Evaluating non-anesthetic veterinary dental cleanings
Curious what a non-anesthetic dental cleaning entails? Pet Dental Services, a company that provides these services within veterinary practices by hygienists under a doctor’s care, shows its 11-step process in a video. They call the procedure a “professional outpatient preventive dental” and say it complements a practice’s already existing dental program. See for yourself, and then read on for comments from experts in the field.
“I was very skeptical when I first learned about these procedures,” says George Zafir, DVM. “At that time, about seven years ago, anesthesia was the only method of doing dental prophys or cleaning. But Pet Dental Services provided a demonstration on my own dog and a couple of staff members’ pets. I doubted they could adequately restrain the pet and be thorough, but they did a decent prophy and sold me on the procedure.”
Others who support the process agree that they were skeptical at first. But not all who have seen now believe.
“The patients that undergo this procedure are not as cooperative as that pet, in general,” says Jan Bellows, DVM, DAVDC, DABVP. Bellows says injury to the pet can and has occurred during these types of cleanings—and that the cleaning is only as good as the person performing it. “Most pets will not receive adequate cleaning without anesthesia,” he says.
Brett Beckman, DAVDC, DAAPM, agrees. “My main objection is that if a patient has gingivitis or calculus, there is a very good chance the patient has disease that is detectable only by radiography that will require surgical treatment,” he says.
Beckman cites studies done at the University of California at Davis veterinary hospital to support his point. In the studies, dogs and cats with no visible oral disease—as determined by boarded veterinary dentists upon oral examination—actually turned out to have oral disease apparent on radiography at fairly high rates: 28 percent of dogs and 41 percent of cats. (See the June 1998 issue of the American Journal of Veterinary Research—click here and here—for more detail.)
“Yes, offering these dentals increases practice revenue,” says Beckman. “And yes, a skilled technician or veterinarian like the one in the video will refer the patient for better care. But the problem is twofold: One, most of the people performing these cleanings are not in that skilled category and, two, there are still those 28 percent of dogs and 41 percent of cats that have disease that can’t be picked up even with a thorough oral exam by very skilled and experience board-certified dentists.”
According to the video, the hygienist conducted a thorough exam, removed all bacteria, and didn’t etch the enamel. Bellows specifically calls out these statements. “She only visibly examined the outside of the teeth and didn’t open the pet’s mouth as a dentist would to properly examine the tongue and internal oral surfaces,” says Bellows, owner of Hometown Animal Hospital in Weston, Fla. “Also, it’s impossible to remove all bacteria, and enamel is always etched during cleanings.”
He also takes exception to the statement that the hygienist probes all surfaces of the teeth. “Without anesthesia, it’s impossible to probe the internal surfaces properly, as you can’t get to the back teeth nor see the probing depths in shadows,” he says.