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The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.


The American Animal Hospital Association (AAHA) made a bold move recently in mandating that all pets undergoing dental procedures, including dental cleanings, require anesthesia. AAHA believes that anesthesia-free dental procedures do not meet their high standard of care and are not in the best interest of the animals undergoing these procedures. AAHA guidelines, says AAHA, must reflect the best practices. And when it comes to dental procedures, these best practices include anesthesia.

The mandate has drawn a great deal of criticism from groups that promote anesthesia-free dentistry. According to these groups, some dental procedures can be done without anesthesia.

So, is anesthesia necessary to carry out a dental procedure properly? Obviously, there will be those who disagree with me. But, yes, I believe that anesthesia is necessary to perform any dental procedure properly. I don’t believe that these procedures can be performed properly in an animal that is awake.

There really isn’t such a thing as “just” a dental cleaning, or at least there shouldn’t be. Any time a pet’s teeth are cleaned, the entire mouth should be evaluated for signs of disease. This means examining each individual tooth. During the examination, all surfaces on each tooth must be accessible for probing, all the way around the tooth. In addition, dental radiographs are especially important for cats, where dental disease may be present below the gumline but not visible above it. Only radiographs can accurately detect these lesions, which can be very painful for affected cats.

The cleaning process involves not only cleaning above the gumline but also below the gumline. Most dental disease starts below the gumline and if that area isn’t addressed, the dental cleaning is little more than a cosmetic procedure without any medical benefit.

None of this can be done properly without anesthesia. In cases where dental disease is present, trying to do so would be painful and inhumane. There’s also the fact that we cannot always tell without evaluating dental radiographs whether dental disease is present or not. That doesn’t mean that the teeth aren’t still painful though.

The mandate also requires intubation of animals anesthetized for dental procedures. Intubation involves placing a tube into the trachea. This protects the airway. Should the animal need supplemental oxygen, it can be administered through this tube. The tube also prevents the anesthetized animal from inhaling blood and/or dental debris into the lungs.

AAHA is not alone in believing that anesthesia is necessary to carry out dental procedures thoroughly and painlessly. The American Veterinary Dental College, the group that is recognized as the expert voice in pet dental care, endorses this standard as well.

This mandate is required only for hospitals accredited by AAHA. Hospitals not accredited are not subject to the guidelines. However, hospitals failing to follow the guidelines cannot be approved for or maintain their AAHA accreditation.

I understand that many pet owners are frightened of anesthesia. I can’t say that there is no risk involved with anesthesia. But I can assure you that the risk for most animals is minimal. We’ll talk next week about modern anesthetic practices and the precautions that your veterinarian takes to make sure that your pet is safe while anesthetized. In the meantime, if you’re concerned about anesthesia for your pet, my advice is to have a frank discussion with your veterinarian about your pet’s risk.

Some people may wonder why people can have dental work done without anesthesia but pets cannot. To address this issue, I’ll quote AAHA:

“People don’t usually have to be anesthetized because we understand what is going on during a dental procedure — we understand when someone asks us to keep still in order to avoid being hurt. However, even some people react so strongly to dental procedures that they need to be sedated. In people, a trip to the dentist most often means cleaning clean teeth; with dogs and cats, painful periodontal disease is commonly present, which needs to be treated with anesthesia.”

For more information about AAHA’s new dental guidelines, please see AAHA Standards: Anesthesia and intubation for dental procedures.

Dr. Lorie Huston

Image: kudrashka-a / Shutterstock

Comments  3

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  • Safety
    09/16/2013 06:25am

    In my opinion, anesthesia is also a safety measure for the medical professionals. Restraining a critter for a dental procedure for a critter that isn't anesthetized seems like it would be hard on the critter as well as a safety risk for the humans.

  • For some pets
    09/16/2013 12:40pm

    It is all well and good to say it is necessary but what about old dogs that are too old to be put under? As a groomer the dogs I see with the most dental problems are the old dogs that vets are not willing to use anesthesia on. I would say a incomplete but best you can do cleaning for these dogs would be better than nothing. This rule gives vets no option to offer even a little relief for those dogs except going to a non AAHA vet. These are the kind of rules that tie the hands of people who are trying to help the small percentage of dogs that do not fit the "average".

  • Educate....
    09/16/2013 01:44pm

    How about we stop the emotional and financial drain on clients and the stress placed on the pets and educate pet owners on benefit of brushing their pets' teeth regularly. Similar to how we teach children the benefits of brushing their teeth, we can educate pet owners the benefits of brushing their pets' teeth. I had a dog for 14.5 years and he never had to have dental work done. I now two pups (ages 2 & 1) who's teeth shine brighter than a lightbulb. And that's simply by brushing their teeth twice a week. Just sayin' :)

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