A Vet’s Perspective on Anesthesia-Free Dental Cleanings

Anesthesia-free dentistry services are becoming popular throughout the United States. Although the thought of anesthesia makes many pet parents nervous, when done properly, the true risks associated with anesthesia are actually very low. More importantly, a proper dental exam and cleaning cannot be performed in an awake animal. For this reason, anesthesia-free dental services are not endorsed by the American Veterinary Dental College or the AVMA (visit http://avdc.org/AFD/).

 

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ANESTHESIA SAFETY: Who Should Be On Your Pet’s Team: One of the most important parts of anesthetic safety is having a caring and well-trained team! There should be a licensed technician directly involved in both the anesthesia and the dentistry AND a veterinarian/dentist always present. … ❓One important question to ask when your pet is having a dental procedure is “Who does the dentistry/extractions and who does the anesthesia?” … A doctor should always be involved in surgery and a licensed technician should be assisting with anesthesia. There should be one person assigned to monitoring the vitals of the patient at all times and that person should be trained to address changes promptly. 👨🏻‍⚕️👩🏽‍⚕️ #themoreyouknow #ittakesateam #petadvocacy #dentistry #petdentistry #veterinarydentistry #veterinaryteam #anesthesia #veterinarytechnician #licensed #safety #vitals #mypetssmile

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Let’s further explore the reasons to avoid anesthesia-free cleanings.

 

Diagnosis in human dentistry usually starts with what hurts. A patient’s symptoms are critical to the diagnostic process. But because animals cannot tell us how they feel, veterinarians must look for other diagnostic clues. Most dogs and cats display no symptoms of oral pain, even when they have significant oral disease. It is not in their nature to act painful, stop eating, or cry. Therefore, veterinarians must rely on oral examinations and dental X-rays to find and treat disease in the mouth. These cannot be performed properly on awake animals.

 

 

Dental disease is not caused by plaque or calculus on the crowns (visible portions) of teeth, but rather by build-up in pockets under the gums, causing inflammation and loss of support tissue. Detection of these pockets of disease requires the use of a periodontal probe on all sides of a tooth. Such probing, especially in the back of the mouth and on the inside of the teeth, would not be tolerated by an animal that is awake.

 

Another aspect of a complete oral examination is exploration of teeth for lesions (areas of disease) such as caries (cavities), tooth resorption (painful areas of tooth substance loss commonly found in cat teeth), and oral ulcerations and masses. This inspection uses a periodontal explorer, a sharp instrument that can cause pain or discomfort, especially in areas of disease.

 

Hard and soft deposits built up on human teeth, called calculus and plaque respectively, also occur in dogs, cats, and other animals. Dental calculus becomes firmly adhered to teeth and is difficult to remove without the use of sharp instruments called scalers, especially under the gums. This is painful and difficult to safely accomplish in an awake animal.

 

Following dental scaling, all surfaces of the teeth are polished. This important part of dental cleaning smooths enamel surfaces and is not a routine part of an awake cleaning.

 

A dental x-ray showing both bone loss (periodontal disease) and resorption on a cat’s lower teeth.

 

Because most dental disease is located under the gum line, dental X-rays are part of a complete oral examination. They allow a veterinarian to examine the roots of teeth and the bone around those roots. However, in animals, dental X-rays cannot be taken without heavy sedation or anesthesia. Humans can have X-rays taken fully awake without discomfort, but a dog or cat will not understand directives to hold their head at a particular angle, allow the film to be placed uncomfortably far back in the mouth, or remain motionless.

 

There is a big trend towards fear-free veterinary visits and reducing stress in animal patients going to the doctor. The practice of holding them down and/or wrapping them tightly in a towel for an awake scaling with sharp instruments causes extreme stress for most pets and is not something pet parents would want for their family members.

 

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ANESTHESIA SAFETY continued: Equipment! … One of the most important components to a safe anesthetic episode is proper monitoring equipment. … 👆Pictured is a monitoring device showing: ✅heart rate (top line) … ✅CO2 and respiratory pattern (next line down) ✅pulse ox (oxygenation status, second line from the bottom) ✅blood pressure (bottom line) ✳️Additionally, the body temperature and depth of anesthesia should be checked often. All of these values should be monitored during anesthesia as changes in any one of the above could indicate a problem. Acting on changes quickly and appropriately saves lives! This is why having a good team is vital! 👩🏽‍⚕️👨🏻‍⚕️✅ #anesthesia #anesthesiasafety #monitor #heartrate #temperature #co2 #pulseox #bloodpressure #depthofanesthesia #team #dentistry #petdentist #petdentistry #veterinarydentistry #veterinarydentist #mypetssmile

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In conclusion, besides the value of thorough cleaning for preventing future health problems, the discovery of caries, fractured teeth, resorption, or gum (periodontal) disease through an oral examination can lead to proper and effective treatment to help your pet feel better and enjoy life! Consider how much better a person feels once a toothache is gone. You may be surprised at how your cat’s or dog’s behavior changes for the better after professional dental care.

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Dr. Mary Buelow

Dr. Mary Buelow is a Board-Certified Veterinary Dentist practicing in Leesburg, VA. She lives with her husband, two rescue dogs (Frankie and Noodle) and two rescue cats (Kitten and Squash), for a total of 135 teeth. We won't say who's missing what...

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