Is Anesthesia-Free Teeth Cleaning Good for Your Dog?



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Adrienne is a certified dog trainer, behavior consultant, former veterinarian assistant, and author of "Brain Training for Dogs."

Anesthesia-Free Dental Cleaning: Good or Bad?

Considering anesthesia-free dental cleaning for your dog? If so, chances are that you just came home from seeing your vet, and after he took a peek at your dog's teeth, he suggested a dental cleaning. You are probably wondering if there are any alternatives to consider. Whether you got sticker shock from the estimate your vet gave you or you don't feel like putting your dog under anesthesia, you may be on the lookout for alternative dental cleaning options.

Making an Informed Decision

One popular option seen a lot lately is anesthesia-free dental cleanings. This may sound like a cost-effective solution, and from reading the reviews and information provided on websites a marvelous one, too, but there are always two sides to the story. This article will reveal what vets have to say about these cleanings and what can be done to ensure your dog's safety.

Video: Is Anesthesia-Free Dental Cleaning on Dogs Legal?

What Is Anesthesia-Free Dental Cleaning?

First and foremost, what are anesthesia-free dental cleanings and how do they work? As the name implies, these are dental cleanings that do not use anesthesia. The idea seems promising: Your dog gets his teeth cleaned at a fraction of the cost, and you have no need to worry about your dog going under. Your dog then goes home with beautiful white teeth, and you feel much better now that you have finally taken care of the problem.

Is It Too Good to Be True?

Many people are intrigued by the idea and lured by the before and after pictures provided by those who offer these services. In one picture, you see yellow-brown teeth full of tartar, and in the next, you see pearly whites attained just minutes after going into a facility that provides such services. It truly seems magical.

What You Are Not Told

As promising and alluring as anesthesia-free dental cleaning may appear, there are some things that you may not have been told about that you really need to be aware of before using these services. Knowledge is power when it comes to dealing with your dog's precious teeth and making important health decisions. This article is meant to be an eye-opener for what anesthesia-free dental cleanings for dogs actually entails.

Anyone providing dental services other than a licensed veterinarian, or a supervised and trained veterinary technician, is practicing veterinary medicine without a license and is subject to criminal charges.

— American Veterinary Dental College

Why Veterinary Professionals Oppose These Procedures

We refer to dental cleanings performed when the dog is wide awake as anesthesia-free dental cleanings, but the American Veterinary Dental College refers to them as "non-professional dental cleanings." Why?

When conducted independently by non-veterinarians and outside of a veterinary hospital, these services are unprofessional. Veterinary medicine is conducted by licensed veterinarians who legally perform surgery, prescribe medicine, diagnose, and offer dentistry services. According to the American Veterinary Dental College:

"Anyone providing dental services other than a licensed veterinarian, or a supervised and trained veterinary technician, is practicing veterinary medicine without a license and is subject to criminal charges."

However, this practice becomes acceptable if a dental cleaning is done by a veterinary technician or veterinary assistant when working under the direct supervision of a veterinarian.

The American Animal Hospital Association (AAHA) is so deeply convinced that non-professional dental cleanings pose no benefit to pets, that it has made it mandatory that all its affiliated hospitals must perform dental procedures with anesthesia or else they risk losing their certification.

Many people are not surprised that veterinarians and veterinary associations would frown upon these cleanings because they take away business from them, but before making such assumptions, it's important to see why so-called non-professional dental cleanings may cause more harm than good.

6 Reasons Not to Do Anesthesia-Free Dental Cleanings

1. There Is a Risk for Aspiration Pneumonia

Anesthesia and required intubation of the airway actually protects your dog from inhaling dangerous aerosolized calculus, blood, plaque, and oral bacteria. Dogs that are not intubated and anesthetized are actively breathing in bacteria, which can lead to aspiration pneumonia.

Before and after a dental cleaning and polishing, vets will perform an antiseptic flush to rid the mouth of bacteria, according to Parkway Animal Hospital, and the insertion of an endotracheal tube during anesthesia prevents the accidental aspiration of debris. Companies performing dental cleanings with no anesthesia only use tissues to wipe off debris as it accumulates. Their rationale is that since the dog is awake, his gag reflex will prevent accidental aspiration, which is true to a good extent, but accidents can always happen, so this remains a possibility.

