Have you heard about non-anesthetic dental cleanings for your pets? In this blog post Dr. Pattie will discuss the risks of such dental practices as well as the benefits to traditional dental care at the vet’s office. If you have any questions about your pets oral health, the safety of anesthesia, or what you can do at home, please don’t hesitate to contact us, or to schedule time with a licensed veterinary technician to answer your questions.
ANESTHESIA-FREE DENTAL CLEANINGS : FACT VS. FICTION
Veterinarians, including those at Aldie Veterinary Hospital, are more frequently encountering cats and dogs that have had “Anesthesia-Free Dental Cleanings” (AFDC) or what has been termed “Non-professional Dental Scaling” (NPDS). The alternative is professional dental scaling & polishing with a licensed veterinarian, which is exactly the same procedure you do at your dentist checkups. The only difference is that animals don’t “open up and say ahhh”, therefore a professional veterinary dental cleaning requires general anesthesia.
There are a few reasons for this notable increase of AFDC/NPDS. Fortunately, this is primarily the result of more owners being aware of the importance of oral health care for their pets. These owners also have natural concerns about the risks of anesthesia and the associated costs. Unfortunately, AFDC/NPDS has been marketed as an attractive alternative that touts the same benefits as professional scaling without the cost and risks. By definition, a complete and comprehensive oral exam includes a complete visualization of all dental/oral structures, probing the gum-line, and may include taking dental X-Rays. In spite of the claims, it is IMPOSSIBLE for anyone to perform a “complete, comprehensive and thorough” oral assessment on companion animal patients without the assistance of general anesthesia.
The reason for this impossibility is because not all surfaces of a pet’s teeth are even visible in an awake patient. Periodontal disease affects the surfaces 360 degrees around the teeth (just like humans). Most periodontal infections start in locations BETWEEN teeth where the toothbrush does not reach. The hidden bacteria that cause periodontal disease and infection is NOT addressed with AFDC/NPDS, and a false sense of accomplishment is conveyed. These pets may continue to be affected for years with chronic oral infection which progresses to the point of pain, gum recession, and eventually tooth loss. When infections are finally recognized, the patients are usually older, and often have additional health related problems that increase the risks of anesthesia. Instead of treatment being an elective, preventive procedure on a relatively healthy patient, there is often urgency to treating the problem on a less healthy patient. Additionally, the problems become not only more urgent to treat, but treatment costs are then often greater.
As for general anesthesia, no one should ever say it is without risk; however, it can absolutely be approached safely with appropriate pre-sedation screening and trained professionals. Most major anesthetic risks are associated with two things: 1) the general health of the patient (young & healthy vs. older & existing problems), and 2) the level of training, knowledge, caring and skills of those individuals administering and monitoring the anesthesia itself. Highly trained and experienced veterinarians and technicians are found here at Aldie Veterinary Hospital. Bottom line: risk of sedation must be outweighed by the potential benefit (pain relief, etc.). The more we know the details of your pet’s health, the safer we can deliver anesthesia and effective oral health care.
Furthermore, with AFDC/NPDS, proper treatment of any oral problem is even less possible to perform and can even be dangerous. In California, a recent (2012) case of a patient’s fractured jaw led to a ruling against the party as practicing veterinary medicine without a license. The reason this accident happened was due to the non-sedated animal struggling against attempts to perform oral work.
It is acceptable for well-meaning clients to decline professional treatment because of their fear of anesthesia or if they cannot afford it. However, it is another thing to be fooled by the marketing of untrained individuals that target this fear and offer an alternative that is “just as good”. AFDC/NPDS is a service whose marketing sounds appealing and logical on the surface, however, it promises a lot more than can be delivered. It is essentially a cosmetic procedure that addresses only the visible surfaces of only some of the pet’s teeth. Unfortunately, without the benefit of general anesthesia, pets most often do not receive the proper and timely preventative care, diagnosis and treatment of oral problems. What results are pets that are not receiving thorough preventative care, and some have serious dental problems that go undiagnosed and/or are improperly treated.
