When Your Vet Advises This "Routine" Procedure, How Should You Answer?

The answer may seem fuzzy because it's one of today's most controversial pet issues. But once you read this, the answer will be much clearer than you expect... regardless of the newfound popularity of the alternative. And you'll recognize risks you didn't even know existed.
There's a debate raging in the veterinary and animal care community over anesthesia-free dental cleaning (also called non-professional dental scaling, or NPDS) for dogs and cats.
In case you've never heard of NPDS, it involves cleaning just the surface of the teeth of a fully awake pet. It does not involve evaluating what's going on below the gum line or in other unseen areas of the oral cavity.

Anesthesia-Free Dentistry is a Cosmetic Procedure

Anesthesia-free dentistry is gaining popularity with well-intentioned pet guardians who may be fearful of anesthesia or may not be able to afford professional veterinary dental care.
They want to provide some form of oral care for their pets, so they opt for NPDS, but unfortunately, anesthesia-free cleanings are purely cosmetic procedures that address only the parts of your pet's teeth you can see.
One of the questions many pet healthcare professionals are asking is whether NPDS procedures are doing more harm than good. A concern many veterinarians have with just scraping teeth is that the mouth is full of blood vessels, which can launch oral bacteria into the bloodstream.

Once the bacteria is in the bloodstream, it can infect other organs like the valves of the heart.
Another concern is that NPDS can give pet owners a false sense of security about the state of their dog's or cat's oral health. Even though the areas of your pet's teeth you can see may look clean after an anesthesia-free dental procedure, what you can't see is actually more important.
Problems like tartar buildup below the gum line and gingivitis aren't addressed during a procedure that only scrapes and polishes the teeth. Most oral disease happens below the visible surfaces of your dog's or cat's mouth.

Why Most Pets Should Be Anesthetized for Dental Procedures

My friend and colleague, veterinary dentist Dr. Stephen Juriga, believes that NPDS is confusing to pet owners because on the one hand, they fear having their pet anesthetized.
But on the other hand, they don't understand the real limits of an essentially cosmetic dental procedure that cleans just the surface of the teeth.
Dr. Juriga compares NPDS to going to your own dentist and not allowing use of a periodontal probe to check for pockets or bone loss, or digital x-rays to check for cavities or infection.
He feels pet owners need to realize that in capable hands, the risk of anesthesia for dental procedures is far, far less than the risk of the systemic effects of untreated periodontal disease.
 The fact is, a thorough oral exam and cleaning can't be accomplished on a pet who is awake.
Anesthesia has several benefits when it comes to dental procedures, including:
  • Immobilizes your dog or cat to insure his safety and cooperation during a procedure he doesn't understand and is stressed about
  • Allows for a thorough exam of all the surfaces inside the mouth and the taking of x-rays
  • Allows for scaling below the gum line where periodontal disease is most active
  • Allows for pain management as required
The vast majority of fully alert dogs and cats simply won't tolerate a thorough inspection of their mouth. They'll jerk away if possible, wiggle, squirm and move around a lot, which makes the use of sharp instruments dangerous.
Cleaning below the gum line of a fully alert animal is something that should never be attempted. Pets won't stand for it because not only does the procedure cause significant stress, it's also painful. And if tooth extractions are necessary, they are out of the question for un-anesthetized pets.

What About Anesthesia Risks?

If you're nervous about anesthesia for your cat or dog – and most people are, especially those with older pets – you should know that it's actually quite safe when performed according to current standards.
The reason senior pets are handled more cautiously for anesthesia is because they are more likely to have a systemic illness. That's why additional tests are run on older pets prior to scheduling procedures requiring anesthesia.
These tests usually include a complete blood panel, urinalysis, chest x-rays and a BNP test that checks for certain forms of heart disease.
If your pet's test results show no problems with her general health, there is no increased risk for anesthesia. And even if there are some borderline numbers in an animal's test results, we must weigh the benefits of creating and maintaining good oral health against the potential risks associated with anesthesia.
A well-trained, skilled and experienced veterinary staff, following the most current standards of practice, can safely anesthetize senior and geriatric pets, as well as pets with significant systemic disease.
By using the latest anesthetic monitoring equipment, pets can benefit from the same diagnostics as people undergoing anesthesia. Make sure to check with your vet about how anesthetic monitoring is performed during your pet's procedure and recovery period.

Is There Ever a Good Reason to Clean a Pet's Teeth Without Anesthesia?

For the majority of pets, the answer is probably no, since most dogs and cats today have some degree of dental disease. More often than not, during the anesthesia-free procedure, the technician uncovers issues that require further investigation under anesthesia.
Even raw fed pets who get lots of recreational bones to gnaw on can have genetically weak tooth enamel and other dental problems that require professional care on a routine basis. The same is true for pets whose owners brush their teeth every day.
If your pet has no sign of gingivitis (gum disease), only a mild calculus buildup on her teeth, and has a calm easygoing temperament, she might be a candidate for NPDS.

Article written by Dr. Becker
Images submitted by PNM



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