2. It's Hard to Reach Certain Areas

Generally, the outer sides of the dog's teeth are the ones most heavily encrusted with tartar, and thankfully, these are also the easiest to reach. These areas are generally worse because saliva is less likely to flow here and the tongue doesn't come in contact with these sides of the teeth. However, surfaces of the teeth facing the tongue are also important to clean and these areas are challenging, if not almost impossible to clean on a fully conscious dog.

Also, in order to perform sufficient under-the-gum cleaning, you will need a dog that stays still, even if things get uncomfortable or painful. Under-the-gum cleaning is the most important part of dental care since periodontal disease thrives underneath the gums. In humans, cleaning under the gums is easily accomplished because we know what is going on and we are aware of the benefits. Despite this, consider that many humans find the procedure hard to tolerate and even painful!

3. Ideal Dental Tools Cannot Be Used

When a dog is put under anesthesia, the noisy ultrasonic scaler and the polisher can be used to effectively clean and polish teeth. An awake dog will be very reluctant to allow noisy, scary tools in his mouth. Hand-held scalers must be used on awake patients, but in order to work, they must have a sharp working edge. Any movement from a non-collaborative canine can potentially cause injury. Polishing the teeth after tartar is removed is important as the smoother surfaces will help prevent the adherence of more plaque and tartar.

4. A Thorough Evaluation Cannot Be Done

When a dog goes under anesthesia, his teeth can be evaluated carefully with a probe to measure pockets in the gum line and necessary x-rays can be taken to evaluate what cannot be seen by the naked eye (under the gum line). If anything is discovered during this time, it can be taken care of since the dog is anesthetized. Veterinarian and dental specialist, Brett Beckman, claims "Without radiographs, the cleaning is cosmetic only."

5. Preventive Care Isn't Initiated

In some cases, dogs may need antibiotics before having a dental cleaning. This is more often seen when dogs have advanced dental disease with bleeding gums and a high number of bacteria in the mouth, or in dogs with underlying health conditions that predispose them to a high risk of complications from dental procedures.

According to the American Veterinary Dental College, dogs considered high risk are those who are immune-compromised, have underlying cardiac, hepatic, and renal disease, and dogs with severe oral infections. During a dental cleaning, bacteria risks entering the bloodstream when the gums bleed, and once there, it can affect the dog's heart valves, kidneys, and liver, and cause serious infections.

6. Owners Get a False Sense of Security

One of the worst aspects of anesthesia-free dental cleanings is that it gives dog owners a false sense of security. They bring a dog with yellow-brown teeth to the office and pick up a dog with white teeth. Yet, they fail to understand that yes, the teeth look good, but they're only looking at the tip of the iceberg as 60% of the remaining teeth are located under the gum line in those hard-to-reach areas.

Within the pockets underneath the gum lines, debris will still accumulate, the bad breath will soon make a come-back, and the pet will suffer, explains Jan Bellows, a veterinarian and specialist in veterinary dentistry. This is a disservice to patients and to their owners.

Video: Why Avoid Pet Dentistry Without Anesthesia

Are Anesthesia-Free Dental Cleanings Truly Bad for Dogs?

Now that you have seen different opinions on the topic, you may think anesthesia-free dental cleanings are very bad, but there are also some cases where they may provide some benefit. As with most controversial issues, there is always two sides to the same story.

One good thing about anesthesia-free cleanings is that more and more veterinarians are offering them in their clinics. This means that even if the dental cleaning is done by a veterinary technician or veterinary assistant, they're working under the direct supervision of a licensed veterinarian who may monitor and intervene as necessary.

Anesthesia-Free Services Offered by Veterinary Professionals

Pet Dental Services is a popular option that is growing steadily. Their services are not intended to substitute for the deep cleaning, extractions, and radiographs done under anesthesia, but they can be helpful as a maintenance program after the dog undergoes a traditional cleaning under anesthesia. Their website also claims that services may be rendered in some cases for high-risk anesthesia cases such as old dogs or dogs with chronic kidney, liver, or heart disease. These cleanings, of course, are not appropriate for dogs suffering from severe gingivitis, abscesses, caries, or loose and fractured teeth.

