As a veterinarian in practice, I agree with Dr K completely - but I do find myself asking a question: does she feel that there are ever any exceptions to the rule?
What about big placid Labradors that just have chunky tartar on their canines and perfect teeth otherwise? Anything wrong with clicking this off during a health check consult? Or what about penniless clients who you know are not going to have the full job done - again, with gentle, easy-going, non-reactive dogs, would you never just take off the worst of a tartar build up? Would this not help the animal more than leaving it alone?
I don't know the answers - this is a debate that I have with myself!
Pete

I was at a preceptorship during my first year of vet school at a clinic that performed non-anesthetic dentals, and it's still burned in my mind as one of the least ethical things I've seen done in a clinic. The poor dogs were pinned down by three techs, while a fourth went at their teeth with a hand scaler. The dogs were left bleeding and terrified, and nothing had really been accomplished to improve their dental health. I'm sure the poor things developed a strong fear of vet clinics after that, though.

Pete- the problem with removing visible calculus is that calculus above the gumline is purely cosmetic, so removing it has no effect on dental health. For pet owners, the visible calculus *is* the disease, but as veterinarians, we know that the calculus which causes gingivitis, periodontal pockets, bone loss, etc is all below the gumline. Plus, the use of a hand scaler causes fine scratches to the enamel which, under anesthesia, are smoothed again with the polishing step. Without anesthesia, polishing is not possible, and now you have a pet with enamel that is rough and provides a better surface for bacteria (and thus calculus) to adhere.

The American Veterinary Dental College has a nice position statement about non-anesthetic dentistry here: http://avdc.org/Dental_Scaling_Without_Anesthesia.pdf

I'm aware of the issues that you describe so clearly Megan - but I still am left wondering about my big placid Labrador with a large build-up of tartar only on his upper canine teeth. The rest of his teeth are perfect. It's easy to remove this by hand - there's no bleeding, he doesn't try to move away, and while of course he really should have sub-gingival polishing of the tooth, it's hard to see that any harm is done.....
I know that it's not "current thinking" but what I'm talking about is quite different to the forcible restraint that you experienced. I hasten to add that this is not my standard practice by any means, but I find myself wondering "why not" in some, carefully selected cases....

Yeah, you know I've had that debate with one of my in-hospital colleagues. He removes the tartar and feels it offers more-than-cosmetic benefits. The other two of us staunchly disagree unless––and this is what I believe you're asking––the pet will tolerate scaling below the gumline *and* a proper polishing. Without these two features, the evidence is clear: the damage to the enamel caused by the scaling forms a heavenly matrix for bacteria.

Hence, why my near-tartarless Sophie Sue went from light tartar before her non-anesthetic cleaning to moderate tartar within two months of the procedure. Anecdotal, sure, but it does follow the pattern we'd expect when a proper polish can't be achieved.

And how horribly my normally very placid dog struggled! That sealed it.

correction: "above" the gumline.

As a tech that does all of our clinics dental cleanings I do not see any way this can be achieved without anesthesia. I get this question a lot from clients "Why can't my dog/cat be awake during this?" To me it just seems like a dumb question from the person whose dog is sitting there snarling and growling during a routine wellness exam is not going to tolerate loud, sharp instruments coming at his mouth. I do not see how there is anyway to properly remove any of the junk above the gumline without anesthesia. To me it just can't be done. But hey there are a lot of things being done that I don't approve of. Dr. Khuly what do you think about a local vet here that diagnoses by places her hands upon her tech who has her hands on the animal?

Laying hands second hand? Seriously? Prob as helpful as an anesthetic-free dental. But hey, it's not a problem with the Board of Vet Medicine as long as there's full disclosure and clients understand what they're paying for. People pay for stranger services.

I absolutely agree with Dr. Khuly here.

Apart from the risks of hand-scaling an awake dog, there is no evidence that visible calculus correlates with true periodontal disease, and it is easy to find examples of cases with perfectly clean crowns that have severe periodontal disease (e.g. http://www.vin.com/WebLink.plx?URL=http://www.toothvet.ca/PDFfiles/perio_hidden.pdf).
Plaque (the biofilm containing bacteria) is what causes tooth loss and gum disease, and it can't be seen. Cracking off big chunks of visible calculus is purely cosmetic, and it creates a false sense of security because without a full exam with charting and x-rays under anesthesia, we don't really know if the teeth are healthy or not no matter how they look.

Aren't they given any sedative? I was offered a chance to have a dental cleaning for my dog but the vet used sedatives.
Could that be better then anesthesia in some cases?

