By Dr. Becker
If your vet clinic currently offers anesthesia-free dentistry and is also accredited by the American Animal Hospital Association (AAHA), it won’t be offering the service much longer.
Effective November 1, all AAHA-accredited veterinary practices will require patients to be anesthetized and intubated for dental procedures, including cleanings. According to the AAHA, the 2013 AAHA Dental Care Guidelines for Dogs and Cats is what prompted the mandate. The report’s authors determined that cleaning a pet’s teeth without general anesthesia and intubation falls below the standard of care and is therefore an unacceptable practice.
From the guidelines:1
"General anesthesia with intubation is necessary to properly assess and treat the companion animal dental patient. It is essential that aspiration of water and debris by the patient is prevented through endotracheal intubation. Cleaning a companion animal’s teeth without general anesthesia is considered unacceptable and below the standard of care. Techniques such as necessary immobilization without discomfort, periodontal probing, intraoral radiology, and the removal of plaque and tartar above and below the gum line that ensure patient health and safety cannot be achieved without general anesthesia."
Why Nonprofessional Dental Scaling Isn’t Ideal for Most Pets
Anesthesia-free dentistry is essentially a cosmetic procedure that doesn’t address gum problems or other oral diseases. It doesn’t give the practitioner the opportunity to probe the gums for periodontal pockets or for bone destruction resulting from gum disease.
If you’ve had NPDS performed on your pet, her teeth probably looked clean and fresh following the procedure. But that’s the part of the teeth you can see, and unfortunately, it’s what you can’t see that’s more important to her health.
Scraping and polishing the visible surface of the teeth doesn’t address tartar buildup below the gum line or gingivitis. And the fact is most dental disease first takes hold below the visible surfaces of your pet’s mouth. By the time you can actually see a problem in there, it’s typically well advanced.
Benefits of General Anesthesia with Intubation for Dental Patients
Anesthetizing a cat or dog prior to a dental procedure offers a number of benefits, including:
- Immobilizes the animal to insure his safety and cooperation during a confusing, stressful procedure.
- Provides for effective pain management during the procedure.
- Allows for a careful and complete examination of all surfaces inside the oral cavity, as well as the taking of x-rays.
- Permits the veterinarian to probe and scale as deeply as necessary below the gum line where 60 percent or more of plaque and tartar accumulates.
Intubation while the patient is under general anesthesia protects the trachea and prevents aspiration of water and oral debris.
For Pet Owners Who Are Apprehensive About General Anesthesia
If you’re nervous about anesthesia for your cat or dog – and most people are, especially those with older pets – you should know that it’s actually quite safe when performed according to current standards.
The reason senior pets are handled more cautiously for anesthesia is because they are more likely to have a systemic illness. That's why additional tests are run on older pets prior to scheduling procedures requiring anesthesia. These tests usually include a complete blood panel, urinalysis, chest x-rays and a BNP test which checks for certain forms of heart disease.
If your pet's test results show no problems with her general health, there is no increased risk for anesthesia. And even if there are some borderline numbers in an animal's test results, we must weigh the benefits of creating and maintaining good oral health against the potential risks associated with anesthesia.
A well-trained, skilled and experienced veterinary staff, following the most current standards of practice, can safely anesthetize senior and geriatric pets, as well as pets with significant systemic disease. By using the latest anesthetic monitoring equipment, pets can benefit from the same diagnostics as people undergoing anesthesia. Make sure to check with your vet about how anesthetic monitoring is performed during your pet's procedure and recovery period.
Is There Ever a Good Reason to Clean a Pet’s Teeth Without Anesthesia?
In my practice, I occasionally remove plaque and tartar from a pet’s teeth without using anesthesia. I only do this on pets for which I have a dental history, and I don’t do it in lieu of a thorough dental exam. But if, for example, I have a patient with a large chunk of tartar causing irritation in his mouth, I’ll remove it without anesthesia if I can do it easily and without stressing the patient.
Tips for At-Home Oral Care for Your Pet
- Learn how to brush your pet's teeth and do it consistently (daily if your pet is older or at least several times a week for younger pets).
- Feed a balanced, species-appropriate raw diet. As your pet chews the bones in her raw food, they help to scrape away tartar and plaque on her teeth. The cartilage, ligaments and tendons in the raw meat act as a natural dental floss.
- If your pet is a dog, offer an all-natural, fully digestible, high-quality dental chew bone.