There was also a study conducted on the efficacy of anesthesia-free dental cleanings. The study refers to such cleanings as "Professional Outpatient Preventive Dentistry" (POPD). In this study, the technician was able to perform scaling both over and under the gums thoroughly and safely on 12 dogs and 12 cats. The study details that though such cleanings are not intended to be a substitute for anesthetic dentistry, they may be a valuable supplemental treatment.

Video: Non-Anesthetic Dental Procedure Done in a Vet's Office

An Informed Decision Is the Best Decision

As seen, there are several risks associated with anesthesia-free dental cleanings. One of the biggest is undetected periodontal disease after years of anesthesia-free pet dentals.

So as seen, there are risks to be aware of, and dog owners should absolutely avoid dental cleanings performed out of the veterinary office by non-professionals. Research is a must for the safety of our pets.

The Importance of Brushing Your Dog's Teeth Every Day

For Further Reading

  • The Best Bones for Cleaning Dog's Teeth
    What dental bones are best for your dog? Your dog's teeth need the right types of bones to keep them in good shape and prevent the harmful accumulation of plaque. Let's see what vets recommend.
  • Understanding Puppy Teeth Stages
    Confused by the puppy teeth stages? No need to be! This guide will reveal the whole process clearly and will provide some interesting, little-known facts about your pup's teeth.

© 2014 Adrienne Farricelli

Rachel on August 03, 2020:

I have had all my 10 dogs have holistic dental work done with nothing but great results. There is always a risk with anesthesia. My doggies were all happy and healthy and all lived to be over 14 years old and kept their teeth until they passed away never had a problem with dental issues. I did have them cleaned every 6 months and not over a year. Thank you for making a way for us not to put our pets at risk by having to put them under.

Adrienne Farricelli (author) on October 26, 2019:

Funkymut, in order to understand why non-anesthesia dental cleanings in dogs aren't effective, it takes learning more how plaque and tartar works (the video above explains that clearly).

A thorough dental cleaning requires going under the gum line which is something that requires a dog to be very still as it can be uncomfortable.

This usually can't be done in an awake dog for safety of the dog and dental cleaning staff, and to prevent a dog from enduring in an unpleasant procedure which will make the dog likely reluctant in having his mouth touched in the future. On top of that, it would be difficult to reach the back molar teeth which in dogs are very deep.

Vets who miss huge chunks of tartar are doing something very wrong. I am not sure which vets do this, but a vet doing that is certainly one I would run away from. My dogs had their teeth cleaned a few times (we religiously brushed their teeth every day) and they were perfect and polished.

Funkymut on October 24, 2019:

The writer is a Vet Tech so of course is not going to be bias in her opinion. Non-anesthesia is an alternative to many who otherwise would not have anything done at all. it might be the fear of anesthesia or the high cost. Certainly Vets will also be bias because it threatens them. I have seen first hand dogs that had vets do their cleanings and miss huge chunks of plaque and tartar! The poster below had her dog's teeth done at, "age of 2 or 3" and then states fallowing that at age 8 that 15 teeth were extracted! Well what happened in those 5-6 years? She states she had 3 other teeth cleanings done "by the vet", well if that is true then why didn't the vet eradicate the periodontal disease going under the gumline or noticing it sooner? I believe the issue is with the poster's vet and 3 the poster doing only cleanings in 6 years is not enough, but had it been if she went more often this all could have been avoided. Periodontal disease does not happen overnight and a quick look in your "baby-dog's" mouth would have been an indication. It must have smelled and looked like the bottom of a sewage tank for 15 plus 16 teeth to be pulled. Stop it and take ownership for your own

neglect.

CS18 on May 16, 2018:

PLEASE, PLEASE DO NO do anesthesia free cleaning. I had my dogs teeth done at a local pet shop when she was about 2-3. Just yesterday my dog had 15!!!!!!!!!!!!!!!! teeth taken out from periodontal disease at the age of 8. (5/15/18) She had 16 teeth taken out in two previous under-anesthesia teeth cleanings with vets since 2016. I have brushed her teeth all her life, given her good food, and had 3 teeth cleanings now with vets. There is no explanation from them BUT I think it is from having this non-anesthesia, teeth scraping which CAUSED my baby-dog to now only have 10 teeth let at the young age of 8. DO NOT DO THIS. RUN. SAVE YOUR DOG!

