Most of us don’t get overly excited about visiting the dentist for exams and teeth cleanings. According to WebMD, up to 20 percent of Americans say they avoid going to the dentist because of anxiety or fear. If it’s that stressful for people, what must it be like for our furry friends?
Options for dental cleanings for pets, commonly known as nonanesthetic dentals (NADs), are available, but are they the best choice for our pets’ dental care? In many states, NADs are often offered by groomers or individuals in pet food stores who may have very little, if any, training. In other states, though, these services are illegal if provided by anyone other than a veterinarian or supervised and trained veterinary technician. But even when administered by trained staff, is NAD the best option for good dental care for our pets?
Providing the highest level of care for companion animals is what the American Animal Hospital Association (AAHA), the AAHA Standards of Accreditation, and AAHA-accredited practices strive to achieve every day. The 2013 AAHA Dental Guidelines for Dogs and Cats state that general anesthesia with intubation is necessary to properly assess and treat companion animal dental patients.
Dr. Sarah Bashaw, with AAHA-accredited El Dorado Animal Hospital in Fountain Hills, Ariz., says, “NADs are cosmetic procedures that only address what we can see.” She believes that NAD treatments are giving pet owners a false sense of security because they are often promoted as equal to the thorough and deep dental care that can be accomplished with pets under anesthesia.
The American Veterinary Dental College notes that because humans cooperate during dental cleanings these procedures can be completed successfully without anesthesia. But access to the subgingival area of every tooth is impossible in an unanesthetized dog or cat. Removal of dental tartar on the visible surfaces of a pet’s teeth has little effect on their health and provides a false sense of accomplishment because the effect is purely cosmetic.
Dr. Bashaw recently treated a seven-year-old terrier mix dog who had been receiving yearly NAD treatments for most of his life. She says, “The owners thought they were doing the right thing for him, avoiding anesthesia and getting the teeth cleaned. They thought they were getting the same kind of treatment we do with anesthesia.”
Once the dog was under general anesthesia, Dr. Bashaw was able to identify some of her patient’s problems by thoroughly probing around the teeth and gums, something she would not have been able to do if he hadn’t been under anesthesia. “He had significant bone loss at the lower first molars due to disease at the second molar. And, this might have been missed if I hadn’t taken radiographs [X-rays]. Radiographs are an absolute necessity, and dental procedures cannot be performed adequately and thoroughly without them. I take full-mouth radiographs on every patient every time they are under anesthesia,” says Bashaw.
During the dental procedure, she identified additional problems, including crowding of his upper premolars, gum recession, and exposed roots on many teeth. This thorough dental examination, performed under anesthesia, helped her check for additional problems, like broken or abscessed teeth, oral tumors, and any other oral problems that could be causing pain. Because our pets can’t tell us when they’re in pain, these problems may remain undetected for years.
Ultimately, Dr. Bashaw’s patient needed 12 extractions. “He had gum disease throughout his mouth. He also had an underbite and his upper incisors were causing trauma to the lower tissues, and the upper incisors had significant periodontal disease. He had no broken teeth, but he was missing five teeth, and these conditions had to be painful.”
This is an unfortunate situation for pet owners who thought they were making the best choice and choosing the best care for their dog. Bashaw says, “I have treated almost a dozen patients who have been receiving NAD treatments, and all of them have required multiple extractions.”
The American Veterinary Dental College advises against anesthesia-free dental cleanings and believes that performing dental treatments on an unanesthetized pet is inappropriate for the following reasons:
- Dental tartar is firmly adhered to the surface of the teeth. Scaling to remove tartar is accomplished using ultrasonic and sonic power scalers, plus hand instruments that must have a sharp working edge to be used effectively. Even slight head movement by the patient could result in injury to the oral tissues of the patient, and the operator may be bitten when the patient reacts.
- Professional dental scaling includes scaling the surfaces of the teeth, both above and below the gingival margin (gum line), followed by dental polishing. The most critical part of a dental scaling procedure is scaling the tooth surfaces that are within the gingival pocket (the subgingival space between the gum and the root), where periodontal disease is active.
- Inhalation anesthesia using a cuffed endotracheal tube provides three important advantages: the cooperation of the patient with a procedure it does not understand, elimination of pain resulting from examination and treatment of affected dental tissues during the procedure, and protection of the airway and lungs from accidental aspiration.
- A complete oral examination, which is an important part of a professional dental scaling procedure, is not possible in an unanesthetized patient. The surfaces of the teeth facing the tongue cannot be examined, and areas of disease and discomfort are likely to be missed.
For many of us, our pets are part of the family. We feed them high-quality foods, give them toys, make sure they have a comfortable bed (or many of them sleep on our beds with us), and we make sure to take them to see the veterinarian at least once a year for preventive check-ups. Providing them with the best care is what we strive to do. So, when you are considering the best option for dental care for your pet, consider what the experts in the field of veterinary dentistry, the American Veterinary Dental College, and the guidelines from the American Animal Hospital Association recommend. The best dental care for pets is performed by licensed veterinarians and/or supervised and trained veterinary technicians, who perform these procedures on pets that are intubated and under general anesthesia.
Read more about dental care in the below articles:
Anesthesia-free dental cleaning
AAHA standards: Anesthesia and intubation for dental procedures
The only thing to fear is the fear of anesthesia
Ask a vet: Why are cats anesthetized for routine dental work?
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