The idea of this session is to decrease the stress in the practise. To increase the percentage of accepted accepted treatments, to increase the percentage of dental issues that are found when looking at it, and to increase the practise income. The reason why I came up with the presentation was.

I have a dog, and a lot of times when dogs used to go into dental surgeries, go to surgeries, they were not. Looked after in the same way as cats would, so we came up with ways of making it so both cats and dogs could be treated in the same sort of way when, when it was, we were talking about dentistry. And also, I am a dog lover.

So I am 3 believes in living in the real world of veterinary dentistry, so everything that we do and everything we produce is to make life easier, and safer for both the vet and for the animal. And we make it real. We understand the problems and we understand what needs to be done.

So what we did, we've looked what is happening, we looked at what was happening in the practise and what is happening in practise now. So what is happening in most practises around the world and it's not just one country, it's a lot of countries. So So what normally happens is the animal comes in for a check, the vet lifts the lip and sees the dog's teeth need treating.

A lot of the cases the vet doesn't lift the lip. I think the joke normally is if we lift the lip, we'll find something. If we don't lift the lip, we won't find anything and we don't have to do a dental.

So, if you lift the lip, you find, the vet lifts the lip and sees that dogs need treating. The vet says they can see you about two teeth that need extracting. You know you need to do a scan and polish.

OK. Vet grades, the level of treatment that that is needed, . A lot of the, there's a lot of pushing for people to grade the level of dentistry that's needed, just by looking at the teeth.

My answer is the vets don't have X-ray eyes, and you can't ask the animal where it hurts, so that's very difficult to do it at this point to grade what level of treatment is needed. The owner agrees to extract the two teeth that you did see, and, and agreed with the, with the scale and polish. The animal is booked in for the following day.

I was brought in at 8 a.m. Placed in the kennels.

All the other operations are done first because you know everybody hates dentistry. And then it comes to time for the dental. First the animal is taken into the dental room.

The vet who was lasting, does the scale and polish. It always is the last person or the person that wasn't there when you were deciding to do dentistry. They're normally on holiday.

They probe and find that there's actually 11 teeth that needed treating. And the vet decides to do all 11 tree teeth to save another visit. They're just all in one go because vets are nice people and you, you want the best for the animal.

So they start, start the treatment, there's a nurse doing anaesthesia, so this time starts to tick. And the time takes a little bit more and a little bit more. Some more, and just a wee bit more.

And there goes the lunch. And at this point, the nurse is looking at the vet. Going there goes my lunch again, all very stressed, and then the final stages of surgery are rushed because afternoon consults have have started.

Now it's time to tell the owner. You cannot, can't tell them that it's, you've extracted 11 teeth because you only actually told them you're going to extract 2. So you decide you'll change that, charge them for 5 instead, and the owner will be happy with that when you've been getting 5, you extracted 1 and you spent all morning on it, the nurse hates you, and yeah, it's 5 will be fine.

But the owner is still upset, and you said it was 2 teeth and even extracting, you've extracted 11 teeth, the pet's unhappy, everybody's unhappy because it's just a horrendous time. It's just crazy. Nobody's happy, you've had a bad day because of it.

Nurse hates you still. So yeah, it's crazy. That's why everybody hates dentistry.

Bet hates doing dentistry because he never knows what's gonna happen, never knows what you're gonna find. It always overruns, . Cass always take a lot longer than you planned because you don't know what you can find.

Owner acceptance is really hard because you don't know what what you're gonna find when you open the mouth. You don't know what to tell the owner, you phone the owner. They don't like being told that the dog has to have 11 teeth out over the phone.

You might get acceptance, but you also might get acceptance. And the, the animal will never come back and see you again because they think you have done this on purpose. Owner never seems to happen no matter what you do.

And, and it's really not worth the stress or the cost of doing dentistry, you can do an orthopaedic surgery far better, far cheaper, and it's more, it's a lot less stress. So, and you can only do 2 dentals a day anyway, so why bother? I mean because you don't know what you're gonna find, so I normally only book in one dental, so, you know, it's you know it's just, yeah, it's not worth it.

It's dirty as well. And it's really not very sexy. Dentistry is not sexy.

So that, that's really what normally happens with surgeries, . This is what should be happening now in your practise, and it's tried and tested. There's many practises all over the world doing this, and this isn't something new, but it's something that if you want your practise to be more profitable and you want an easier life, dentistry is the way to go.

