Non-anesthetic veterinary dentistry pays: But at what cost?

What happens when patients that have had non-anesthetic cleanings develop a problem?
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Nov 01, 2013

Offering dental prophylaxis without anesthesia gets clients in the door. The service offers an alternative for those who can't afford anesthesia or who are fearful of it. It opens the doors of communication and accustoms clients to the need for dental care. No one can argue with those claims. They bring in business, and they may ostensibly enhance pets' dental health.

But what happens when patients that have had non-anesthetic cleanings develop a problem? "At least once a week I see a client whose pet had non-anesthetic dentistry done come in with a pocket or problem with a tooth," says Kate Knutson, DVM, owner of Pet Crossing Animal Health and Dental Clinic in Bloomington, Minn. "They wonder how dental problems are possible when they've had their pet's teeth cleaned just a few months ago."

She says she can quickly see that the problem has been there for years, even though the outsides of the teeth look attractive. "The teeth look nice and white on the outside, but a more thorough exam and radiographs tell a different story," she says. The problem she faces is how to tell clients that less-than-stellar care has contributed to health problems when clients think they've been doing the right thing.

One of the most poignant cases Knutson has seen involved a cat that had been receiving non-anesthetic cleanings every six months for some time. The owner had complained to a friend that her cat's breath still smelled terrible. The friend referred her to Knutson.

"When I finally saw this cat, it was trembling, obviously scared," Knutson says. "The owner told me she had swaddled the cat in the past to calm her down, thinking it was a good thing. I took one look at the cat's mouth and saw obvious tooth resorption. The cat was refractory, didn't want her face touched, and became almost catatonic when touched."

Ultimately, under anesthesia, Knutson found that 23 of 30 teeth had resorptive lesions. That's what it took to make this cat owner a firm believer in anesthetic dentals.

"When I listen to non-anesthetic proponents talk, it sounds beautiful to me, all the flowers and birds and happiness," Knutson says. "But dental care is terrifying to the pets, and we just can't do a good job with the pets awake. Their cortisol levels rise from anxiety, and we just can't see all that's going on below the gum line."