Service animal, comfort animal or pet?

What to know about bringing animals into the dental practice

When patients visit the Valley Village dental practice of David Firestone, DDS, they are often put at ease by Rocky, a 6-year-old Maltipoo. As a regular in Dr. Firestone's practice, Rocky’s job is to greet patients and sometimes sit on welcoming laps during treatment.

Having a comfort animal in the dental practice is a growing trend for dentists looking to offer a calm environment for their patients. Finding a way to break the tension for patients is something Firestone has always strived for — he’s tried music and even movies to watch during treatment. But nothing has worked quite as well as when he picks up the silky, 9-pound Rocky and places him on a patient’s lap.

"Every day that I go to work brings me great joy in the value that dentistry adds to people's lives. Now that I have Rocky helping us out, it is an even more meaningful experience to me, the staff and, most of all, the patients we serve, whose goal is to achieve better dental health," Firestone said. “People love this dog.”

Online reviews of Firestone’s practice feature patients raving about how Rocky makes it feel like they aren't even in a dentist office and how kids enjoy playing with the dog. Some even ask if they can take Rocky on walks.

According to the ADA Center for Professional Success, a National Institutes for Health study, having a companion animal correlates with improvements in a person's social, mental and physiologic status.

Before dentists begin opening their doors to animals, however, they should keep a few things in mind. There are three categories of animals when it comes to their use in public places — service animals, comfort/therapy animals and pets — and they are very different.

Service Animals

A service animal is a dog that is properly trained to assist a person with a disability. Disability access laws allow someone with a disability to bring a service animal in to a place of "public accommodation," and a service animal cannot be prohibited from entering. They are allowed in medical facilities, such as hospitals, clinics and physicians' offices, as well as grocery stores and restaurants. When it comes to a dental practice, infection control regulations do not place limitations on service dogs; therefore, a service dog may accompany its owner to the treatment area.

California law does state that a service dog must be on a leash and tagged as a "guide dog, signal dog or service dog by an identification tag issued by the county clerk, animal control department or other authorized agency," but federal law does not have the same requirements. Under the Americans with Disabilities Act, “service animals must be harnessed, leashed, or tethered, unless these devices interfere with the service animal’s work, or the individual’s disability prevents using these devices. In that case, the individual must maintain control of the animal through voice, signal, or other effective controls. Only dogs are recognized as service animals under federal law.”

If dental staff is unsure if a dog is a service animal, they are permitted to ask:

(1) Is the service animal required because of a disability?
(2) What work or task is the animal trained to perform?

Comfort/Therapy Animals

Comfort/therapy animals such as Rocky are animals that have been trained and screened for the ability to interact favorably with humans and other animals, according to the National Service Animal Registry. They are not service animals and do not have the same legal protections, and their owners do not have protections under the ADA or Fair Housing Act.

Nothing in California law prohibits such animals, which can sometimes include cats, from being in a dental practice, however. The only registration requirement would be at the local level, as for any pet, because the comfort animal is viewed as the owner’s pet.

CDA Practice Support is aware that some California dentists have comfort animals in their practice and advertise their use. TDIC and CDA Practice Support advise dentists with comfort animals to notify patients of the animals’ presence in case of patient allergies. Dentists may also want to speak with a professional allergist to seek advice on particular breeds of dogs, which is what Firestone did with Rocky.


The third category of animals is basic pets that patients want to bring into a dental practice. Dentists and their staff should consider creating a pet policy for the practice. If the staff determines they prefer that patients leave their pets at home, then a no-pets policy can be developed. Such policies are for the practice owner to decide.

If a patient does bring an animal into a dental practice, it is advised that the staff determine whether the animal is a service animal. If it is not and the staff prefers that the animal not be in the practice, they can use their no-pets policy to ask the patient to take the animal home.

As for Rocky, he won’t be leaving his practice any time soon as he is now a key part of the dental team. He will continue to focus on spreading joy for Firestone’s patients.

“It's so incredible how a comfort dog can make a dental visit into a fun experience,” Firestone said.

For more information on service animals, see the CDA Practice Support resource “Best Defense Against Disability Lawsuits.”

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In their day-to-day practice, dentists and their teams must know and comply with federal, state and local laws — from the layered requirements of federal and state employment laws to the dentistry-specific California Dental Practice Act to local laws that enforce building codes. A first resource for dentists to help them navigate these laws is the Legal Reference Guide for California Dentists, updated and published in January by the CDA Practice Support experts.

A free mobile app by the Centers for Disease Control and Prevention can assist dental facilities in monitoring their compliance with recommended infection control practices. The CDC DentalCheck app automates an infection prevention checklist and allows dental health care providers to “easily move throughout the practice as they evaluate their compliance with recommended infection prevention practices.”