And this is what you should do to make that happen. So, you should look at start doing a comprehensive health assessment and then treatment. You should look at probing and full mouth charting.

Scale and polish. Full mouth X-rays. And then you do a treatment plan.

The 1st 3 points on that, the nurse should be, the nurse should be doing that. That should be a nurse, a nurse should be given the, the challenge and the ability to do that and the training to do that. The treatment plan will be done by the vets and the treatment plan will be done, with a clean mouth, with the knowledge of the X-rays, and with a, a chat to look at.

Then once, once that's been done, you've got your treatment plan, you can then judge what time you've got left in a 2 hour slot, and you can do whatever treatment you need to do within that 2 hour slot. Then, Once you've done that in your head, you know what you can do in either stage 2 or stage 3. So you know you have 11 teeth to do, you know that some of those surgical extractions, and within the 2 hours you may do 3 or 4.

So you know that you're gonna have to do a stage 2 and a stage 3 possibly. So what should happen? Animal comes in for a check.

The bad list the lip. Vets suggests staging and discusses staging and explains to the owner what staging is. The owner understands what's gonna happen.

The owner understands that as they would do if they went to a human dentist, they, everything's not going to be done at once, but everything's going to be done in an orderly fashion, understanding what's gonna happen. The appointment is booked. Animal is brought in the clinic again at 8 o'clock in the morning and placed in the kennels.

Straight away, in a separate dental room, the co op, so the first stage is done by the nurse. The vet then reviews the X-rays, the charting, and the animal, and does a treatment plan. And any work is then done done in that 2 hour slot.

That is like The nurse then can then carry on on another table, which which is what you'll find will happen, carries on doing a neck scan and polish. So you have one table doing the actual dentistry and one table doing scan and polishes. Now it's time to tell the owner.

The owner is presented the treatment plan of what you did and what you should have done. You show them the X-rays and any photos you've taken, you explain exactly what you've done and what needs still to be done using the photos and using the x-rays you've got. And the acceptance is a lot better because people expect to see photos, people like seeing photos X-rays if you explain what you're doing.

It's a matter of explaining and letting them understand. The owner understands better with pictures and photos, it's far, far better. You can then at this point, book stage 2.

You can say, OK, this is what we've done now, this is what needs to be done. You give them the treatment plan of stage 2 to take away with them so they know what is going to happen in stage 2. It's not, I'm just gonna do this.

This is what we're going to do in stage 2. And if there is a stage 3, then you can do that and book that out later, book that as well if required. Or you can do stage 2 and book stage 3 when you've done stage 3.

So animals taken in the dental room. The vets on the 2nd 2nd time, so when the owner comes back to stage 2, the animal's booked in the dental room for the time that is required to do the treatment that is still in, stage 2. So it could be an hour, it could be 2 hours.

You book it to what you can do in the time, but no more than 2 hours. The vet know knows how long he needs and what what how to do cos he has the X-rays, you have photos, you have all that information. The vet does the required work.

The treatment takes as long as expected because it's been booked in to the time that vet can work to. So there's no point somebody booking in. 24 hours work into a 2 hour slots if the vet can only do 2 hours in that slot.

So what, what the vet can do and what the vet is capable of. That the vet actually can get the lunch. And to be honest, the nurse then likes them again.

The vet starts to love doing dentistry because what you what what is planned, it always takes as long as planned. So you know you have a 2 hours dentistry at the beginning, you know you have another 1 hour and a half, you know what is happening, and you can put more dentals in because of that. The owner is happy because there is a.

Are costing exactly what they're going to pay when they start. The 1st 2 hours is budgeted and the next lot is budgeted. So stage 1 and stage 2 can be budgeted before you even start the treatment because you know what you're going to have to do.

The vet is happy because it's very, very, everything is simple, everything is planned, everything is in the diary. And with the amount of stress that happens within the practise at the moment, to have a treatment where you can say that treatment is only 2 hours and nothing else is going to happen within those 2 hours. Gains control back in the vet's mind.

So dentistry becomes a good way of bringing the stress levels down within the practise. And the nurse can even get their lunch, which is very, very important, both the nursing team huge under huge pressure as well, so they can get breaks as well is very, very important. At that point you could book stage 2 or it can be conferred for a later date.

Why don't we do the staging now? Firstly, is it's . Excuse the word of a corporate, it's a corpora, it's an owner perception of what the dental is.

