Practical steps to safer, faster dental care

Mary Berg, BS, RVT, RLATG, VTS (Dentistry), presented a virtual VMX session on the complete oral health assessment and treatment (COHAT). Her objective was to explain to teams how to work efficiently while still providing high-quality standard of care. The dvm360 team sat down with Berg and asked her to share her insights. In this Q&A, she focuses on workflow, infection control, instrument technique, client conversations, scheduling and follow-up, and more.

What was the focus of your session at VMX?

Berg: My VMX talk was on the steps to a COHAT and ways to make the procedure more efficient. It’s more than just cleaning teeth. It includes getting the client on board, doing a complete oral exam, taking radiographs, and then using tips and tricks that together reduce anesthesia time. The main goal is to do a good, thorough job while making sure the pet is well cared for.

RELATED: 5 practical tips to improve efficiency and safety in veterinary dental procedures

What common workflow mistakes do you see, and what should teams change first?

Berg: One big change is to take dental radiographs early. I teach doing radiographs with the patient in sternal and dorsal, so they are intubated, connected to monitors, and warm, and then when they reach a surgical plane of anesthesia, take the dental rads. That lets the veterinarian review images while the technician is charting and cleaning. If something unexpected appears, you can call the owner right away without stopping the procedure to hunt for permission.

Another step is team training on charting and oral evaluation so technicians can recognize abnormal findings. Those basics reduce delays and improve decision making during the procedure.

Any simple infection-control or prep tricks that change the case?

Berg: Yes. After charting, brush the tooth surfaces with a soft toothbrush and power-wash the mouth with the air-water syringe, both buttons pressed. That removes more than 80% of plaque bacteria. Plaque is hard to remove with the scaler and when you aerosolize with the scaler that bacteria spreads up to 6 feet and stays in the air for 8 to 12 hours. Brushing first removes most of the plaque, so you can then dry and rapidly remove gross calculus. It shortens the case and improves the working environment.

One practical tip is to soak a toothbrush in chlorhexidine, rinse it well, and send it home with the owner so they have a toothbrush for the pet.

What about scaler tips and polishing. Any efficiency tips?

Berg: Many hospitals use only the universal tip, but the universal tip is large and slow for crown work and too big for deep pockets. Use a beavertail tip on crowns to remove gross calculus quickly, using only the distal 2–3 millimeters of the tip with a light touch and fast motion. Then switch to a periodontal tip for subgingival cleaning. Changing tips takes seconds but saves huge amounts of time overall.

For polishing, instead of filling the cup repeatedly with pumice, I spread the pumice paste on the teeth with my finger and then polish. It saves time without sacrificing the finish.

How do you coach teams to explain cost and value to owners?

Berg: First, change the vocabulary. The word “dental” is vague. I prefer COHAT—comprehensive oral health assessment and treatment—because it communicates that this is an involved procedure, not just a quick cleaning. I also avoid jargon like “periodontal disease” and say “a painful infection in the mouth.” Owners understand pain, and they understand infections.

When discussing cost, price procedures by stage of disease. A stage 1 or 2 case is faster and should be less expensive than a stage 4 that requires extractions. Keeping early-stage pricing accessible encourages owners to bring pets in earlier, which is better for the pet and for scheduling. Offer third-party payment plans rather than doing in-house financing.

Finally, make the conversation two-way. Ask what the owner knows, validate their concerns, explain how you make anesthesia safe, and then ask them to tell you what they understood. That engagement helps owners commit.

How important is the discharge appointment and home care?

Berg: Very important. Schedule a tech discharge appointment when the patient is dropped off so you can meet the owner at pickup and explain what you found, what was done, and what to do at home. Discuss home care options, but don’t just hand over a VOHC list. Recommend one or two products you trust and explain why they work. If owners won’t brush, offer other practical home-care options. Also schedule a follow-up tech check in a week or two to see how home care is going. That follow-up reinforces the bond with the clinic.

Do you talk about the mouth–body connection with clients?

Berg: Yes, I explain that oral infections can affect the rest of the body. In people, periodontal disease is linked to heart disease, stroke, and kidney problems. We don’t have as much data in animals, but there is evidence and strong clinical suspicion. I tell owners that keeping the mouth healthy may help prevent other problems and can help pets live longer and healthier lives.

Should clinics be forward-booking dental appointments?

Berg: Definitely. Human patients always leave with the next appointment booked. Veterinary clinics should do the same. When owners leave and the appointment is already scheduled they are far more likely to show up than if they have to remember to call later.

Any final practical takeaways for teams wanting to improve their COHATs?

Berg: Train your team on a consistent workflow, take radiographs early, brush before scaling, use the right scaler tips for crown and subgingival work, polish efficiently, schedule tech discharge and follow-up appointments, price by disease stage, forward-book when possible, and communicate clearly and confidently with owners. Small changes add up to big improvements in safety, efficiency, and patient care.