Why Anesthesia-Free Dental Care is Wrong, Cruel, and Medically Inappropriate
Posted: 2012-02-06In Canada (and the United States), only licensed veterinarians can practice veterinary medicine. Veterinary medicine includes veterinary surgery, medicine and dentistry. Anyone providing dental services other than a licensed veterinarian, or a supervised and trained veterinary technician, is illegally practicing veterinary medicine without a license and shall be subject to criminal charges.
We are seeing an increase in “Anesthesia-Free Dentistry”, or more accurately “Non-Professional Dental Scaling” (NPDS), at pet stores, grooming facilities, and more. The following is a concise, clear cut explanation on why NPDS should be avoided at all costs, written by Dr. Fraser Hale – a local board certified veterinary dentist:
- 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. Because the patient cooperates, dental scaling of human teeth performed by a professional trained in the procedures can be completed successfully without anesthesia. However, access to the subgingival area of every tooth is impossible in an unanesthetized canine or feline patient. Removal of dental tartar on the visible surfaces of the teeth has little effect on a pet’s health, and provides a false sense of accomplishment. The effect is purely cosmetic.
- 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. (As in human dentistry, water is often required for the rinsing of tissues. This water, along with dangerous pieces of removed calculus can be accidentally inhaled (aspirated) into the airway in an awake patient, which can cause massive inflammation and infection of the lungs and associated tissues). - 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.
At our hospital, a procedure requiring general anesthesia begins with a thorough examination by the veterinarian. Pre-anesthetic blood testing is performed for an overall impression of organ health, including the liver and kidneys, important in the metabolism of anesthetic drugs. An anesthetic plan is than carefully tailored to each patient, ensuring the absence of the sensation of pain, stress and anxiety, and a quick and uneventful recovery for the patient. A technician is present at all times, carefully monitoring the patient and anesthetic depth both with technology (the many monitors that we have here on site – see our Anesthesia and Patient Monitoring Page for more details) and with their hands and ears, frequently listening to the heart and lungs, assessing the pulses, gum colour, and more. This results in a safe, uneventful procedure that results in the improvement of the health of your pet, with no undue harm. As Dr. Fraser so rightfully states, NPDS = Fraud + Theft + Malpractice+ Animal abuse + Rotten PR. To quote him further:
Regardless of who provides the NPDS, it is wrong. It is wrong for a groomer to do it. It is wrong for a breeder to do it. It is wrong for an owner to do it on their own pets (even if they are a registered dental hygienist – they should know better). It is very very wrong for any employee of a veterinary facility to offer this service and it is even more wrong to accept payment for such harmful treatment. When offered within the context of a veterinary facility, even if it is at the grooming centre next door, the client has a right to assume that the treatment is safe and medically beneficial. Since NPDS is neither, it is wholly inappropriate to offer it.
This blog entry was written by Westbridge Veterinary Hospital, an animal clinic in Mississauga dedicated to providing high quality, modern veterinary care to our beloved pets and their families.
The Why's and What's of Dental X-ray
Posted: 2012-01-16
Studies have shown that without dental radiographs, significant pathology and disease is missed in up to 75% of pets. Westbridge Veterinary Hospital has therefore invested in a high resolution digital dental radiograph system, and includes full mouth x-rays on every patient undergoing complete oral health exams. The purpose of this entry is to explain and outline the necessity of dental radiographs in our veterinary patients.
If a pet has succumb to an injury, for example being hit by a car, basic diagnostics are required to ensure that any ailments are detected, and treated appropriated. For example, if they are limping afterwards, an x-ray is necessary to develop a treatment plan (e.g. is there a fracture?). When a pet presents with inappetence and vomiting for an extended period of time, diagnostics such as blood testing are necessary to determine the problem, and therefore develop a treatment plan. Do you see where this is going?
Well over 2/3 or 66% of a tooth in our canine and feline patient resides underneath the gum line. This includes the majority of the important structures of a tooth. With this in mind, the reasoning for dental x-rays can be put quite simply – it is the ONLY way to examine the entire tooth and all of its inner structures. To demonstrate this thought, a 1998 study (Verstraete et al. Am J Vet Res 1998 59: 692-5), in animals with abnormal findings on oral examination, full mouth radiographs showed other undetected pathology or disease in over 50% of cases. Further, in those with no clinical findings on exam, radiographs showed clinically important pathology in 27.8% of dogs and 41.7% of cats. If you would like more information on dental radiography including many real case examples of their importance, please visit our dental x-ray page on our website.
This blog entry was written by Westbridge Veterinary Hospital, an animal clinic in Mississauga dedicated to providing high quality, modern veterinary care to our beloved pets and their families.
Cats Are a Unique Species, with Unique Dental Disease
Posted: 2012-01-09
Cats have an oral disease process that is very specific to their species, called feline odontoclastic resorptive lesions. That’s a mouthful! When visible to the naked eye, they appear as erosions on the surface of a tooth, often associated with gingivitis (red, inflamed gums) in the progressive stages. There are no specific causes that have been clearly identified, though recent research suggests that prolonged inflammation (from dental plaque and bacteria) and excessive amounts of vitamin D may play a part.
They are extremely painful and unfortunately extremely common, with over 30% of cats developing them in their lifetime. The premolars and molars are the most likely teeth to be affected, but they can also be found on the canines (‘fangs’) and incisors (the tiny teeth at the front of a cat’s mouth). These defects are often covered with calculus (tartar) and may not be noticed until the calculus is removed. The lesions may also be covered by hyperplastic gingiva (excessive gum growth due to inflammation) and filled with granulation tissue. Cats with these lesions are often, but not always, reluctant to eat hard food due to the pain involved. Others will swallow kibble whole without chewing or direct kibble to non-painful parts of the mouth. These lesions can so painful that even when the cat is under anesthesia, the cat’s jaw will twitch when the lesions are touched! Affected cats are typically middle-aged, but they have been seen in cats as young as 2 years of age. Purebred cats are the most susceptible, with the Persian and Siamese having the highest incidence.
The only treatment is complete extraction of the tooth and associated tissues, and often they are only identified by dental x-rays, as their development and origin begins underneath the gum-line.
This blog entry was written by Westbridge Veterinary Hospital, an animal clinic in Mississauga dedicated to providing high quality, modern veterinary care to our beloved pets and their families.