There's a perception that you can see what's going in the mouth by just looking. You can't, you can't grade the treatment at consult time, it is impossible. You cannot see what's going in the mouth without taking X-rays.

Majority of the work is under the, under the gum line. You need to take the X-rays to see what's going on, and you should not be doing dentistry without taking full mouth x-rays. There is a perception that dentistry is easy to do.

The, when, people say, we're just going to do a dental, if you go and see a human dentist and show what an extraction is or a surgical extraction is in a cat or a dog, a standard human dentist would not do that. It would be, sent to an oral surgeon. What you're doing, as everything in veterinary, you're doing one level up than a normal human practitioner would do.

You're doing oral surgery. It is a difficult thing, and you charge minimal amounts of money for it in some cases. Dentistry is a very skilled job and what you do is a skilled job.

You should charge that amount and not call it a dental. It is oral surgery. It's not only a dental.

The other one was one anaesthesia, . There's a big stress over anaesthesia and the time and the cost, . There are many studies that say that you should not do an anaesthesia or the risks for anaesthesia grow after 2 hours.

So you need to keep, there's that 2 hour golden slot, where anaesthesia is safer. There's a reason why we keep mentioning 2 hours. If you keep to the 2 hour time slot, that is far better.

The cost, of doing one anaesthesia compared to 2 is minimal. You do not have to keep charging the full price of anaesthesia if you do two anesthesias. A lot of the cost is your time and your time is set by the time that you're booking in.

And it's an owner perception, the owner perception of the fact that anaesthesia is unsafe comes from people telling them that anaesthesia is unsafe. Yes, you need to be honest with the owners about the fact that anaesthesia, there is risk with anaesthesia, but by controlling the time that anaesthesia takes, this, this reduces that risk, . It's better to do 2 hours than a 6 hour anaesthesia, or even a 3 hour anaesthesia, for both you, and for the animal.

The other last one is full mouth X-rays, . A lot of the time when you're looking at full mouth X-rays, and in the past, when, there was only DR systems on the market, full mouth X-rays for animals was very, was done as needed. And then part of the reason was that it came from the human world.

And they based it was based on using, size 2 DR sensors, and it's based on bite wing sensors. When you go to a human dentist, they use a size 2 sensor, in your mouth, and they do take left and right what are called bite wings to see where, it's because they can do that, because that's where we, when we eat, that's where the carries will happen, because we impacted it into the teeth. And they take it to find carers, and they do left and right right wings using a size 2 sensor, and that came as everything goes directly into the vet world and was seen to be, the best.

That was, about 25 years ago. And in human, they changed to start using ring because they're missing, because it's not easy to buy sectangles, as everybody will know when to take them in veterinary. And yeah, it's size 2 and DR has been around longer than any, other dental technology.

Slightly different from what is people's perception. . But the, it is based on human, and that is the problem where we don't work in humans.

And then they use basically to do X-ray position you use two techniques, parallel technique, and that's what we do in the human world. You'll do a parallel technique for your by wings, very easy, very simple, and then the bisecting angle technique, which is what we do when in, veterinary because we have no choice. There's only one shot you can do parallel.

We have to do it the opposite way. So Different techniques, the parallel technique is as you can see here, the X-rays come parallel to the receptor whether it's a DR or a CR. We have, what you get then is the object is the same size as, the X-ray.

So basically the X-rays are passing through the object like a tree in this case, the sun does, and the shadow on the object, would be the shadow of the object. For this case onto a wall is the same size as the object. And what you get is a perfectly sized X-ray with no elongation and no foreshortening.

Now, bisecting angles is really, really difficult. This is a huge issue why a lot of people don't take a lot of X-rays. If it was all parallel life would be easy, but it's not bisecting angles is very difficult.

And you would not, you have to put the X-ray film in. You then have to, in your head, imagine the long axis of the tooth. You need to know the the anatomy of the teeth and where the apex is.

You then draw another virtual line between those two, Two angles and then you put the X-ray head parallel to that. That's not easy. You have to be a visual person and not everybody is a visual person.

If you're analytical, you will find it very, very hard, no matter what, how many times you are trained. So if you do it properly, and in human dentistry, they found it very difficult to do it properly as well, and that's why they brought up what's called the RI technique, which are positioners, because they were taking far too many X-rays and overdosing those humans, which is not seem to be a good thing to do. So then if you do it properly, you can again get the shadow the same size of the object, in our case, the X-ray the same size of the tooth, and you get a perfect X-ray, which is perfect.