If you get full work-ups of blood work for your dog, before a teeth cleaning with your vet, they should be just fine. It is the safer and more healthy way to go. ~devastated Chris, parent of a cocker.

Adrienne Farricelli (author) on December 31, 2017:

Eddie, good point but would you like to see a dog being forced to keep his mouth open for a long time while awake and risk getting injured with sharp instruments in his mouth? The vet is also at great risk from getting bitten, especially when trying to reach the back teeth which are far back inside the dog's mouth.

Eddie on December 31, 2017:

I always ask the proponents of using anesthesia for tooth cleaning if they would like to see their young human child put under for a tooth cleaning

Usually they mutter, ' of course not - anesthesia has serious risks'. But for an animal they say 'no problem'. Uh hunh...

Devika Primić from Dubrovnik, Croatia on December 31, 2014:

I like the photo and you always inform us best about our good friends.

stella vadakin from 3460NW 50 St Bell, Fl32619 on December 31, 2014:

Great informative hub. I use the anesthetic free dental cleaning. It seems to help maintain Trixies teeth. My dalmatian loved to go to the vet and get his teeth cleaned. He also loved to get his teeth brushed. He lived to be over 15 years old. Stella


Brushing your teeth is probably one of the first things you do in the morning and one of the last things you do at night. Oral hygiene is extremely important and is probably something you were brought up doing on a daily basis. But what about your dog? Keeping your dog’s teeth clean is a little trickier than caring for your own. After all, your dog can’t brush his own teeth and he’s unlikely to sit still long enough for you to do it for him every day.

Whether you brush your dog’s teeth or not, it is recommended that you have them cleaned about once per year by a professional. Many veterinarians recommend anesthesia for dog teeth cleaning, but there are other options. Keep reading to learn more.

What is Involved in Dog Teeth Cleaning?

You’ve undoubtedly been to the dentist before to have your teeth professionally cleaned, so you have some idea what to expect. The process is similar for dogs, but there are some key differences. Most veterinarians choose to anesthetize dogs for the procedure because they are unlikely to sit still long enough – it is also done to prevent pain and to keep the dog’s airway open.

Before starting the cleaning, your veterinarian (or an assistant) will examine your dog and review his medical history. He’ll take your dog’s weight, body temperature, and check his teeth, heart, and lungs. After the dog has been anesthetized, the technician will start by removing large chunks of tartar from the teeth and will then check for infection, cavities, and other signs of disease. If no abnormal findings are reported, the next step is removing plaque under the gumline. From there, the teeth are polished and treated with fluoride to protect them until the next cleaning.

Can It Be Done without Anesthesia?

Veterinarians who use anesthesia during teeth cleanings are extremely careful. In addition to taking your dog’s weight, they will review your dog’s chart and complete and exam to determine whether any adjustments need to be made to the dosage. During the procedure, your dog’s vitals will be closely monitored, and he will be kept for observation for a short period after just to be safe.

Though standard procedure is to anesthetize pets before a dental cleaning, some pet stores and groomers are starting to offer it without anesthesia. Some dogs are more sensitive to anesthesia, making the risk higher, but most veterinarians agree that anesthesia-free dental cleanings are dangerous. Because there is no anesthesia being used, your dog will be physically restrained which can be a scary and unsafe experience. Plus, the procedure is less comprehensive than it otherwise would be, because the don’t won’t allow certain things to be done.

Your dog’s teeth might end up whiter, but they won’t be healthier.

A thorough dental cleaning for dogs can be a complex procedure, especially if your dog has advanced periodontal disease or damaged teeth. If your dog’s teeth are still in fairly good shape, do him and yourself a favor and start brushing your dog’s teeth regularly to keep them healthy.


Why it’s Important to Have Your Dog's Dental Cleanings Performed Under Anesthesia

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Just like people, pets often have problems with gum disease and plaque and tartar build-up on their teeth. In fact, by three years of age a majority of dogs and cats will have mild-to-moderate dental disease that would benefit from a comprehensive oral examination and treatment performed under general anesthesia. Left untreated, dental disease can lead to more serious health complications, some of which may extend far beyond your pet’s teeth. For many reasons, it truly is important to include dental care as part of your pet’s overall preventive health care program.

The benefits of routine dental hygiene include reduced bad breath, better overall health, decreased pain, increased longevity, and reduced pet health care bills down the road.

