quote]

It's unacceptable whatever they charge. As you know.

[quote user="GrooveJet"] What do you charge for a GA, dental assessment, x-rays and extracting 3 carnassials, a premolar and a canine? [/quote]

It depends. On many things.