Great, no problem at all. The problem is, if you get it wrong, if you put the X-ray tube too low, you get what's called elongation, and that means the tree is a shadow of the tree is a lot longer, and that means the tooth is a lot longer and it looks wrong. And you can miss diagnose.

And again if for this case again the sun is too high, so the X-ray tube is too high compared to the tooth, you get full shortening so the shadow is a lot smaller and again you can miss stuff and misdiagnose. So the first people that came out was, and this was from a vet in Sweden, they came out with this positioning guide, it's very clever idea, try to get the bisecting angles correctly, it works well, but again, you still need to be visual because you still need to be able to draw those lines in your head, but it does help. To do a full mouse series using size 2, it's about 6 to 10 images for a cat, which is why a lot of people will do full mouths in cats, but it's between 16 and 22 images in a dog, and that's the reason why a lot of people don't do fullouts in dogs and why a lot of the time dogs are not, having full mouth x-rays.

And it is the same problems in dogs as cats, you can get resolved with lesions in the same way. And the only reason there is not having full mouth X-rays of dogs is because it's 16 to 22 images. So although DR.

In theory it quicker sometimes. CR is far quicker because you take less X-rays. That is a 22 X-rays are using a DR system.

I have a full mouth. It actually has missed some apexes. I gave in, I have to be honest, with 22, but I wouldn't really need to take 24 to get the apexes that came out.

Now, Based on the, as I say, positioning and biceps and angles was based on, how the humans worked about 20 years ago. It was also based on unlimited time. So if you have unlimited time to take your X-rays, bisecting angles is fine.

Or if you're a diplomat that or a specialist that do it on a daily basis or you do it, you can do bisecting those very quickly and you'll see people on training sessions just Zooming around, taking x-rays, it's very good when you know, and if you're good at it, you can do it very quickly, but not everybody is a visual person, as I said, and not everybody can do bisecting angles. And It's really based on how we always have done it, and it not everything should be based on this is how we always do it. We should always look at the future and look at how we can improve what we can do.

And it's a bit based on the misconception of technology that DR is more modern than CR invented dentistry, which it isn't. DR has been around since about 1985. CR was brought in about 2001 to 2006, depending on the manufacturer.

So, it was different in full body X-ray, but in in dentistry, it's opposite way around. It's a bit, so. The is old.

So we have, this is what you would get with a PR sensor, you would, this is coding off here as well, so you get a very limited view of what's going on. And we didn't like that. I came into this business, in 2009 and could not understand, why we were using size two sensors in large animals, which is it's crazy.

So what happens, well, the nurses who take a lot of the X-rays or the vets, if they're taking the X-rays, take limited x-rays because it takes too much time to do it, . They, they don't want, if you have limited time, you take limited x-rays and you can't see and you miss things. If you don't do full mouth X-rays, you miss treatments.

On both financial note, that's not good, but on a clinical note, that's quite unacceptable. If your animal walks out with treatment that's still required. It's it should never happen.

And although I understand that DR is easy because you can retake, you shouldn't need to retake. Why, why retake? You should do things once, limited X-rays, limited time.

Keep people working. I don't understand why people make themselves, make their life hard. I believe in making my my life easy, and it's not.

It's not what you see, it's what you miss. So you may get a nice X-ray, but what you're missing. So, we looked at this and we looked at how we can improve this.

So we came up with. Basically, we came with a bigger sensor. So at the moment, size 5 is the biggest available, it's practical within the market.

We then have, there is one that's called 3.2 or 4C, which is a smaller, and then there's a size 2. There is a size 4 that's a little bit bigger in between the size 4C and the size 5, that we do.

But you can see how much more information you can get on one plate and one shot than you would do from a size 2. So how did we make that easy for everybody? Well, we, we came up with positioning kits and we came up with positioners.

We're trying to make it simple and easy to use with utilising a nice large poster and a step by step guide of how to do it. So we have for the dog, we have the cat, and we even have a rabbit poster should teach you how to do rabbit X-rays and we do a rabbit sensor, a rabbit size see our plates to help you to do that. We have a positioning kit and the, holders then show you the plate holders show you basically take the plate when it's in the mouth and gives you something to connect the ankle guides to, so you can leave them in when you're taking the X-rays.