For general information on performance of dental procedures on veterinary patients, please read the AVDC Position Statement on Veterinary Dental Healthcare Providers, which is available on the AVDC web site (www.AVDC.org). For information on effective oral hygiene products for dogs and cats, visit the Veterinary Oral Health Council web site (www.VOHC.org). or ask any of our trained and knowledgeable professionals at Aldie Vet.
We believe preventative medicine is the key to provide lifelong health through annual exams, immunizations, spaying and neutering, dental cleanings, as well as geriatric profile. We will provide you with recommendations and information needed so you may make educated decisions for the best care.
Adult Care – Your adult pets need to be examined at least annually in order to prevent/detect any medical issues. Pets age faster than we do and as a result, health problems can progress much more rapidly. Regular wellness exams will confirm that your pet is healthy or help catch problems before they can become more serious. During the annual veterinary visit, we will do a complete health consultation and physical exam. In addition, your pet may need blood work, vaccinations, and an intestinal parasite screening.
Vaccinations – Our goal is to provide the safest immunization schedule possible. Therefore, each vaccination schedule is tailored especially for your pet, based on the specific lifestyle and potential exposure to diseases.
Dental Care – Routine teeth cleanings and polishing is an important and necessary part of preventative medicine. Studies show that approximately 80% of dogs and cats over three years of age are affected by some type of dental disease. Left untreated, pet dental problems will result in discomfort, pain, and possible loss of teeth. Infected gums and tartar buildup play host to a large number of bacteria, which can find their way to other parts of your pet’s body, which can lead to major health problems. Signs your pet has dental disease include:
Missing or eroded teeth
Reluctant to play with toys or eat
A typical routine dental cleaning includes:
Complete blood work to ensure your pet can safely undergo anesthesia
Custom anesthesia plan (based on your pet’s age, risk factors, lab results, and level of dental disease)
Digital dental radiography & x-rays of the chest and abdomen (depending on your pet’s age)
Teeth cleaning & polishing utilizing our ultrasonic and air driven equipment
Full oral examination
Fluids administered to prevent dehydration
Continuous monitoring by our veterinary team after the procedure to ensure a pain-free, low-stress, safe recovery
A home dental care plan, including before and after pictures
Senior Care – As part of our preventative medicine, we recommend doing an annual geriatric profile on your pet. This profile includes blood work to look at organ function, as well as white and red blood cells. We also look at a urine sample to ensure the kidneys are functioning properly. We do recommend taking radiographs to ensure the heart, lungs, kidney, spleen, liver, as well as other internal organs, appear normal.
Puppy/Kitten Care – If you have recently adopted a puppy or kitten, you should visit Aldie Vet for a complete physical exam as soon as possible. Our goal is to screen your pet for any health problems, fleas, ticks and intestinal parasites, as well as discuss the nutritional needs that your puppy or kitten will need as they are in a high growth stage. This will help to ensure that your new family member is healthy and that disease is not transmitted to other pets in your home. Puppies and kittens are especially vulnerable to parasitic infections that can threaten their health. Proper screening and preventative products can help protect them against intestinal worms, fleas, and heartworm disease. Puppies and kittens also have immature immune systems which make it difficult to fight off disease. Therefore, if you notice any of the following, please give us a call immediately:
Many animal owners suffer from the problem of tartar buildup on their pet’s teeth. Some animals of the same species develop tartar much more quickly than others. This may mean that one dog needs a professional anesthetic dental cleaning every 2-3 years and another dog may need one every 6-8 months! Some animals develop periodontal disease at a faster rate than others as well, meaning that the gums pull away from the teeth that become loosened from their boney attachments. This can lead to pain, tooth loss, infection or abscess.