General anesthesia is an important part of the veterinary dentist’s toolkit and it need not be a scary process – for you or your pet. For several very good reasons, the American Veterinary Dental College recommends that pets undergo general anesthesia for dental cleanings as well as for more involved procedures. These reasons include:

  • Safety of both the patient and hygienist
  • Reduced pain and stress for the patient
  • Ability to perform a complete oral examination
  • Ability to perform a professional cleaning of all tooth surfaces, including areas below the gum line
  • Ability to polish and smooth out any microabrasions caused by the scaling process
  • Ability to perform radiographs (x-rays) of the teeth to detect damage and infection
  • Prevention of aspiration (inhalation) by protecting the pet’s airway (wind-pipe) with an endotracheal tube

  1. By three years of age a majority of dogs and cats will have mild-to-moderate dental disease that would benefit from a comprehensive oral examination and treatment performed under general anesthesia.
  2. Anesthesia-free dentistry is becoming more popular and is often touted as a ‘safer alternative’ to anesthetized dentals, but it is important to be aware that such practices can compromise the health and safety of your pet.
  3. Anesthesia-free dentistry may remove visible tartar and leave teeth looking clean, but gum and tooth disease could still be present.

Anesthesia-free dentistry is an example of when dental scaling is performed on animals that are awake. Though this practice is becoming more popular and is often touted as a ‘safer alternative’ to anesthetized dentals, it is important for you, as your pet’s advocate, to be aware that such practices can compromise the health and safety of your pet. Here are a few of the many reasons why anesthesia-free dentistry is not recommended:

  • When your pet is alert and awake, dental procedures often increase stress and cause pain.
  • If your pet moves during the cleaning procedure, there is potential for the sharp scaling tools to injure your pet’s mouth.
  • Because your pet is awake, the operator is unable to perform a thorough examination of the mouth, including the important evaluation of the ligaments and bone below the gum line. This means that significant disease often goes undetected and untreated.
  • Similarly, when your pet is conscious, it is not possible to thoroughly clean all surfaces of the teeth, including the surfaces below the gum line where most problems exist.
  • When your pet is not anesthetized using an endotracheal tube, there is risk of tartar, water, cleaning material and debris going into your pet’s lungs.

Anesthesia-free dentistry may remove visible tartar and leave teeth looking clean. However, gum and tooth disease and sources of pain that are not visible or easily accessible in an awake pet cannot be effectively addressed with such non-anesthetized procedures.

Unlike you and me, who can obey our dentist’s instructions to open our mouths and turn our heads this way and that, your pets are not likely to cooperate enough to allow for a safe or thorough examination and cleaning if they are awake. And consider this, if your pet won’t sit still for you to brush their teeth, how do you think they are going to react to a stranger trying to scrape their teeth with sharp instruments?

Now that you know why it's important to have your dog's teeth cleanings and dental work done under anesthesia, take an important moment to learn what you can do to make anesthesia safer for your pets.


Some people believe they are being asked to restrict their dog’s diet 8-12 hours before surgery simply because the veterinarian doesn’t want to deal with the possibility of defecation. This is not the reason.

Anesthesia is delivered on an empty stomach so that food does not travel up the esophagus and enter the airways during surgery causing your dog to aspirate. What is aspiration? If you’ve ever had liquid “go down the wrong pipe” then you’ve aspirated.

Aspiration is any foreign object in the airways. When it happens under anesthesia, aspiration is silent. Your dog will not be able to cough the food out of her windpipe and aspiration could be deadly.

Never assume you’re being nice to your dog by giving her a meal before surgery. Follow pre-surgery instructions to a T.


Anesthesia-Free Teeth Cleaning For Your Dog

It's a great idea for some dogs – but it should take place in a vet's office.

ANESTHESIA-FREE TEETH CLEANING OVERVIEW

1. If your dog’s teeth are tartar-encrusted, or if his gumline looks inflamed, schedule an exam with your vet. Make sure she is aware of all of your dog’s health issues, and ask for her treatment recommendations.

2. If your dog’s teeth need cleaning, but he has health problems that put him at risk for complications during anesthesia, ask your vet whether she will perform an anesthesia-free teeth cleaning. If she declines, make it clear that you will seek the services of a veterinarian who will provide the service.