It's a very simple and very easy way of taking X-rays, and it gives you a full mouth series with the same number of X-rays both for cat and dog. And it's an overview, it's an overview of what's going on in the mouth, so you can do the treatment plan very easily, very much needed when you're doing staging. So we can do 6 or 7 depending on your requirements in dogs, and the same in dogs.

And this is how we do it, you can put the do the maximum the mandible. You put a position you're in, gives you a 45 degree angle, it's put at the edge of the teeth, you put the position of the lower part of the tube, and you find the X-ray and you get up. A parallel shot, well it looks like a bisecting angle shot, a proper angle with no elongation and no foreshortening.

For the anterior, for the Kang shot, which is a really cool shot, you can go halfway between the plate, using a 70 degree angle, and you take the shot again and you get, This shot, beautiful K9 in one shot with a size 2 sensor, you'll be talking 2 to 3 X-rays to get the same shot in one shot. With this one shot, you can also see the anterior teeth as well, perfectly with no elongation. So you can use this shot for both getting a beautiful canine and also to use your anteriors as well.

It's a really good shot to you. And then for the maxil mandible, you can use this shot if you required, and you can get this shot. Sometimes you would use the canine shot because sometimes these overlap the apex of canines.

If that's the case, then you would use the canine shot. And then for the cats, same sort of solution, we have a 30 degree angle and a 40 degree angle depending where it's maximal or mandible and again you get this. And then you've got the canine shot again.

And then the maximum mandible again. Very simple, very easy to use. Somebody walking into a practise with zero training should be able to take X-rays following the easy guide and following the easy, step by step positioning using the positioning kit.

Makes life easier, makes life so you can actually take full mouth X-rays without an issue. By knowing the timing, so that overviewing the station and by knowing the timing, you can increase the number of procedures. Scan and polish on one table and treatment onto another.

By empowering your nursing team to do more, you both motivate your nursing team and you increase the productivity of the practise. Nurse the nurses are the most important part of the practise and giving them a large part of the practise by giving them the chance to scale and polish. The full mouth X-rays and the probing and charting, this gives them that power and means that they can continue to do that and that becomes a part of the practise, huge part.

I have this in a few practises where if, if you, if the pet does like doing the dental work, don't ring fence it, share the love of that dentistry. Everybody in the practise should like it. It should be a huge part of the practise.

I know in Scandinavian countries, it's around about 40 to 50% of the practise turnover now. In other countries it's less, but that is the aim. You need it to be.

It can be, and it should be about 40 to 50% of your practise turnover. And if done properly, it will be a love of everybody. The money bit.

So, cost of staging, the comprehensive oral health assessment and then treatment, really depends on you where you are and what you can charge. But a skin and polish normal cost is about 165 to €190 probing and full mouth charting and full mouth X-rays, I know that is a low figure, but if you do full mouth X-rays, you'll find a lot more treatment by doing the X-rays than you would do by not doing the X-rays. So the cost of the X-rays will be.

Recruit by the amount of treatment you will get, . You'll do a treatment plan and then a total cohort, 190 pounds to 220. Again, it's an average, it can be more or it can be less.

It doesn't want to be too much because you want to do more of them rather than less of them. So if you do one at 400 or 8 in a day at 300, you'll make more money, you see more animals, you treat more animals, and more animals get their dentistry done as they should be. The cost of treatments, physical treatment depends on the treatment plan.

If a lot of work is needed, you should stage it, as we keep saying, that's why it's called staging. So you can stage it and keep it within that 2 hours. And you, you'll know how much work needs to be done because you've done the first stage and you know the costing, whether it's an oral, whether it's physical oral surgery, whether you're doing, bone removal, whether you're having to, and all these things you take into account, and you know how many X-rays you can do postop preop post.

So you can judge all that when you're doing that. Based the staging on the need. The vet's ability to do it, the time given, and the owner's ability to pay.

Sometimes you'll have an owner that cannot afford to pay 2.5 €3000 pounds for a dental treatment. So you may have to stage it over furthermore, or offer them payment terms.

It depends on the ability of you to practise and depends on the ability of the owner. But it's more important the animal gets the treatment. So Also, there is sometimes a big issue that people will book a vetting to do 2 hours work 4 hours working in 2 hours.

