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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Is an 'anesthesia-free' dentistry for your pet?

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October 13, 2008 / (23) comments


Fear and loathe veterinary anesthesia though you might (and I wouldn’t necessarily blame you), the answer to the above question is a no-brainer for me: the so-called "anesthesia-free" dental cleaning is NOT an appropriate approach to managing our pets’ dental health.

A variety of companies are now offering this service in a bunch of states. California seems especially targeted (according to Pet Connection’s Christie Keith, who provided the impetus for this post with her own from last Saturday). The procedure’s gained some traction among pet owners as a result of…

1) our heightened understanding of the need for dental care for our pets,

2) the fear of anesthesia, since most of us also know that anesthesia carries risks, and

3) the reduced expense such a service requires relative to the standard, anesthetic dental cleaning procedure veterinarians urge our pets to undergo.

I’m often in a position to field the question, "Is there any way I can clean my pet’s teeth without anesthesia?"

Though I’m loath to hit my client with a rapid-fire answer in the negative, I’m firm on my stance: No anesthesia-free dentistry has yet been shown to do more good than harm.

Yes, it’s true. Non-anesthetic dental cleanings have actually been proven to be harmful to pets. Here’s a run-down on why:

1) The stated goal of this service is typically to remove visible tartar for cosmetic reasons. These companies don’t (and can’t) promise health benefits for our pets.

2) The necessary, below-the-gumline cleaning of teeth is painful, requires minimal movement for accuracy, and is generally considered impossible without anesthesia.

3) Polishing the teeth after a thorough cleaning and scaling is absolutely essential to the continued health of teeth and gums and cannot be properly undertaken without anesthesia.

(Polishing is necessary because the invisible damage done to teeth during the cleaning process must be mitigated by the smoothing action afforded by the polish. Otherwise, the teeth and gums become more susceptible to bacterial infection than before cleaning.)

4) Pets don’t tolerate even basic cleaning and scaling well. They struggle and stress. Even if they do hold still enough, the results are always unsatisfactory relative to the anesthetic version of the procedure.

How do I know? Not only do I have cause to believe the respected, board-certified dentists who have evaluated the anesthesia-free procedure, I’ve got my own dog’s example to consider.

My Frenchie, Sophie Sue, became the reluctant guinea pig for this anesthetic-free dental cleaning a couple of years back when a company began making the rounds of our South Florida neighborhood.

Though our practice had pretty much decided against the service (which would be performed at our hospital by "dental specialists" trained in the procedure) based on the advice of the veterinary dental establishment, we thought it would be only fair to see how it worked.

Sophie Sue carried a very mild tartar buildup, despite her advanced age, because of my weekly brushing and (I believe) because I offer her raw, meaty bones on a regular basis. Nonetheless, I didn't think it unreasonable to subject her to a free cleaning.

Not only did Sophie Sue (generally a model patient) resist quite impressively, her teeth suffered an unreasonable buildup of tartar in the months that followed (in spite of my unchanged home-care protocol). I may be wrong, but I attribute that to an inability to polish her teeth effectively during the procedure.

Even if you discount my anecdotal findings, its clear that the academically-inclined veterinarians among us are in opposition to anesthetic-free dental cleanings based on similar evidence: Incomplete (purely cosmetic) dental cleaning is worse than no cleaning at all.

And yet the practice seems to be gaining some ground. Instead of targeting veterinary practices with this service (which seemed to yield no fruit after vets became aware of its consequences), the companies offering anesthesia-free dentistry are now looking to groomers to partner with, as Christie Keith’s post points out.

The California company she mentions, Canine Care, has been called out for its practices (at one point it was enjoined against providing this procedure), despite its contention that this version of dentistry is only offered for cosmetic purposes and claims no health benefits (the latter which might place it in violation of a law prohibiting non-vets from offering healthcare services).

However you feel about the ability of unlicensed laypersons to offer healthcare services to pets, this concept is a dud any way you slice it. It’s just not reasonable to expect any pet to suffer a complete dental cleaning without anesthesia. And the resulting halfway approach clearly does more harm than good.

