fractured carnassial tooth

Anaesthetic Free Dentistry

Anaesthesia free dentistry for dogs and cats is now available in most major cities in Australia, including Adelaide.

I’ll be frank. Vets are horrified by this. I want you to know enough about dental hygienic procedures so that you can see what it is that scares us.

First though, I need to talk about the reasons why this service exists in the first place. Vets, myself included, aren’t doing a good enough job in three key areas:

  • Explaining the importance of dentistry
  • Overcoming fear of anaesthesia
  • Cost

The importance of dentistry is easy for vets to see, and also easy for pet owners to see after major dentistry. However, it’s very hard to explain why a preventative clean (which is much cheaper and less painful) will stop us having extractions and a painful mouth later. Prevention just isn’t sexy.

Fear of anaesthesia is widespread and understandable. I’ve written about how vets monitor anaesthetics before, but let me add two things:

  1. Like at most vets, no pet at Walkerville Vet has ever died during or after a dental procedure. That’s despite the fact that dental patients are older than average and often have heart or kidney problems.
  2. It’s probably more dangerous going for a walk

Cost is a tough one. It’s true that good dentistry is expensive but there may be ways to reduce the cost. You can discuss with your vet whether it’s safe for your pet to opt out of intravenous fluids, X-rays and blood testing. Feel free to discuss with your vet ways to spread or reduce the cost; we really don’t mind.

Current costs of anaesthetic free dentistry in Adelaide are actually higher than many vets currently charge.

What’s Wrong With Anaesthetic Free Dentistry?

Stress, Anxiety and Fear

Try this next time you’re at the dentist.

You’re simultaneously try to keep your mouth open, tolerate the scraping and probing and avoid swallowing the foul stuff in your mouth. Your civilised and educated self is firmly telling your primitive mind to stay still and not worry, but it’s not buying that story.

As you lie back gripping onto the chair like it’s a lifeboat, think about your dog or cat.

The practitioners of non-anaesthetic dentistry claim that their procedure is gentle and stress-free. I really want to know how they can tell.

Seriously, I have tried a number of times to do dentals without anaesthetics. Each time the dog was calm, fearless and only had tartar on the very front teeth. I always used an experienced nurse. Each time I had to give up due to the stress I was causing and the substandard job that resulted.

Will pets become ‘head-shy’ or aversive to handling around the face? That will make future assessment very difficult

cosmetic teeth cleanIncomplete Cleaning

In my opinion the only way to make the procedure stress-free is to not do a complete job. Have a look at the earlier video of a standard dental procedure and ask yourself: is it really possible to scale these areas in a conscious animal?

Then have a look at the picture from a Melbourne service. I’m hoping it’s just not a very flattering photo but I can’t easily imagine what else that brown area could be.

The most important area to clean is where the gum attaches to the tooth. This is where the active gum recession and infection occurs, and how teeth are lost. This is also the hardest area to clean, especially if there are already gingival pockets (see picture below). It hurts.

Tartar sitting exposed on a crown is just a cosmetic issue by comparison. This might be why anaesthetic free pet dentals are often advertised as ‘cosmetic’ or ‘hygienic’. Remember that bad breath should completely disappear after dentistry.

gingival sulcus depth

1 Total loss of attachment
2 Gingival recession 3 Probing depth
By Lesion (Own work) [CC BY-SA 3.0], via Wikimedia Commons

Failure To Remove Bad Teeth

The video also shows a common trap: the pulp exposure. This tooth required a complex extraction involving a nerve block and stitches but the dog is already more comfortable. Leaving bad teeth in the jaw causes chronic pain, and infection which can spread elsewhere.

The anaesthetic free dentistry people state that they send dogs and cats needing extractions to vets, but I have to ask: how do they know?

I usually don’t know whether a tooth needs removal until I’ve probed the periodontal pockets and looked for pulp exposure. If they can do this conscious they are better than me.

This is one of the reasons dentistry gives vets a bad name- the dreaded phone call when we say the job we thought was a routine clean is now including extractions. Sorry- we really hate extracting teeth too.

The Five Stages Of Dental Grief

  • Denial – “They aren’t infected roots and a cavity, I’m imagining it.”
  • Anger – “This was supposed to be a routine scale and polish, it’s just not fair!”
  • Bargaining – “Maybe If I just take out these really loose teeth, the others won’t seem so bad.”
  • Depression – “This isn’t why I became a vet; why can’t I just see puppies all day?”
  • Acceptance – “There goes lunch: may as well stop grumbling and get on with it.”

 

Infection Control

Will procedures be infection-free between patients? I read a few websites and noticed a few didn’t seem to understand the difference between disinfection and sterilisation.

It’s essential that strict hygiene is monitored for every patient.

The Challenge

To finish I want to put out three challenges: to vets, pet owners and anyone cleaning teeth without anaesthetics.

Challenge 1: To vets. Let’s allow pet owners to watch our dentistry. I’ve done it twice (both times they were dentists who were interested) and it wasn’t too distracting.

Challenge 2: To pet owners. Has your pet had a dental clean without anaesthetic within the past month? Would you like to be sure? I will offer your pet a free examination with or without anaesthetic as long as you let me record the procedure. You can stay and watch the whole thing.

Challenge 3: To anyone cleaning teeth without anaesthetics. If you truly believe what you do isn’t stressful, then let the owners stay and watch. Go on pet owners!- ask them and see what they say.

Related: Keeping Dogs Teeth Clean | Dental Diets For Cats | All About Veterinary Dentistry

Have something to add? Comments are welcome (if not of an abusive or personal nature) and will appear within 24 hours of lodging.
Have something to add? Comments are welcome below and will appear within 24 hours of lodging.


By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These blogs are from a series regularly posted on Facebook and Twitter. Like or follow our page or subscribe via email to read the latest.

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2 replies
  1. Dr Belinda Parsons says:

    Love the 5 stages of dental grief. I can totally relate. Well written and I too am concerned by the development of anaesthesia free dentistry. Purely cosmetic and of no real benefit to the pet. As you state it can actually harm them emotionally. Thanks for another great blog

    Reply

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