Otherwise I think it would be terrifying for most dogs.
When you say NO anesthesia...is it just a straight forward approach? How awful for everybody.

My vet said that sometime this year they will have some type of bone or chew that has enzymes which help clean teeth. Anyone heard of this?

Dr. K I agree with you completely. For a short while I was doing non anesthetic dentistry for a local grooming shop on Sundays. It was part of an agreement I made that I later regretted. The whole time I was trying to explain to the clients that I was not providing their pet pets with the level of medicine they deserve. Some of the clients listened and some did not. We need more articles like this one to increase client awareness so pets get the best medical treatment possible. Client education is the key.

www.missionvet.com

i agree with dr. k 100%. any dental "cleaning" done without anesthesia is a cosmetic procedure at best. at my hospital, we've been shooting full mouth dental xrays on all of our dental patients for about 8 months now. what a difference that has made to how be practice dentistry here! we're catching pathology that would otherwise be missed, even with a good oral exam under anesthesia. there's just no way you can take good dental xrays without general anesthesia. and there's no way i will do even a "routine" cleaning without xrays anymore.

Apologies for not topic specific comment but felt it necessary as gardening season is blossoming to get this to your readers and you:

Sunshine of Africa- Cocoa Shell Mulch is tantalizing and toxic to your Dogs and Cats. It is sold at the following retailers: Target, Home Depot, Forman's Garden Supply and other garden supply stores.

Most of us know that Chocolate- specifically the cocoa beans that contain THEOBROMINE is lethal to our pets. This mulch contains it. The chocolate smell will attract dogs and if ingested the worst. This mulch does not have warnings regarding this but there have been several reported deaths in the past 2-3 weeks.

Although the mulch had NO warnings printed on the label, upon further investigation on the company's web site, this product is HIGHLY toxic to dogs and cats.

Cocoa Mulch is manufactured by Hershey's, and they claim that "It is true that studies have shown that 50% of the dogs that eat Cocoa Mulch can suffer physical harm to a variety of degrees (depending on each individual dog). However, 98% of all dogs won't eat it."
*Snopes site gives the following information:http://www.snopes.com/critters/crusader/cocoamulch.asp *

Thank you for reading

I have to STRONGLY DISAGREE. I think non-anesthesia dentals are great.(although i do think animals should get RADS around 2 incase of any caries or resorptive lesions). 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?

Nowadays we 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.I have seen this done! Most have the new technology necessary to have an effective/safe cleaning done. 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.Although there are different people that do things in different ways.i have seen this done with little to no stress! 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!" This is not for ALL pets so Dr Patty Im sure your dog was not a good candidate and you should continue the anesthetic cleanings. This is funny to me because a dental cleaning without the harsh use of anesthesia is the most logical and natural way to go????? how could anyone not agree with that? it seems very narrow minded to me.

I would never in a million years think of putting my dogs and cats thru a dental cleaning without anesthesia. I also think it is absurd to compare an unruly child with an animal that has no idea what is happening. While I'm sure a few animals would tolerate this, by approving something like this you are setting up lots of animals to go thru hell because of owners who are looking to save a few bucks.

And as for recommending cleaning every 6 months for animals. If you buy them a good quality dry food (or feed raw)and include lots of hard crunchy treats there will be no need to have their teeth cleaned every 6 months. My dogs have not had their teeth done since I've had them (5 and 6 years), and since they are rescues I highly doubt their previous owners bothered. Their teeth are perfect. Cleaning every 6 months is just another way for some Vets to make some extra cash.

Last year my 7 yr old cat finally had his first cleaning. I could never in a million years think of the trauma he would have gone thru if they hadn't used anesthesia. I do know however that if my Vet ever suggested such a thing I would be finding a new Vet.

I found the remarks/comments by "Dr Anne G" absolutely amazing and not worthy of belief. As an apologist for and defender of those who "practice" nonanesthetic "dentistry" it is manifestly clear that, if indeed "Dr Anne G" is actually a licensed vet and not a shill for the entrepeneurs who prey on the ill-informed and easily-misled pet owner, she must be one of those who personally profit from the "clinics" put on by these unlicensed "services".

It is well-known throughout the "holistic" and traditional veterinary businesses that a tidy profit can be pocketed from the extra charges added on by the Vet or Vet Hospital during these "clinics" -- pure and simple profit with the least amount of involvement required (let alone alleged "supervision" of these unlicensed and questionably-trained "service providers".

It's incredible how these freelancing snake oil salespeople get away with it. Some day they will be stopped.