More and more frequently I am asked about “Anesthesia-Free dental cleaning” for pets by my clients. I always try to be as open-minded as I can and have done some further research into the subject and now have a more educated opinion on teeth cleaning without anesthesia.
First of all, I am sensitive to the fact that many people have a fear of anesthesia. Of course, there will always be some risks associated with anesthesia. However, many factors influence the safety of anesthetic procedures and there are ways to decrease the risks. First, there must be a thorough medical evaluation of the patient prior to anesthesia; this should include a physical exam and often blood and urine testing. Pets with certain diseases require additional testing, such as heart disease patients require chest x-rays and possibly an echocardiogram prior to anesthesia. Current anesthetic medications and protocols have drastically improved in the last 10 years and increased the level of safety. Increased support for the patient during the procedure, such as intravenous fluid therapy to maintain blood pressure and patient warming to decrease hypothermia also decrease risks to the patient. Finally, close monitoring of the patient using not only monitoring machines, but a trained assistant is the best line of defense against negative outcomes. I routinely anesthetize senior, diabetic and heart disease patients using protocols specific to each pet’s situation. When screening each pet for risk and using the appropriate anesthetic medication for each pet’s condition along with maintaining a high level of support and monitoring during the procedure, the risk is minimal compared to the benefits that can be gained.
Next I will discuss anesthesia-free cleaning and what that means. It is important to remember that just like for you and I, pets need cleaning above and below the gum line. Cleaning and evaluating under the gum line is not possible in an awake pet. In fact, there is actually a risk of injury to the pet’s gums if sharp dental instruments are placed below the gum line in an awake pet. If the pet jerks, it will cut the gums. This is the difference between you and your pet, when you get your teeth cleaned, usually you will hold still and let the hygienist clean below the gum line and evaluate periodontal pockets. In addition, I’m guessing you’ll probably sit still for the dental x-rays to be taken, and dental x-rays are an important tool in diagnosing endodontic disease (abscessed tooth roots, abnormal tooth roots, etc). You’ll also open your mouth nice and wide so the hygienist can clean all the surfaces of your teeth. In an awake pet, there will be areas of the mouth that are difficult, if not impossible to evaluate when awake. When a pet has a dental cleaning at our hospital, a team of trained professionals work together to manage each pet’s case, just like at the dental office. The licensed veterinary technician acts as hygienist; cleaning, polishing and applying fluoride and sealant to the teeth. The assistant closely monitors anesthesia and alerts the technician and doctor if there are any problems. The veterinarian evaluates the teeth and decides if the teeth need extractions, x-rays or periodontal treatment. I’m not exactly sure what happens in an anesthesia-free dental cleaning, and it isn’t clear to me the training the person doing the cleaning has and what kind of support there is from a veterinarian.
I realize that the tartar and plaque above the gum line are not pretty and it is nice to have your pet have clean teeth. An above the gum line cleaning is only for the cosmetic purpose, it doesn’t address the medical problems associated with periodontal and endodontic disease that if left untreated will lead to pain, infection and eventually loss of the tooth. I always tell people teeth are like icebergs, there is as much to worry about below the gum line as there is above. Look at what the underwater part of an iceberg did to the Titanic! It’s what you can’t see that is going to cause a problem. Veterinary dental specialists fear that above gum line cleaning gives the client a false sense of security and puts the pet at risk of having undiagnosed, progressing dental disease.
I mostly want to give you something to think about; if you are considering having a dental cleaning done on your pet, know what you should be asking. Not all veterinary facilities offer the same level of care, so even if you decide to have a teeth cleaning with anesthesia, ask about anesthetic monitoring, what training does the person doing the cleaning have? Is there patient warming? Is there fluid/blood pressure support? Can they take dental x-rays? I have a great photo album on our Facebook page that shows exactly what happens to a patient when having a dental procedure at Wilderness Animal Hospital. If you decide to have an anesthesia-free cleaning, realize this is only for aesthetics, and some serious medical problems could be missed. You should ask what training the person doing the cleaning has had and how long they have been doing it. Also, ask what level of involvement a licensed veterinarian has with the procedure.
If you have any questions, feel free to contact me. I’ll be at Maple Valley Farmers’ Market the first Saturday in August in a booth, but will be visiting the market in July, because it’s the place to be on a Saturday! Visit our Facebook page:www.facebook.com/#!/Wilderness…, or web page: www.wildernessvet.com.