Getting to the root of anesthesia-free veterinary dental care - DVM
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Getting to the root of anesthesia-free veterinary dental care
More veterinarians are sanctioning cleanings without anesthesia. Here's what you need to know.


Weighing the risks

On the flip side, Brett Beckman, DVM, DAVDC, DAAPM, says non-anesthetic cleanings do get clients to comply when otherwise they might not, but that's not good enough. "Without radiographs, the cleaning is cosmetic only," says Beckman, past president of the American Veterinary Dental Society. "If disease is present, which in almost all cases it is, then it does little to no good for the patient and wastes valuable client resources that could be used to actually help the pet with a thorough evaluation, radiographs and treatment. We see a tremendous amount of disease that is severe that we never detect on oral exam."

AAHA and the AVDC, along with many others in the veterinary community, agree that the procedure isn't thorough enough, could cause more damage and does a disservice to patients—and to their owners, who think their pets' teeth are getting cleaned at an appropriate level.

"A thorough dental procedure includes a tooth-by-tooth exam, tooth mobility tests, probing and radiographs," says Jan Bellows, DVM, DAVDC, DABVP. "This just cannot be done without anesthesia. Sixty percent of the tooth is located under the gum line, you can't see pathology without radiographs, and dogs and cats can't tell their dentist where the pain comes from. Dogs and cats have to suffer silently, and we can't thoroughly assess their dental health without anesthesia."

Dental experts also worry about a pet aspirating dental tartar or calculi and other debris produced during cleanings without the use of an endotracheal tube during anesthesia. "I think the non-anesthetic dental companies prey on clients' fear of anesthesia," Bellows says. "Fortunately, due to advances in anesthetic protocols, the risk is minimal."

Proponents of non-anesthetic cleaning, however, say the risk of aspiration during cleaning is a nonissue because a pet's gag reflex will provide protection. And as for the cleaning being less than thorough, Sur says, "My 12-year-old dog has had her teeth cleaned without anesthesia twice a year since she was 2 years old. She has never developed subgingival pockets or major calculus buildup and has never required an extraction. I never saw a lingual side that was missed or a tooth that was unpolished. They are able to get under the gum line comfortably, but just like humans, if deep root planing is needed, this should be done with anesthesia."

As the saying goes, it appears some members of the profession will have to agree to disagree on whether non-anesthetic cleanings are a good idea. AAHA and the AVDC have posted their views on the issue, and AAHA practices that don't comply can lose their accreditation. This has also been a political issue in California and other states in recent years, with veterinarians working to make or keep it illegal for nonveterinarians to perform dentistry on pets. However, many veterinarians are bringing the service under their hospital roof where they can supervise to comply with the law.

"I know these companies say they promote anesthetic dentals as well, but I have seen the opposite," says Bellows. "I've seen animals that had their teeth cleaned this way for years ultimately present with a mouth full of hurt."

Sarah A. Moser is a freelance writer and editor in Lenexa, Kan.


Source: DVM360 MAGAZINE,
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