Unfortunately, I can find no hard evidence to validate the claim that eating cheese will help reduce tartar levels in the mouth. So my fondness for cheese has not kept the dentist at bay. There are, however, lots of things you as a pet owner can do at home to prolong the period of time before Fluffy needs to be fully sedated for thorough teeth cleaning.
To start lets review some terms and concepts. Plaque is a film of bacteria that accumulates on your teeth – which is the wooly feeling your teeth get after you’ve eaten a lot of sweets and haven’t brushed your teeth in a while. Gross right? Well if that bacteria isn’t removed it hardens (calcifies) and turns into tartar, which is the yellowish brown coating on your pet’s teeth that tips your veterinarian off that it is time for a cleaning. If left in place over time that tartar and bacteria party leads to bad breath, gum disease (gingivitis), tooth decay, periodontal disease, tooth root abscesses and the potential for that bacteria to get into the blood stream and cause problems in other organs like the heart, kidney, and liver. The hardened tartar is difficult to remove and often requires specialized equipment to scrape it off like dental picks and the ultrasonic scaler. We use the same equipment as your dentist to clean your pet’s teeth. Full anesthesia is required to complete a dental cleaning because once we clean off the tartar we polish the teeth smooth to remove tiny microscopic crevices for the plaque to grab a hold of. Pets do not tolerate having this done awake.
At home dental care is a huge part of prolonging the period between dental cleanings at the vet’s office. Often in older animals, we need to get the heavy tartar off to get a clean slate for you, the owner, to maintain. Young dogs should be introduced early to home dental hygiene to keep their teeth as healthy as possible and stave off the need for the full dental cleanings as long as possible. The plaque on teeth is very easily disrupted by mechanical action. This is best accomplished by a soft toothbrush and daily brushing of all teeth. Think about wooly teeth and how much fresher you feel after good teeth scrubbing. All dogs will eventually tolerate teeth brushing, but slowly introducing it over weeks in a very positive way is key to the fastest acceptance. Make sure to get primarily the outside of the teeth as that is where the majority of the plaque accumulates. Get all of the teeth from the little incisors up front, the long sharp canine teeth, to the all the premolars and molars that go way back in the cheeks. Repetition and patience, as with any training, is key to getting your pet’s acceptance.
Daily tooth brushing is the gold standard of home dental health. However, knowing that we don’t live in an ideal world where everyone brushes their dog’s and cat’s teeth nightly. Luckily, there are other products you can use to help. There are antiseptic rinses and gels and water additives the goal of these products is to reduce the amount of bacteria from your pet’s mouth. Safe chews, treats, and pet foods are available that contain both enzymes to break down bacteria and/or a mechanical action against the tooth as the pet chews to shear off plaque. Check out the Veterinary Oral Health Council’s (VOHC) seal of acceptance to find products proven to decrease plaque and tartar accumulation by going to www.VOHC.org and clicking on “Products awarded the VOHC Seal” link. Your veterinarian will also have a lot of good advice, ideas and references.
The American Veterinary Dental Council (AVDC) does not recommend cow hooves, dried natural bones or antlers, or hard nylon products because they are too hard. Instead of helping to shear off tartar like a wild animal would get from a fresh carcass, these products often damage the pet’s teeth. The result is often a fractured and very painful tooth that requires surgical removal. Rawhide and other “edible” dental product should be used with care. Give these products when you are around to ensure that a big piece isn’t swallowed or choked on. It may be necessary to remove a large chunk from an exuberant eater’s throat. It is also possible for large chunks to get stuck in dog’s esophagus or intestines that may require endoscopic or surgical removal, so make sure you pick a sized product appropriate for your pet. Reasons that you should have your pet evaluated by a veterinarian include: particularly foul breath, excessive drooling, swelling or oozing, pawing at or rubbing the face, difficulty eating, discolored, painful or broken teeth. Your vet is your ally and a great resource for your war on plaque and tartar. Pleasant teeth brushing! May yours and your pet’s smile be bright!