Why to Avoid Non-Anesthesia Dentals
What’s included?
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Physical restraint or sedation
without anesthesia
Scaling of the visible portion of
teeth with hand tool
What’re the risks?
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Patient experiences stress and/or pain
Trauma to patient and/or veterinary staff
Advancement of dental disease undetected
below the gumline resulting in infection,
bone loss, etc.
If the teeth are not polished after cleaning,
the grooves caused by scaling encourages
rapid bacterial regrowth
Aspiration pneumonia, infection, or death
caused by inhalation of plaque/bacteria,
water, or vomit
Rapid reoccurrence of dental disease and
increased frequency of treatment needed
Recently you may have heard of a procedure known as a non-anesthesia
dental, anesthesia free dental cleaning, or non-professional dental scaling
offered by a groomer, a day care or boarding facility, or even a
veterinarian. A non-anesthesia dental involves the scaling of a pet’s teeth
without putting the pet under general anesthesia. Although this may seem
appealing to owners whom have concerns with anesthesia or those looking to
keep costs low, unfortunately it has the potential to cause more harm than
benefit to your pet. Before making a decision in regards to your pet’s dental
health it is important to understand the difference between a non-anesthesia
dental and a professional dental cleaning and know the current
recommendations for dental and oral health.
A non-anesthesia dental involves physical or chemical restraint
without general anesthesia of a patient while a sharp dental scaling
instrument is used to remove plaque from the visible portion of the
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tooth. Unfortunately this is the entirety of the procedure, lacking
essential steps required to properly treat dental disease. The
American Veterinary Dental College (AVDC) describes a non
anesthesia dental as “purely cosmetic” and providing “no benefit to
your pet and does not prevent periodontal disease at any level.” The
AVDC provides resources explaining the harmful effects from missing
these essential steps. To begin, a patient that is only physically or
chemically restrained without general anesthesia can experience
stress, pain, and may cause trauma to themselves or those
performing the procedure. Due to the limitations of these methods of
restraint a full oral exam cannot be accomplished and only the visible
portion of the tooth is able to be scaled. This leaves the other 60% of the tooth below the gumline vulnerable to
progressive dental disease, which is where it is most active. Unfortunately the appearance of a clean, visible tooth, lacking
tartar gives the impression that the tooth is healthy when in fact it can be decaying beneath the gumline. The only way to
properly evaluate and scale beneath the gumline is by using dental probes, ultrasonic scalers, and dental radiographs --which can only be accomplished while the pet is under general anesthesia. Also, a non-anesthesia dental may not involve
polishing of the teeth after scaling. This leaves micro scratches on the surface of the tooth encouraging bacterial regrowth,
plaque build-up, and perpetuating oral disease. This means that although the non-anesthesia dental is a cheaper option it
will have to be done more frequently alleviating any savings one may think they are getting. Lastly, without an
endotracheal tube (breathing tube used during anesthesia), loosened tartar and bacteria in the mouth leaves the pet at
risk for inhalation of bacteria/plaque and accidental aspiration which can result in severe pneumonia, and can also be
fatal. Given the information provided, non-anesthesia dentals are not recommended due to the associated risks and lack
of benefit to the pet’s oral health. Inversely, this is why a professional dental cleaning is recommended and dental care
guidelines have been established.
The 2013 American Animal Hospital Association (AAHA) Dental Care Guideline for Dogs and Cats proclaims,
“Dental care is necessary to provide optimum health and optimize the quality of life. Untreated diseases of the oral cavity
are painful and can contribute to local and systemic diseases”. This is way it is of the utmost importance to provide proper
dental care in the form of a professional cleaning versus the inadequate non-anesthesia dental cleaning. As per the AAHA
guidelines, the essential steps for a professional dental cleaning are as follows:
1. Perform a complete oral evaluation
2. Radiograph the entire mouth for an accurate evaluation and diagnosis of dental disease. If full mouth films are not
taken, the client must be informed
3. Scale the teeth supra- (above the gumline) and subgingivally (below the gumline) using a hand scaler or
appropriate powered device followed by a hand instrument
4. Evaluate the patient for abnormal periodontal pocket depths using a periodontal probe
5. Polish the teeth using a low speed hand piece running at no more than 300 revolutions/min with prophy paste that
is measured and loaded on a disposable prophy cup for each patient
6. Perform subgingival irrigation to remove debris and polishing paste and inspect the crown and subgingival areas
(visible surface of teeth)
7. Apply antiplaque substances, such as sealants
8. Provide instructions to the owner regarding home hygiene
Additional steps are required if further therapy is needed including:
What’s included?
1. Perform periodontal therapy based on radiographic findings
and probing
2. Administer perioperative antibiotics when indicated
3. Perform periodontal surgery to remove deep debris, eliminate
pockets, and/or extract teeth. When either pockets or gingival
recession is >50% of the root support, extraction or periodontal
surgery is indicated and should be performed by a trained
veterinarians or referred to a specialist.
4. Biopsy all abnormal masses that are visualized grossly or
noted on radiographs. Submit all samples for histopathology to
be analyzed by a pathologist
5. Take postoperative radiographs to evaluate treatment applied,
especially in extraction cases
6. Recommend referral to a specialist when the primary
veterinarian does not have the skills, knowledge, equipment, or
facilities to perform a specific procedure or treatment
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Furthermore follow up care is recommended every 6 months to yearly
for healthy mouths to mild dental disease and as frequent as monthly
for severe dental disease until it is controlled. Client education
regarding home dental care, nutrition, and dental chews should also
be discussed.
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Dental care is extremely important to maintain a happy, healthy
life for your pet. All members of the veterinary staff must strive to
increase the quality of dental care and oral care education to clients.
Based on these principles, a professional dental cleaning is
recommended to properly maintain dental care and treat dental
disease as outlined by professional guidelines and recommendations.
References:
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Preanesthetic physical exam and bloodwork
IV catherization and administration of fluids
Intubation to prevent aspiration
Continuous monitoring of vitals by veterinary
professionals
Complete Oral Exam
Radiographs to assess teeth
below the gumline for disease
Scaling of all visible teeth and
below the gumline of each tooth
Polish the teeth using prophy paste and
adequate machinery
Exam teeth again following procedure and
remove any debris from the procedure
Application of a sealant to prevent
bacterial/plaque regrowth
Discuss at home and follow up care
What’re the risks?
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General risks associated with anesthesia,
anesthetic protocols are in place to decrease
risks per individual patient
1. American Veterinary Dental College. Available at: http://avdc.org/AFD. Accessed July 28, 2015.
2. Steven E. Holmstrom, DVM, DAVDC, Jan Bellows, DVM, DAVDC, DABVP, Stephen Juriga, DVM, DAVDC, Kate
Knutson, DVM, Brook A. Niemiec, DVM, DAVDC, FAVD, Jeanne Perrone, CVT, VTS (Dentistry). 2013 AAHA
Dental Care Guidelines for Dogs and Cats. J AmAnim Hosp Assoc 2013; 49:75–82. DOI 10.5326/JAAHA-MS4013. Available at: https://www.aaha.org/public_documents/professional/guidelines/dental_guidelines.pdf.
Accessed June 28, 2015.