There's no point booking 4 hours work in 2 hours if the vet can't do. That amount of work, so book it to the flexibility. It's, it is always better better to do it together, but only if it can be done safely.

Constant constant contact. This is a huge thing with dentistry. If you believe it, it can happen.

You really need to first of all understand. The animal and the owner. And this is just basic sales, basic things that we look at as, people come into your practise as the owners and also come into your practise as, salespeople or engineers.

We look at this and we see this and pass this on to you. So, it's always good to know the place of the animal in the family. .

There's no reason you cannot sell dentistry or get dentistry accepted by an owner, no matter who they are. So if it's a working dog, I get told a lot that I cannot get a working dog owner to accept dentistry because they don't care about the animal. Well, they might not care about the animal as an animal, as a loving pet.

But they do, it does represent an income source or it's not a working dog. So a farmer who uses a dog for sheep rearing, the sheep moving around, then that is a working dog, so you treat it like a tractor. You do servicing.

It gets serviced and that's what you're doing with dentistry. You're serving so it will work better. If it's a love pet, that's the hardest one.

You have to work out, if it's, . You, you've got to judge what other income, what other things have been pulled onto these people with income, and a love pet is. Something between 20 and 30, 35, and they've just started out and it's one it's one before the first child or one when they have young children, and they have other income pools.

So this is the hardest person to sell to because they do love the pet, but they have school uniform to buy, they have a new kitchen to buy, so you have to take that into account and you have to work out the budgeting for that. The child replacement, people 40, 45, 50, 60, when the kids have left home, that's the animal. Easy to sell to, tell them what's needed.

They will spend the money because it's a child replacement. Trust me, I'm, I, I have a child replacement. Understand the owner.

Male or female people will react differently to be given a request and also they are married and single people will react differently to the way you ask, and the way you present what needs to be done. A married man, majority of the time, depending on where they're from, will, not be able to make a decision without speaking to his mother, his, his wife. A married.

Lady will, majority of the time, make a decision. Not making generalisations, but it is normally the case. Take that into account when you're working out and the fact you may need to take, and if it's a man, sometimes as men we have a habit of not listening.

So you need to write down what you've said because they probably haven't listened to anything you've said during your treatment plan. So make sure that they take away something if they're not willing to make the decision. Old and young do not presume young people have no money and don't presume old people don't.

That is really not the case. And there is no such thing as looking at somebody and working out if they're rich and poor. So it is a give three different solutions and let them choose which they can afford.

And shy and aggressive, I always say treat an aggressive and shy . Owner, same way you would, the way you would treat a shy and an aggressive dog, there's not much difference between them, so. Stand your ground and yeah.

One thing that's really important is take the stress, in the consult room when you're doing it, when you're speaking to them. So if you're presenting a case and presenting why they should spend €2000 or 2000 pounds with you, try and make the consult area a less stressed area. Have access to the images and don't take them into the clinical area.

Use large screen TVs or iPads to show the X-rays and the pictures you've taken. Take the animal out if it's stressed, so if you know the animal is going to be stressed, and a lot of animals do not like to be in the consult room, don't bring them in until you've done, you've done this presentation of the what needs to be done to the animal. Even have a non-consulting room, with chairs and discussed treatment, if you're doing a lot of dentistry or a lot of high-end treatments, it's worth having a non-consulting room where you can sit down with a coffee or a cup of tea and discuss what needs to be done for the animal in a more non-clinical environment.

Always good, pull the heartstrings and keep the animal happy. If the animal is there, make the connection with the with the problem, not the problem and the animal. So make them realise that this dental problem is the animal, so you're relating it to the animal.

I have had people give a present to the animal after surgery, little tips really cool if you have it branded the surgery's colour scheme. Explain the pain the animal is in and relate it to humans. So whenever you're talking about dentistry, you relate it to what you felt when you had an abscess, what you felt when you had dental treatment, and that the animals have the same pain, they just don't show it, and that's what you have to relate to the owners.

Very hard when they haven't got a broken leg to show, well this is the animals in the same pain as they would do with a broken leg with with dental problems. Ask for their thoughts and wishes of what they want to happen with the treatment, and you'll find sometimes they sell the treatment themselves to themselves. As I keep, I mentioned before, always have three options for treatment plans, have what you want as the middle one.

I'll always have treats, if, if the animal loves you, the owner does too, and it keeps that sense of what you are, the good guy. Basic selling of the treatment, believe in it. Understand the own take away away from the stress when you when you're discussing this.

