Risks of Anesthesia-Free Dental Procedures

By Catherine Barnette, DVM

What is an anesthesia-free dental procedure?

Anesthesia-free dentistry is a service that is commonly offered at pet stores and grooming facilities. It involves scaling (scraping) the tartar from the teeth of a dog or cat that is awake, without the use of anesthesia. This procedure stands in contrast to veterinary dental procedures, in which the pet is fully anesthetized to permit thorough examination and treatment of the oral cavity.

In order to perform anesthesia-free dentistry, a pet is first restrained on an exam table. Next, a sharp instrument, known as a dental scaler, is used to chip away tartar from the visible surfaces of the teeth. After this scaling, the pet’s teeth may also be brushed using a toothbrush and toothpaste.

How does a veterinary dental procedure differ from an anesthesia-free dental procedure?

Veterinarians use general anesthesia during dental procedures to permit a thorough oral examination and treatment of any diagnosed dental disease. Prior to anesthesia, each pet receives a thorough pre-surgical exam, pre-anesthetic blood testing, and pre-anesthetic sedation. Next, an injectable anesthetic agent is given via an intravenous catheter. This injection anesthetizes the pet, allowing your veterinary team to place a breathing tube that can be used to deliver inhalant anesthetic for the duration of the dental procedure.

While the pet is anesthetized, a veterinary technician and veterinarian work together to evaluate the pet’s oral health. The entire oral cavity is examined, looking for evidence of masses or other lesions on the lips, gums, palate, or tongue. Each tooth is carefully examined visually, then further evaluated with a periodontal probe. A periodontal probe allows a veterinarian or veterinary technician to find periodontal pockets, deep pockets in the gums, indicating the presence of periodontal disease. Full-mouth dental radiographs (X-rays) are also typically performed, allowing your veterinarian to evaluate the jaw bones and the roots of the teeth.

After the mouth is fully examined and all findings are documented in the pet’s medical record, the veterinary technician will scale the pet’s teeth with an ultrasonic scaler. This scaler is used not only to remove visible surface tartar, but also to remove tartar from just below the gumline and the areas between the teeth. Additional treatments (such as extractions, advanced dental procedures, or local antibiotic administration) may also be performed if needed. Finally, your pet’s teeth will be polished and your pet will be recovered from anesthesia.

Is anesthesia-free dentistry less stressful than going under anesthesia?

At face value, anesthesia-free dentistry might sound appealing because it avoids putting a pet under general anesthesia, but unfortunately, anesthesia-free dentistry is often a higher-stress option than the alternative.

"Scaling the teeth involves placing sharp instruments inside the mouth."

Scaling the teeth involves placing sharp instruments inside the mouth. Veterinarians anesthetize pets before a dental procedure, so that they can safely use these instruments without a need for prolonged restraint and with minimal risk of injury. In anesthesia-free dentistry however, the pet must be physically restrained for a lengthy period of time, in order to allow scaling of the teeth. Depending on the pet, high levels of restraint may be required, and this can be very stressful. Additionally, if a pet wiggles or moves during anesthesia-free dentistry, they may be injured by the sharp dental instruments. This can cause further stress and pain.

Does anesthesia-free dentistry offer the same benefits as veterinary dentistry?

No. A veterinary dental procedure has two primary goals: diagnosis of oral/dental disease and treatment of disease. A thorough oral examination is arguably the most important component of a veterinary dental procedure, because it allows your veterinarian to look for evidence of oral disease and determine the most appropriate course of treatment. Anesthesia not only permits a thorough oral evaluation, but also aids in treatment by giving your veterinarian access to your pet’s entire mouth, including all surfaces of the teeth and areas below the gumline.

"Anesthesia-free dentistry is far more limited than veterinary dentistry."

Anesthesia-free dentistry is far more limited than veterinary dentistry. Few pets will permit a thorough oral evaluation without anesthesia, which means that only the outside surfaces of the teeth can be examined. Significant disease can be missed, including periodontal disease, oral tumors, and dental abscesses. Additionally, while anesthesia-free dentistry may help to remove some visible tartar from easily accessible surfaces of the teeth, there is no way to remove tartar below the gumline or between the teeth without anesthesia.

Given these drawbacks, the majority of major veterinary organizations, including the American Veterinary Dental College, the American Veterinary Medical Association, and the American Animal Hospital Association, agree that dental cleanings should be performed only under anesthesia. While anesthesia-free dentistry may offer a slight cosmetic benefit, it offers little true medical benefit for patients.

What if I am concerned about my pet going under anesthesia?

If you are hesitant to have your pet anesthetized, talk to your veterinarian. Your veterinarian knows your pet’s complete medical history and can help you balance the benefits of a dental cleaning against any risks associated with anesthesia.

Your veterinarian will perform a thorough physical exam and blood testing, including a complete blood cell count and serum biochemistry, prior to anesthesia. This pre-anesthetic evaluation will help detect any underlying internal conditions that might affect your pet’s risk, allowing your veterinarian to customize your pet’s anesthetic plan for your pet’s overall health condition.

While your pet is under anesthesia, your pet will be closely monitored allowing for detection of any anesthetic complications. Most veterinary practices use a combination of a pulse oximeter (which detects blood oxygenation), blood pressure monitoring, electrocardiogram (ECG monitoring), temperature monitoring, and other monitors to provide information about your pet’s body function while under anesthesia. Any abnormalities that are detected on monitoring can be addressed by anesthetic changes or other medications, further reducing the risk of any significant anesthetic complications.

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