Considering that responsible veterinarians guide themselves by the "above all do no harm" mantra, it seems self-evident that this practice deserves to die once and for all.

See Christie's three articles on this subject for [much] more information.

 

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COMMENTS (23)
1
by John G DVM on 01/21/2009 11:27pm


I have seen this procedure first hand by a company called Pet Friendly Dental Care. I have been in practice for 15 years and I have to say I was so impressed with this procedure. There is NO reason why in a compliant pet with level 1-3 buildup we cannot clean the teeth without anesthesia. We clean childrens teeth without anesthesia!!!! A routine dental cleaning without extractions should not be painfull. I have my teeth cleaned twice a year with no discomfort. I watch this company perform this procedure on the correct candidates with NO hesitation from the pet . I have watched them use curretes on the sub-gingival areas without any trouble. This is a new and cutting edge procedure... John G DVM

2
by Suzanne CVT on 11/19/2008 07:51pm

I have to STRONGLY DISAGREE.
I am in the process of becoming dental certified, and I think non-anesthesia dentals are great.(although i do think animals should get RADS around 2 incase of any diciduous or non-eruptive teeth)
Not only for the high risk patients (heart disease, murmers, liver/kidney disease), but also for any routine dental... why not?
If an animal can get the same treatment it needs without anesthisia then why not? Nowaday veterinarians are recommending dentals every 6 MONTHS! For most animals living to 12-15 yrs old that would be going under anesthesia 22-26 times in their life time!
The non-anesthetic dental technicians are very knowledgable and patient, with what they do. Most have the new technology necessary to have an effective/safe cleaning done, (like the ceramic tip ultrasonic cleaner ,generating no heat to the tip, and minimizing the amount of water/chlorohex solution needed to adequetly clean)
The key to the treatment is patience... most canines/felines that receive the treatment eventually get use to it and simply sit back and relax as we would at the dentist.
Most people think of non-anestheitc dental as some one pinning down animal and fighting it until it surrends, but it is completly opposite.
During the procedure the technician
1. Charts the mouth
2. Probes
3. Subgingival scaling
4. Ultrasonic scaling
5. Polish
6. Floride
7. Chlorohex and smile!

If a technician sees any abnormallities or believes the animal would be a better canidate for anesthetia they will report it to the Veterinarian.
What anesthesia free dentistry dose is like no other.
Im not saying being under anesthesia is unsafe, if using the right medications and monitroing properly it is 100% effective. But if there is not a need to Do x-rays, have extractions, or any other kind of dental surgery then why?

So, next time you go to the dentist for your routine dental, ask what they do when they have a difficult child patient. Im sure he wont say "Put them under Anesthesia!"

3
by katy on 10/21/2008 11:54am

for cats or dogs with compromised immune systems or disease a cleaning without anesthesia is better than the risk or no cleaning at all. i have a cat with HCM and asthma both are mild and both are stable but i am terrified of having anesthesia used on her. i do brush her teeth daily and this has kept dentals at bay until early this year. belle had a FLOR which i wouldnt have found if i didnt brush her teeth. since that tooth had to be removed they did a dental. they used isoflourne instead of ketamine. although i know my cat would never allow a stranger to clean her teeth and i think the stress of it would do a lot of harm. i will continue to do my best keeping her teeth brushed and cared for at home.

4
by Elizabeth - from Nova Scotia on 10/16/2008 11:09pm

Megan : You would think that they would have done clinical trials on the oral care gel before they put it on the market and making the claims they do addDddbout it.

5
by Megan on 10/16/2008 10:32am

barri- I spoke to the owners of the PetZLife company, and they are in the process of having clinical trials done on the oral care gel. I can't say whether or not the gel works, but at least we'll have some objective data about it soon.

6
by Robin on 10/14/2008 07:37pm

When my dog was diagnosed with a jaw abscess (he had it when I got him), he was x-rayed. It picked up that two teeth needed removing, when if he had not been x-rayed, they would have taken one, and had to go back for the second. It can be useful, but I am not sure if its necessary every time.