3. This is not the time for bargainhunting. Whether or not anesthesia is used, be prepared to pay for appropriate supportive measures as needed: blood tests, IV fluids, antibiotics, and/or pain-relieving drugs. Any or all of these may be needed to maximize the safety and effectiveness of the procedure.

Most of us have seen signs or advertisements for “anesthesia-free teeth cleaning” for dogs and cats. To most people, this sounds like a good idea, especially if you have a really old dog, a dog with a heart condition, or any other dog you’d hesitate to put through general anesthesia.

The procedure can be a terrific service for some dogs, but only if rendered under the direct supervision of a veterinarian, if not by a veterinarian. Unfortunately, some vets don’t offer the service – often, because they don’t believe it’s necessary. This pretty much guarantees that some pet owners will seek out non-veterinary technicians who perform the procedure – illegally – in grooming shops or pet supply stores.

We suggest that dog owners who are concerned about the risks of anesthesia ask their own trusted veterinarians to provide dental cleanings without anesthesia – and to seek out another veterinarian who does provide the service if their own veterinarian does not or will not. Here’s why:

Teeth Cleanliness Means Dog Healthiness

Tartar-encrusted teeth are not just unattractive they are absolutely dangerous to a dog’s health.

Just as with humans, tartar or calculus forms on a dog’s teeth when plaque – a combination of salivary proteins and bacteria – accumulates on the teeth and is not brushed or mechanically scraped away by vigorous chewing. And just as with humans, some dogs seem more prone to tartar accumulation than others. Some of this may be due to an inherited trait it’s also thought that the chemistry in some dogs’ saliva seems to promote tartar formation.

However it happens to accumulate, the mineralized concretion acts as a trap for even more plaque deposits. Soon, the gums become inflamed by the plaque, and bacterial infections may develop. Yes, the dog will have bad breath and unsightly red gums. He may experience pain when he’s eating his food, playing with toys, or during recreational chewing. Chronic mouth pain can cause behavioral changes, including crankiness and sudden onset of “bad moods.” But even more serious dangers are lurking unseen.

When plaque deposits begin to form in proximity to and then, gradually, under the dog’s gums, the immuno-inflammatory response begins to cause destruction of the structures that hold the dog’s teeth in place: the cementum (the calcified tissue that covers the root surfaces), periodontal ligament (connective tissue that helps anchor the teeth), and alveolar bone (the bone that surrounds the roots of the teeth). As these structures are damaged in the inflammatory response “crossfire,” the teeth can become loose and even fall out.

A more serious danger is the bacterial infection and resultant inflammation in the gums, which can send bacteria through the dog’s bloodstream, where it can wreak havoc with the heart, lungs, kidney, and liver. Dogs with chronic health problems that affect these organs and dogs with immune-mediated disease are at special risk of experiencing complications due to periodontal disease. For this reason alone, owners of these dogs should be the most proactive in keeping their dogs’ teeth clean.

Fears Around Teeth Cleaning with Anesthesia

People whose dogs are in poor health, however, are often the most reluctant to schedule a teeth-cleaning. Most frequently, they cite the effects of anesthesia on their dogs’ already compromised health as their biggest concern. In many cases, though, there are more serious things they should be concerned about, because the fact is that the vast majority of dogs, even old ones, come through the anesthetic experience without peril, as long as the veterinarian provides appropriate supportive care. (See “What You Should Know Before Your Dog Receives Anesthesia,” WDJ November 2002, for a detailed article about the safest anesthesia protocols and how to insist on them for your dog.)

Far more perilous than properly administered anesthesia are the risks posed by dental “technicians” who are not well trained or are inexperienced, and who are working without the benefit of veterinary support or supervision.

Undoubtedly, some of the people who provide “anesthesia-free teeth cleaning” services outside of veterinarians’ offices are well-educated and experienced. Some may be former (human) dental hygienists or licensed veterinary healthcare technicians. Some do a terrific job.

But the fact is, no matter how talented or experienced or well-educated they are, if they are not working with a vet who will perform a complete physical examination of the dog before the procedure and provide care afterward (if needed), they are performing veterinary medicine without a license. And because their services are illegal, it’s not possible for a consumer to confirm their credentials or even have legal recourse if they injure or harm a client’s dog.

