Anesthesia-Free Dental? Not so great a deal.

Posted by Zoe Forward, DVM, Dipl. ABVP (canine/feline)

Information provided by the article written by veterinary dentist, Dr. John Lewis in Veterinary Practice News (Vol 25, No 7)

An anesthesia-free dental cleaning sounds great, doesn’t it?  No anesthesia means lower risk.  But is it less risky? Sure the crowns of your pet’s teeth look great afterwards, but without anesthesia your veterinarian is unable to probe each individual tooth (there’s no way your pet will stay still to have this done), take dental x-rays or get a good look on the inside or back of teeth.  Therefore, this procedure barely scrapes the surface of dental disease….no pun intended. 

Although the term “anesthesia-free dentistry” is commonly used to describe the practice of cleaning teeth without anesthesia, the American Veterinary Dental college prefers to use the term “non-professional dental scaling,” or NPDS, to describe these procedures.

Why isn’t an anesthesia-free dental cleaning a good idea?

1.       Dental procedures can be uncomfortable!  Rarely is a dental cleaning for our animal patients just a tooth cleaning. When we take a closer look with the right tools, there are common problems found. This could be in the form of a periodontal pocket where bacterial infection has created a deep pocket between the tooth and gums. This requires therapy. Or a deep abscess or even a necessary extraction. Even the act of ultrasonic cleaning of the teeth is uncomfortable. We don’t want our patients to feel pain during treatment!

 

2.       A thorough mouth exam requires anesthesia.  A thorough evaluation of each tooth is essential. It isn’t a dental cleaning without this! As well there are mouth structures we cannot see without anesthesia such as tonsils and the back of the throat, where disease often hides.  Pets will not allow us to probe teeth away and this is how we check teeth for fractures, cavities, and infection. Probing means that a periodontal probe is submerged into the gingival sulcus in six places around each tooth. No dog or cat will allow this.

 

3.       Dental radiographs (x-rays) are the best care for your pet.  Dogs and cats simply cannot tell us when they have a painful tooth or when there is an infection brewing. Often the problem is not above the gumline where we can see. Most of these patients will still eat and may even have otherwise normal play behaviors. The only way for us to know what is going on beneath the gums is to take a picture.

 

4.       Scaling requires thorough polishing afterwards.  That gritty stuff your dentist puts on your teeth after cleaning is called polish. It fills in all the little defects caused by scraping off the tartar. If a patient is a moving target while scaling, then potential damage for the surface of the tooth is greater. Polishing smoothes out the rough surfaces, but the patient has to be still. This is often not going to happen on an awake pet.

 

5.       False sense of security.  When the crowns (tops) of the teeth looks clean, we assume all is going well beneath the gums.  The level of tartar is what clues us in that the teeth need to be cleaned and it looks great for a while after it has been scraped off, but it may be that there is more significant disease we didn’t know about brewing beneath the gums.

 

Weighing the Pros and Cons.

There is always some risk with anesthesia, usually small, but in some patients this risk is higher depending on the pet’s medical status.  There are pets who should not be placed under anesthesia, and perhaps only in those patients anesthesia-free dentals could be considered.

However, advances in anesthesia and monitoring equipment have allowed the risk to be lower than ever in the past. At Carolina Pets Animal Hospital we use the most current monitor tools and advanced inhalant anesthesia (Sevoflurane) to maintain our patients.