Veterinary Dentistry Cannot Be Done Without Anesthesia

Brook A. Niemiec, DVM, DAVDC, DEVDC, FAVD, chief of staff at Southern California Veterinary Dental Specialties & Oral Surgery in San Diego, and welfare author and speaker Kymberley Stewart, DVM, talk about the myth that dentistry can be done without anesthesia.

Dr. Niemiec: “I think the next really common myth is the fact that we can clean the teeth without anesthesia. And that's one of the big things in the guidelines is that anesthesia-free dentistry is not acceptable by any of the members. And I found that one of the really interesting things, and I'll give this to Kimberly in a sec, was that, as veterinary dentists, we have been combating and dealing with anesthesia for dentistry for decades and there is not a veterinary dentist in the world that would say that anesthesia for dentistry is acceptable. And so, we're used to it and it's almost common, one of those things that we just see it all the time, but we fight it because we know as veterinary dentists that if we don't clean them under anesthesia the only thing to do is scale the surface of the teeth, which does nothing for that pet.

There's no medical benefit to scaling the surface of the teeth, and so, we see that, and we know, we see the disaster cases: the dogs look perfectly clean crowns that have horrific gum disease. I'm extracting teeth that are perfectly clean, but they're horribly diseased. But the interesting thing to me was that when we talked about this in our committee, that it was actually the anesthesia and the welfare folks that had a bigger problem with it than we did. So, why don't you tell them about the welfare side of it.”

Dr. Stewart: “Performing a dental cleaning is an incredibly complex thing. It involves 10 to 12 steps, depending on who you ask. Each one of them requires incredible fine control of very very sharp surgical instruments. They, if done properly, need to push up and underneath the gum line to areas where nerve stimulation happens, not just in the soft tissues of mouth and the gingiva, but also in the structure of the tooth itself, and sensitization. Most people have experienced what tooth sensitivity feels like when recession exposes the root of your tooth. So the soft tissues as well as the harder tissues of the mouth can be painful. And it also requires an animal to be looked at and examined, both to the naked eye but also radiologically, because radiographs or x-rays uncover dental disease we can't see with our own eyes. Strangely enough that's not rocket science, it's how we take care of our own teeth. Some of us have very easy to diagnose dental disease via cavities. Other people's dental disease does not show up, necessarily on the surface, which is why we take regular x-rays of our own teeth.

But again, taking an x-ray requires a plate to be placed in very unusual areas deep inside the mouth, where we're stimulating the gag reflex of animals. All of those things, the pain involved, the stress, the pain involved in actual manipulation of sharp instruments, the risks if an animal moves, so the intensity of restraint required to keep it safe for that animal. as well as, the actual procedures themselves which are very invasive. Subjecting an animal to doing a proper complete dental therapy is absolutely unacceptable without removal of anxiety, pain, and really in the end run, awareness.”