Friday, January 6, 2012

Anesthesia-free dentals: Not Recommended

Your pets' dental health is important not only for long-term comfort of the mouth. Dental disease can also affect other areas of the body as well.  Heart disease has long been linked to poor dental health in pets.  This occurs because when a pets teeth become severely diseased, every time the pet chews or eats, the overgrowth of bacteria in the mouth gain entry to the bloodstream.  This is because a diseased mouth has unhealthy gums that lack the normal barriers for bacteria.  Every chew and bite cause a bacterial "shower" to enter the bloodstream.  From there, the bacteria must be eliminated by the immune system, but the rogue bacteria can gain entry to places in the body such as the lining of the heart or heart valves.  Regular brushing can help prolong the length of time between a full periodontal treatment, but in most cases, it will not eliminate the need for periodontal treatments in a pets life.

Good kitty!

A trend for Anesthesia-free pet dental cleanings (AFD) is sweeping across the nation.  This trend arose out of a desire for a "safer" alternative for current dental treatments that require general anesthesia, since anesthesia is often the most risky aspect of any procedure.  Problems arise, however, as owners perceive the quality of an anesthesia-free dental to be equal to that of a full anesthetic periodontal treatment.  This is simply not the case.

Anesthesia-free dentals (AFD) use sedatives instead of general anesthesia to relax the patient without completely putting them under.  The portion of the tooth that can be seen by a pet owner is cleaned, scaled and polished and the pet is sent home with a visually attractive set of teeth.  Oftentimes, if a pet cannot be effectively controlled with sedatives, either extra sedatives are used or "bruticaine" is enforced--physical restraint in order to control the patient long enough to clean the surface of the teeth.  Please note that the only portion of the tooth is the tooth seen above the gum line, and most frequently, only the outside of the tooth that the owner can see is cleaned.  Sub-gingival (or portions of the tooth that lie below the gum line) are completely neglected and set the pet up for having severe dental disease that is completely hidden from the owner.  Proper cleaning of the teeth involves the use of very sharp instruments--patients who are not anesthetized are still able to move freely and can react to the discomfort created by these instruments and can be severely hurt.  Other essential tools like dental probes are not used in these cosmetic procedures, and using probes to check for hidden pockets of infection and disease in healthy-appearing teeth is important for long-term pet health.

There is another type of dental cleaning that is frequently performed by groomers is a quick surface scaling of tartar.  We frequently see pets that have had this procedure performed, and owners; often have a misunderstanding about the difference between this quick, cosmetic cleaning and a deep periodontal treatment.  This quick scaling is often done by untrained staff, and the scratches and defects it creates in the teeth can set the pet up for a faster and more serious accumulation of tartar in the future.  A proper scaling is always followed by polishing to eliminate this risk.

A pet before and after a proper periodontal treatment.  You can see the airway tube inside the pets mouth.

A true periodontal treatment performed by your veterinarian not only cleans the visible surfaces of the teeth, but involves probing the sub-gingival parts of the teeth for hidden dental disease.  Although anesthesia is always a risk with any procedure, pet anesthetic protocols are much safer than they used to be.  Pre-anesthetic bloodwork can ensure there is no hidden diseases of the pet to minimize complications.  All vitals are monitored while your pet is anesthetized, including blood pressure, oxygenation, EKG, heart rate and respiration rate.  A dedicated pet nurse is assigned to your pet and will record all parameters for the entire length of your pets anesthetic procedure.  An intravenous catheter is placed and fluids administered, ensuring consistent blood pressures and easy access should an emergency occur.  Passing a tube to protect the airway not only guarantees a safer way of anesthesia for your pet, but also ensures the plaque removed from the teeth is not inhaled by your pet.  The teeth are thoroughly scaled using an ultrasonic scaler followed by a detailed and thorough oral inspection by your veterinarian.  At that time, the decision is made using a dental probe and x-rays whether all the teeth are healthy or not.  Once the teeth have been pronounced healthy, all four surfaces of every tooth are polished using a high speed polishing head.  A fluoride treatment is then applied to your pets teeth to help seal and protect the teeth between treatments.  If your pet has extensive work or extractions, they are sent home with pain medications to ensure their comfort.

Although anesthesia-free dental cleanings seem like a safer, more affordable route to take with your pets' dental care, in the long-run they can thoroughly compromise oral health.

Written by Dr. Elly Burnett