7
by Alli on 10/14/2008 07:07pm

The practice I work summers in got a digital dental X ray system a few years ago. Its been fantastic- the number of things that have been found is surprising. It allows us to deal with teeth that may not be problematic at that time, but will be shortly. The rads are included on all estimates, the client has the option to decline them but must sign something stating that they are aware that there is potential for problems to go undetected and have to be addressed at a later time.
Most people have them done. Several have opted out only to have issues come up in a few months- ones that could have been prevented earlier.

8
by Dr. Patty Khuly on 10/14/2008 06:43pm

Barb: Anytime I see lesions (deep pockets, fractures, cavities) I like to take films. I also take pictures of missing teeth if I know they haven't been extracted. It's amazing what you'll find if you look. It's also amazing that we did dentistry for so many years without this tool.

For everyone else: Make sure your vet has a dental X-ray machine--if not, urge him/her to get one. Without it, unless the teeth are in great shape, we're effectively doing dentals in the dark.

9
by Barb on 10/14/2008 03:06pm

Thanks Jenny! Good to know.

10
by Jenny on 10/14/2008 02:30pm

My vet does digital xray standard before any dentai cleaning. It has really been worth it for us. Two examples:
- Cat 1 with one suspected FORL - Xray actually revealed one more and one tooth that was decayed. Without xray we would have had to revisit two more teeth in a future visit.
- Cat 2 with one suspectef FORL - xray confirmed that it was actually not a FORL. The vet cleaned thoroughly and I believe cut a tiny amount of gum away as it had overgrown. The cat had no more issues. Without xray this tooth most likely would have been removed and didn't need to be.

11
by Barb on 10/14/2008 01:46pm

Dr. Patty, when do you feel that oral x-rays are needed? Do you do them prior to most dentals, or only in certain cases? I'm asking because I'm about to take our little 15 y/o Shih Tzu cross (NOT a ShiCorgi, though! LOL) in for a dental. He's very healthy but is missing a few teeth and I'm wondering about having my vet take some dental films. Do you think it's worth it?

12
by Dr. Patty Khuly on 10/14/2008 12:14pm

Sure, EmilyS. The only thing to remember with anesthesia is that the total length of the anesthetic procedure seems to be an important issue when it comes to adverse anesthetic events. In other words, if your dog doesn't really *need* a dental yet it probably isn't worth it.

13
by EmilyS on 10/14/2008 11:54am

I'll be taking my 2 year old for his OFA xrays soon. Since that also requires anesthesia, can I have the vet do a dental at the same time?

14
by Dr. Patty Khuly on 10/14/2008 09:52am

barri: 80% of our patients will have signs of periodontal disease by the age of three. Now's the time to start. Shorter, more frequent dentistries are considered far less anesthetically taxing (cumulatively) than the fewer, lengthier procedures required by more severe disease left unmanaged for years--not to mention the discomfort that we risk by not addressing things early through prevention.

Melissa: You've got a tough issue. Consider, however, that your 6 pound chihuahua will probably be better off with the occasional short dental. Daily brushing is the mainstay of limiting these, though. I would NOT consider anesthesia-free dentistry.

Does that help?

15
by barri on 10/14/2008 09:38am

I don't disagree with the caveat of buyer beware, but the thought of having to put the guy under to clean his teeth bothers me.. I have been brushing his teeth, but it isn't doing it... Will give it a month.. I just hope I'm not damaging the enamel.. My concern is that he's too young to have periodontal problems
What about the allergy meds?

16
by Elizabeth - From Nova Scotia on 10/14/2008 09:05am

barri: As far as the Petzlife Oral Care Gel goes all I can say if there was a product that did everything it claims too someone would have developed it for human use and made a bundle. Since they haven't done that I will just keep brushing my dogs teeth with their own toothpaste.