The Best Candidates for Anesthesia-Free Teeth Cleaning

Fortunately, some veterinarians now offer anesthesia-free dental cleanings in their clinics, in recognition of the fact that some dogs may be adversely affected by anesthesia, and yet would benefit from dental care. The best candidates include dogs with tartar-encrusted teeth who exhibit any of the following:

• Poor kidney and/or liver function (detected with a blood test)

• Congenital heart defects (including murmurs), impaired heart function (such as congestive heart failure) or arrhythmia

• A recent injury or infection of any kind (even skin infections, including “hot spots,” are good cause to delay scheduling any procedure that requires anesthesia)

• A history of seizures (some preanesthetic sedatives can lower the seizure threshold)

If your dog has one of the conditions listed here, or another health problem that concerns your veterinarian, he may be a good candidate for anesthesia-free teeth cleaning. But you should understand that the procedure is not a walk in the park it can be hard on the dog, and the cleaning is necessarily less thorough than one conducted with the dog asleep.

“It’s so much easier to do a good job on a dog who is asleep,” says Jenny Taylor, DVM, founder and co-owner of Creature Comfort Holistic Veterinary Center in Oakland, California. “You get a vastly more thorough examination and a much better cleaning when the dog is unconscious.”

To do a good cleaning, the veterinarian or technician will need to spend long moments on each tooth – the cute ones in the front and the difficult-to-reach ones in the back. The outer surfaces (closest to the lips) are the easiest to reach and are always the most tartar-encrusted, but even the surfaces on the inside of the dogs’ teeth (closest to the tongue) should be examined and cleaned. This is tough to accomplish with even the most compliant dog.

Also, working without anesthesia may require the vet or technician to work without the benefit of the fastest and most effective tool in the teeth-cleaning arsenal: the ultrasonic scaler. Few dogs will sit still in the face of its noise and vibration, so the vet frequently can use only hand-held scalers. It can be difficult to manipulate the sharp tools with the required force to remove stubborn calculus without causing inadvertent injury to the dog’s gums, tongue, or lips, especially if he’s wiggling.

Finally, there is the dog’s experience to consider. A few happy-go-lucky dogs will comply with any procedure dreamed up by humans, as long as they get kisses and treats. But for some dogs, it’s torture. “People need to understand that working in the mouth can be a traumatic experience for some dogs,” warns Dr. Taylor. “We do a lot of things to keep the dog as comfortable as possible, but the procedure can cause some discomfort. Some dogs can tolerate a little pain and not hold it against anyone. But others can get upset no matter how tactful we are.”

For all of these reasons, even veterinarians who perform anesthesia-free teeth cleaning for certain dogs may promote an anesthetized procedure to the owners of dogs who are not at any special risk of complications from anesthesia. “Sometimes an anesthetized procedure is the kindest, safest thing for the dog,” says Dr. Taylor. “You have to consider each dog’s case individually and weigh all the factors: health, age, condition of the teeth, and temperament.”

Don’t Neglect Your Dog’s Teeth

In the best of all possible worlds, dog owners would provide appropriate home care to prevent their dogs from developing tartar buildup and gingivitis. (Some dogs go through their entire lives with sparkling white teeth, with absolutely no effort on their lucky owners’ part we’re not talking about them!) For dogs who develop tartar buildup very quickly, daily brushing can go a long way to reduce (although, probably not eliminate) the need for professional cleanings.

For people who have concerns about professional teeth cleaning with anesthesia, then, prevention should be key. Maintaining your young, healthy dog’s mouth is largely a matter of daily discipline.

If your dog has already developed tartar accumulations, though, don’t despair. But don’t delay taking action, either, because tartar leads to gum disease which leads to systemic disease. Recent human health studies, in fact, have suggested that there may be a link between periodontal disease, heart disease, and other health conditions, and that gum disease may be a more serious risk factor for heart disease than hypertension, smoking, cholesterol, gender, and age. So get that dog to your vet’s office and map out a management strategy. It might take just one cleaning to get your dog back on a healthy track, enabling you to maintain his pearly whites thereafter.

Don’t Clean Without a Vet!

But in case we haven’t already said it clearly enough, don’t just have a groomer or technician clean your dog’s teeth in the back room of a pet supply store. A veterinarian should examine your dog before his teeth-cleaning appointment, and may want to give you antibiotics to give the dog a few days before the cleaning takes place and for a few days afterward. Even if a dog owner sought out a technician who was not working under a veterinarian’s supervision, this one thing could make the difference between life and death for some dogs.

