Dec 12 2012

Non-anesthetic Dental Scaling!

Have you ever wondered why our veterinary patients have to be anesthetized in order to have a dental cleaning when we are able to stay awake during our hygiene appointments?  Ever wondered why we don’t just try to clean the teeth of our pets without anesthesia?  Non-anesthetic dental scaling is being praised as a non-invasive approach to oral health without the risks of anesthesia. Unfortunately, what sounds great at first actually can be harmful for oral health.  There are many reasons that a full oral exam and cleaning under anesthesia is the absolute best for our pets.  Let’s go over a few…
Tartar? Gross!
Why don’t we just knock off that ugly tartar buildup and those pearly whites can shine through again?  Because the tartar you see is mainly just a cosmetic problem.  Knocking it off doesn’t allow you to clean up underneath the gum line.  That’s where bacteria love to live, and they can really cause some damage.  Another problem area that can’t be reached is the surface of the teeth next to the tongue.  This area cannot be cleaned or visualized without anesthesia, and many potentially painful issues can go undetected unless a full oral exam is performed.  With anesthesia, we are able to scale under the gums as well as the surface of the teeth next to the tongue, whereas hand scaling without anesthesia only gets the surface and can miss a lot.
Leaving a Job Half-Done
 When we scale the teeth, we remove any plaque and tartar that have accumulated.  This scaling itself can cause tiny little scratches on the tooth surface that should be smooth.  These little scratches allow a better surface for tartar and plaque to build up.  This is why every scaling should be followed by a thorough polishing.  This polishing helps restore that smooth surface to the teeth, and it is rarely with non-anesthetic procedures.  This is yet another reason why hand-scaling to just knock off tartar can start to cause more problems even though the teeth look clean initially.
Safety is one of the biggest reasons why we anesthetize our patients (not the other way around!).  For our patient’s safety, when we anesthetize them, a tube is placed into their airway (much like human surgery!) in order to protect the airway and make sure they can always get a fresh supply of oxygen.  This tube also has an inflatable cuff that seals the airway to protect the lungs from any water, bacteria, or debris that may be accumulated during the procedure.
As for our safety, even the nicest animal can react instinctively when they are painful (which is why our anesthetic protocols include pain medicine too).  Without being able to see underneath the tartar and gum line when an animal is awake, there is a potential to hit a painful spot and ouch!…you now have teeth marks on your hand!  Ask anyone who works with animals for a living….they will be soon be able to point out at least a few scars from the patient that “was the sweetest thing until we did ___”.
It’s not just what you see….
Here’s a fun fact….more than 50% of dental disease occurs beneath the gum line where you can’t see it by just looking.  So how do you find it?  X-rays!  Dental x-rays are essential in completing a full evaluation of the mouth in humans and animals.  The x-rays allow us to see the roots of the teeth and make sure there are no hidden problems such as infection. And as you might have guessed, the only way to get top quality x-rays of the teeth is to have our patients immobile and anesthetized.  Remember when your hygienist says, “open wide, this will only be uncomfortable for a minute”?  Then you have to sit still while a large plastic object is in your mouth?  Try telling your cat or dog to open wide and stay still.  Most likely, it’s not going to happen!
Unfortunately, nothing in life is without risks.  There are no anesthetic protocols that are 100% guaranteed safe.  However, there have been many advances in anesthesia over the past 10 years.  We now have much better monitoring equipment to detect subtle changes in our patients’ vitals and we use it all of our anesthetized patients.  The monitoring equipment won’t do you any good if you don’t use it!!  In addition, we used individually tailored anesthetic protocols for our patients based on age, breed, health status, etc. (Yet another reason to do pre-anesthetic bloodwork!)  An older dog with a history of diabetes and epilepsy is going to have very different medications used than a young healthy dog with no medical problems.  There are now millions of dental procedures being done yearly in the United States on our pets.  But keep in mind….not all dental procedures are created equal!
I hope you can see why we do what we do, and why we do not recommend scaling without anesthesia.  Stay tuned for part 2 of this series to best learn how to take care of your pet’s teeth in order to minimize the need for dental cleanings!
– Dr. Freihaut

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