17
by Elizabeth - From Nova Scotia on 10/14/2008 09:01am

People are taken in by the false advertising and wonderful pictures.
At this website they claim to remove all the plaque even below the gum line, quote "The next step is removing all of the plaque above and below the gum line. end quote
http://petdentalservices.com/pet-owners.php
When you see these procedures taking place in Veterinary Clinics or supposedly supervised by a Vet why wouldn't you think they were safe and effective.
As with any product or service people need to do their homework.

18
by barri on 10/14/2008 08:02am

Has anyone heard of the Petzlife Oral Care Gel? It's a gel that claims to get rid of tarter, and plaque.. I started brushing my Socks teeth with it, as I was concerned when I saw the plaque build up, and he's only a 3 yo.. It seems that it has been reducing the plaque.. I'm hesitant to give him meat bones, as I don't know what kind.. I also had a dog that broke a molar on a bone, and needed an extraction..
While I'm on.. Socrates has allergies (eyes, ears, and the new one.. licking his paws), and the vet gave him Tavist.. I don't have samples of Tavist.. Are there any other antihistamines I can use? I have tons of Claritin..

19
by Melissa on 10/14/2008 03:17am

Personally I "might" find interest in this... I have a 6 pound chihuahua with MVD that is 2 years old and I do not think it would be wise to put her under again in her life... I do brush everyday but I know there will come a time when she will need a good deep cleaning... I also know that it is against there health to have bad teeth - so I would have to weigh the options... What would you do for this situation?

20
by Robin on 10/13/2008 11:02pm

and if your pet needs a tooth extracted, what then? might also be less likely to notice that its necessary if no anesthetic is being used.

21
by Sean Clare, RVT on 10/13/2008 10:36pm

I see these advertised at pet stores form time to time. I always go in and ask about them and I am told that an "animal dental hygienist" (there is no such thing) comes in to do the teeth cleaning and there is veterinarian involved.

California law requires that dental operations on animals be performed by or under the direct supervision of a licensed veterinarian

The real issue here is that anesthesia free cleanings don't do any good and can actually make matters *worse* when it comes to your pet's health. These cleanings do not clean under the gum line to prevent periodontal disease.
The teeth are also not polished so after scraping the tartar and calculus there are now scratches on the enamel of the tooth that allow more disease causing bacteria to take hold. They may make the tops of the teeth look shiny but the majority of the bacteria that causes dental disease is located under the gums.

I ended up reporting these business to the California Department of Consumer Affairs. Hopefully they will be able to help put an end to this misleading and deceitful practice.

-Sean, RVT

22
by Elizabeth - from Nova Scotia on 10/13/2008 06:28pm

I researched this when I first heard about it and came to the conclusion it was not in any of my dogs best interest. Research and "common sense" told me this was stupid. They might be able to get visible tartar off them but they were not getting under the gumline and I just might be endangering their health by allowing bacteria to enter the blood stream.
2 weeks ago my 8 1/2 yr old lab had a dental, we did blood work the week before and put her on antibiotics a few days before and afte. I know she was looked after, she was not stressed by being held down, her dental achieved exactly what it was supposed to. I don't want something done just for apearance sake, I want what is best for the health of my dogs. That's why they also get their teeth brushed evey night.

23
by Stefani on 10/13/2008 12:15pm

I dunno.

My ex-boyfriend used to be able to clean his cats teeth at home. He had human dental tools he used, the scraping thing. That was a very laid back and tolerant cat. The vets never said he needed a dental, so it seems it worked. Poor Pashie had to hold pretty still for a long time, it usually took about a half hour.

My cats would NEVER tolerate that. I try to just do basic rubbing on their teeth getting them used to it, doing some surface cleaning. Two will tolerate it a little bit, the other 2 think I'm trying to kill them.

Definitely the method my bf used on his cat -- holding him down for a half hour -- would never be tolerated by my crew. I have to sneak rubs into petting sessions. As much as I'd like to avoid anesthesia and get very nervous when my pets are under, I don't think it's going to be possible with my crew. Maybe the young male who is pretty malleable. The others, no.

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About fully vetted

Patty Khuly, VMD, MBA

Photo of Dr Khuly

Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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