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Are dental programs without anesthesia safe?

Q. I recently received an email about Tsai getting a dental.

He is 14 years old and while mostly in good health, anesthesia is always a concern. Another animal hospital is promoting a full dental program WITHOUT anesthesia. Do you know anything about this and do you or will you offer it too? – Danielle

A: Dear Danielle,
Thanks very much for taking the time to contact us about Tsai’s dental health.  We recognize there can be some concern with anesthesia, especially in our senior patients.  I’d like to address two points:

i) the ways we can minimize anesthesia risk in our senior patients, and
ii) whether anesthesia-free dentistry is effective.

i) We take many steps to minimize anesthesia risk in all our patients, especially our older pets.  These include pre-anesthetic physical examinations to identify any particular concerns, pre-anesthetic bloodwork to ensure proper cell counts and organ function, preanesthetic chest radiographs in those patients with heart disease…all of these are geared towards identifying risk.  As for the anesthetic itself, Tsai is administered medications that are the same as those use in human medicine, and monitoring is very intensive including blood pressure, heart rate, blood oxygenation, respiratory rate, body temperature.  An IV catheter is placed in all pets undergoing anesthesia and IV fluids are administered to maintain blood pressure.  All of these steps are taken in order to minimize the risk of anesthesia.  We perform many of these procedures in geriatric patients and the outcomes are excellent.

ii) As for anesthesia-free dentistry:  There are many concerns with this procedure and it is not endorsed by Board-Certified Veterinary Dental Specialists.  At best, anesthesia-free “dentals” involve the cosmetic removal of calculus from the teeth.  Unfortunately, they completely ignore the majority of the problem areas, which are those areas below the gumlime.  A thorough oral exam is impossible in the awake pet, as are dental x-rays: an integral part of the dental exam process.  It is impossible to scale and polish under the gumline, or provide any therapy for periodontal disease.  These procedures are painful to the pet if there is any gingivitis (gum inflammation) and provide a false sense of security.  The teeth may look pretty, but the real source of disease has not been addressed. Gingival pockets and abscesses are common in older pets, and these cannot be identified or treated in the awake pet.

I hope this information helps. I have provided a link below to Dr Hale’s website (a Board-Certified Veterinary Dentist) and his discussion of the position held by the American College of Veterinary Dentists on the subject.

http://www.toothvet.ca/PDFfiles/Anesthesia-free.pdf

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