10 Jun Are Anesthesia-Free Dog Teeth Cleanings Bad for Your Pet?
While an anesthesia-free dog teeth cleaning and exam may sound like a good idea, it’s actually riskier than sedating your pet. In today’s post, the experts at TheVetDentists.com will expound on the benefits of dog dental cleanings performed under anesthesia.
Why do dogs need dental cleanings?
First, let’s talk about why your pet needs dentistry at all. Believe it or not, dental disease is actually one of the most common conditions seen by veterinarians. Over 80% of dogs develop some kind of dental disease by the age of three. And in most cases, we perform routine dog teeth cleanings to prevent or treat periodontal disease (advanced gum disease).
The mouth is a cesspool of bacteria that can never be sterile. Periodontal disease is caused by plaque, bacteria, and the pet’s immune response. The first line of defense for the tooth against periodontal disease is provided by the Gum tissue (gingiva). The gingiva surrounds each tooth by 360 degrees and has an attached and non-attached component.
The non-attached part of the gingiva is called the free gingiva. The free gingiva creates a space next to the tooth called the gingival sulcus. Accumulation of plaque and bacteria in the gingival sulcus causes inflammation—known as gingivitis. If this early stage of periodontal disease is left untreated it can progress to more advanced stages of periodontal disease that cause soft tissue attachment loss, bone destruction, tissue destruction, and eventual tooth loss.
Beyond tooth loss, more severe consequences of periodontal disease include tooth abscesses, oronasal fistulas, and pathologic jaw fractures. In general, the smaller breeds of dogs are more susceptible to periodontitis.
In many veterinary practices, Yorkies and Chihuahuas are the most severely affected breeds followed closely by Dachshunds when dealing with periodontal disease.
The problem is, our pets don’t show us they’re in pain.
Diseases of the teeth and oral cavity hurt! But cats and dogs mask signs of pain and infection by instinct. They have no way to alert their owners that they are in pain, and in many cases, they avoid showing pain as a sign of weakness. Even if your pet is eating, that does not mean oral pain is not present, it only means your pet doesn’t want to starve. Remember, the cause of periodontal disease is plaque, bacteria and immune response, not tartar—more on that later.
Is a dog teeth cleaning under anesthesia safe?
Anesthesia-free dentistry has gained in popularity due to pet owners’ fear of general anesthesia. We understand this reasoning. Anesthesia can be scary, but let’s talk about this for a second. Whether it’s you, me, or one of our pets going under general anesthesia, there is going to be a minor degree of inherent risk.
There have been great advancements in anesthetic procedures including much safer anesthetic drugs, state-of-the-art monitoring, pre-anesthetic exams and testing, and patient care. Every week, sometimes every day, veterinary dentists perform anesthesia dentistry or oral surgery on senior pets, many with very significant co-morbidities (additional health issues)—all without incident.
How do we ensure it’s the safest procedure possible?
We take every precaution to make sure our furry patients are safe before, during, and after being sedated. Each patient going under general anesthesia will have:
- Recent lab work, an IV catheter placed, and be on IV fluids
- Advanced monitoring including blood pressure and end-tidal CO2
- Warming support, a proper fitting endotracheal tube placed, and be monitored by at least one, preferably two technicians
We often see pet owners come in with their senior, not very healthy pet, for dentistry and oral surgery. Many have been told for years that their pet was either too old, too unhealthy, or both, to go under anesthesia. When performed by a team of well-trained veterinary dentists and technicians, It is very uncommon for these pets to have significant issues with their anesthesia and oral procedure. In fact, after they recover from their procedure, they feel better than they have in years.
Anesthesia is certainly not something to be cavalier about. But when performed correctly and carefully, by highly-qualified professionals, it can be extremely safe.
What is anesthesia-free dentistry?
Now that you know anesthesia can be very safe when performed by competent veterinarians, you may still not be convinced. So let’s talk about what anesthesia-free dentistry IS and ISN’T.
What IS it?
Anesthesia-free dentistry is “dentistry” without general anesthesia performed by anyone. This can mean anyone from a groomer or layperson to a veterinarian is performing this procedure. Think about that for a second—a groomer or layperson? Would you let your hairdresser be your dentist? Very seldom are veterinarians even involved in these procedures.
The person performing the procedure uses sharp hand instruments called scalers or curettes to remove calculus from the outside surface of the teeth. Ultrasonic scalers +/- hand instruments are the preferred method for scaling but cannot be used in awake patients—ever. The awake patient will need to be restrained to some degree based on their level of anxiety and cooperation. This can be very scary and stressful for many animals, not to mention their humans, if they knew what was happening.
What it ISN’T
Why ISN’T anesthesia-free dentistry considered an acceptable substitution for dentistry under general anesthesia? First, each and every tooth (dogs have 42 and cats have 30) needs a complete exam during dentistry. This starts with probing around each tooth in the gingival sulcus looking for periodontal pockets (deep probing defects) and examining for any abnormalities of the teeth and oral soft tissues. All abnormalities should be charted and recorded.
This ISN’T done and, in fact, cannot be done with anesthesia-free dentistry. Most veterinary dentists agree that the most important component of veterinary dentistry is imaging. Without full mouth dental radiographs or CT, very important pathologic findings will more than often be missed. This will lead to sending a pet home with an infected and painful mouth. Imaging ISN’T and cannot be performed with anesthesia-free dentistry.
The outside surface of the tooth is enamel, with dentin next, then the inside of the tooth is the pulp. Do you know anyone that gets tooth sensitivity due to thin enamel when eating or drinking hot/cold food or drinks? This is the dentin feeling these unwanted sensations due to an erosion of enamel that acts as the protective barrier.
It is extremely common for pets to have damaged teeth with no enamel and completely exposed dentin. I’m sure you can imagine what that feels like when someone scrapes across that area of the tooth when not under general anesthesia.
Earlier you learned the cause of periodontal disease was plaque, bacteria, and immune response. You also learned plaque and bacteria live in the gingival sulcus. In an awake patient, you CANNOT remove the plaque and bacteria from this area, using sharp hand instruments. You cannot even effectively scale away the calculus on the inside of the teeth in an awake patient.
And calculus plays a very limited role in the development of periodontal disease. So, essentially, non-anesthetic dentistry removes 50-80% of the non-infective component of periodontal disease while leaving behind 100% of the infective material. It really should be termed “tooth grooming” because that is what is happening. Having the tartar removed so the crowns look pretty but leaving all the infection behind.
Choose a Board-Certified Vet for Your Pet’s Dental Cleaning & Exam
As we have concluded, anesthesia-free dentistry provides little to no health benefits. Anesthesia-free dentistry is very often performed by non-professionals. Anesthesia-free dentistry gives a sense of false security that often leads to significant periodontal disease with tooth loss or worse.
There is no easy shortcut to providing your pet with a mouth free of pain and infection.
We know you love your pet and want to do what is in their best interest. Each and every veterinary dentist on this site has seen the significant unintended consequences of anesthesia-free dentistry. If there is not an AVDC Board Certified Veterinary Dentist near you, find a veterinarian you trust with a good track record that also provides advanced imaging for each patient.
Photo by Yoav Hornung on Unsplash (6/10/2022)