Another reason why a vet exam is critical: She may judge your dog to be a poor candidate for any sort of teeth-cleaning, with or without anesthesia. If your dog has advanced periodontal and/or active infection in his gums, any sort of cleaning may be temporarily out of the question. He’ll need antibiotics to get the infection under control before dental work should proceed.

And if your vet judges your at-risk dog to be very near the end of his life, if he is very ill, or if the amount of gingivitis (inflammation of the gums) is relatively minor considering the amount of tartar present, she may suggest not cleaning the dog’s teeth after all. In these cases, often the vet will opt to treat the dog with an occasional dose of antibiotics to reduce the bacterial burden, and monitor the response. If the dog improves sufficiently, she may proceed with an abbreviated, gentle cleaning.

Dr. Taylor began offering anesthesia-free dental cleaning in her practice specifically to ensure that her clients who were worried about anesthesia wouldn’t just sneak off to a back-room technician for their dog’s dental care. “I want my clients to discuss their fears with me, so I can help them understand all of the ramifications of their decisions, and help them plan the most effective and safest course of treatment for their dogs,” she says. “If they really want the anesthesia-free service, I’m happy to provide it – along with any other needed support. This may include antibiotics, but it also includes flower essences, aromatherapy, and maybe even acupuncture to help reduce the stress of the cleaning.”

It’s a model we wish all veterinarians would emulate.

Unless They Work With a Vet, They Work Without a Net

In the United States, only licensed veterinarians, or certain healthcare workers who are under the direct supervision of a veterinarian, may legally clean your dog’s teeth. (“Healthcare workers” include licensed, certified, or registered veterinary technicians, veterinary assistants with advanced dental training, dentists, or registered dental hygienists “under the direct supervision of a veterinarian” means with a vet in the same building, who will examine the dog and check the tech’s work.)

Some technicians allege that this is a matter of veterinarians protecting their revenue. They claim that teeth cleaning isn’t rocket science, and that an experienced technician can do as good a job or better than most vets. The vastly lower price they charge for the service, they say, encourages more pet owners to have their pets’ teeth cleaned more frequently. This is all true.

But because of the risks of harm that can be done by an unskilled or poorly educated technician – or even a skilled one without veterinary backup or supervision – we suggest making sure your dog’s teeth are cleaned in a veterinary clinic.

Inexperienced technicians, especially working on a wideawake dog, might not notice dental problems that need professional veterinary dental care, such as a fractured or loose tooth, extra or retained teeth that are causing orthodontic problems, or advanced periodontal disease. Dogs with the latter condition (especially small and tiny dogs) risk jaw fractures caused by weakened, diseased bone.

There are also plenty of non-dental health problems that a non-veterinarian may fail to notice, such as early signs of oral tumors, enlarged lymph nodes, or certain odors in the dog’s breath that can indicate other disease processes (sweet, fruity breath can indicate diabetes, and the odor of urea can indicate kidney failure). A vet can take a tissue biopsy or pull a sample for a blood or urine test if she notices one of these signs, thus diagnosing serious health problems in their earliest stages of course, a technician working without a vet cannot.

The most likely problem that can be caused by a technician who has no veterinary supervision, however, is infection. Teethcleaning unleashes a storm of bacteria into the mouth and into the bloodstream. For dogs with cardiac problems and many other illnesses, this can be fatal – if not countered with preemptive as well as postoperative antibiotics, which are legally available only with a veterinarian’s prescription.

Recently, Oakland, California, veterinarian Jenny Taylor had a client bring her dog in for an emergency visit, admitting she had recently had her dog’s teeth cleaned by a technician, who suggested she get the dog to a vet for antibiotics immediately.

“I would have preferred that the tech had declined to clean the dog’s teeth until the owner got the dog on antibiotics,” Dr. Taylor says ruefully. “But at least the tech was competent enough to recognize a case where the dog really needed to get prompt follow-up care from a vet. By insisting the client follow up with a vet, he took the risk that the vet would report him some might have just risked the dog’s health and kept their mouths shut.”


Watch the video: Non Anesthesia Pet Dentistry - Is It Worth The Risk?


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