Always pull those heartstrings and keep the animal happy. So overviewing the X-rays, you want an overview of the X-rays. We have the treatment plan to give to the owner, so you should, especially, I always joke this is the man report, .

We always put a picture of the animal on it, and when a picture when the animal is happy, not a picture when they're on the surgery table, that goes on the top of the report. You then have X-rays, you have photos, you have a brief description of what's happened and what needs to happen and what's going to happen. If you put a picture of the animal on the on the on the treatment plan, the people cannot throw the treatment plan away because it has a picture of the animal and they wouldn't have brought the animal to you if they didn't love it.

So by having a picture there means that this treatment plan will not get thrown away and there's more guarantee of getting this treatment accepted. Put the estimate cost under the treatment plan, not on top. This is more important, the animal is more important than the cost.

By putting it on top, you're saying the cost is more important than the animal. The practise as a whole needs to believe in what you're doing and believe in dentistry as a whole. Always remember the animal cannot pay, you're doing this for the animal, anything that we do is for the animal.

Owners have limited disposable income, but they do love the animal. I always remember that because they wouldn't bring it in even if they didn't. If you, if you're too nice, train the nurse.

Nurses can be as treatment advisors, the nurse then presents it. So you do the treatment, you walk out, the nurse walks in and presents the treatment, presents the cost. So in human dentistry, they use a treatment advisor, which is normally a dental nurse, and that's because the human dentists don't like talking money.

If you're no good at talking money, get somebody that can. Very briefly, dental unit, you need to have a good dental, room. You're gonna be 8 hours a day in the end, doing dentistry.

You get strains in your arms, your necks, and back, causes sickness in the practise, reduces profitability of the practise, and, it's always at the moment, it's always, we used to be always in the smallest room. It was cramped. It was warm, it was an old tub table, everything on top of everything else, the dental unit wasn't old, just working, compressor was really loud, old broken scaler, heavy micro motor.

Yep, the, the future is purpose-built rooms, space for two tables or more tables, fully air conditioned, purpose-built dental tables, everything exactly at hand. The dental unit is cutting edge. And reduced operator fatigue, modern scales, micro micro motor holds itself.

For you, you should be looking at loops to make sure you don't get extra strain, looking at cameras to help you compute, to, help the communication. The PCs and the system should be networked so you can show it within the consult rooms, and you should have marketing material put through so you can then present it and show people what is going to happen, especially with the staging. These are some examples very quickly of dental rooms in different countries, you see some of them have 2, some of them have 3 tables, a majority have 2.

This is what you should like that person actually has 3, but we're gonna show 1, that is 1 out of 3. OK, so top of the range, top of the range dental units, lots of different versions, average cost of a dental room for that sort of level, between 40 to €180,000. Prime, these are practises that are doing 40 to 50% dentistry.

Your dental tables Position of your X-ray and CR7, everything needs to be there and easy. It shouldn't be in the smallish room. It is scary.

Again, X-ray should be an easy, easy positioning, in the area where you're actually physically going to do the positioning, not in a X-ray room, needs to be space, not, not, not at full reach, look where you're gonna be firing the X-ray. The developer should be positioned where you're gonna physically take the X-rays, not in an X-ray room, should have minimal movements to look at the X-ray screen and should be a good diagnostic monitor. Other brief considerations, position of the X-ray and the CR7 should always be where you're taken to in the dental the dental, not in the X-ray room.

The dental unit needs to be of a good standard, because if you're working with poor quality products, poor quality equipment, you'll have, people will get sick, you won't do the treatment to the poor. You should always have sharp instruments. You need to be able to, you should have communication tools and ways of selling easily.

And in conclusion to all that, staging is the way forward. You need to believe that you're gonna do it will cause you less stress and will make you far more organised in this time where we are all very stressed in in the surgeries. It's a really important time to take that stress away and give it a calm and dentistry is really that kind of.

It it stops that stress. Really does. Dentistry, if done properly, could be the part of the practise.

And 20% is the minimum it should be of your practise. You should be looking at between 20 and 40% of your practise taken should be dentistry. 80% of animals walk into your rent practise over 3 years old need dental treatment.

Every animal walking to practise should be getting a scale and polish. It should be a regular thing. Thank you very much, that's everything for me.

Any questions, I'm very happy for you to get in touch, . Thank you.