Tuesday, May 29, 2012

Anesthesia Free Dentals Are Not Good Medicine

A few years ago in a Dental Health Month blog, we briefly discussed the troubling use of anesthesia-free dentistry for pets.  Since then, this procedure - also known as Nonprofessional Dental Scaling (NPDS) - has become increasingly popular with well-meaning owners who understand the importance of dental care but are afraid of the risks from anesthesia.  And because it is usually less expensive, NPDS is also attractive to pet owners who have concerns about cost.

However, as we stated in our first blog on this topic, this procedure actually can cause more harm than good.  Additionally, if this procedure is not performed by a veterinarian, or even under the supervision of a veterinarian, NPDS is actually illegal in many states.

Below are more details and common questions about the procedure.

Is Non-professional Dental Scaling (NPDS) as effective as a cleaning under anesthesia?
No.  NPDS is a purely cosmetic procedure.  Because NPDS only removes tartar build-up from the visible portion of the tooth, it can provide a false sense of completion and illness prevention.  Many times there is plaque built up under the gum line, and most oral disease is actually happening below the visible surfaces of the teeth.  NPDS fails to address or fix these problems.  Dental procedures performed properly under anesthesia are not just about cleaning the teeth.  Radiographs (x-rays) are taken during the process in order to assess general bone health as well as the health of the roots of the teeth.  The visible portion of the teeth can look perfectly healthy, but the cat can have severe bone loss, lesions, or other pathologies below the gumline where they are not visible (see our case study blog on Oz for an example of this type of situation).

Isn't NPDS safer for cats than putting them under anesthesia?
No.  The principal reason anesthesia is required for a proper and thorough dental cleaning is due to patient cooperation.  Unlike with people, we cannot explain to the cat what we are doing and ask that she hold still while her teeth are scaled (have the tartar removed) and x-rays are taken.  Many cats will not tolerate even a cursory inspection of their mouth during a regular office exam, much less a complete exam plus cleaning and x-rays.  Additionally, dental instruments are sharp by design, presenting a clear danger to an awake cat if she jerks away from the process in fear.  And as most of us know from visiting our own dentist, cleaning below the gumline is uncomfortable at best.  Think of the last time you had your own teeth cleaned and how it felt.

We must also worry about the cats ability to breath during a dental procedure.  Dental instruments require water to reduce heat from friction and to rinse the mouth.  When your cat is properly anesthetized, she will be intubated.  This means a tube is placed down her throat directly into her trachea (windpipe) so she can breathe.  Intubation is especially important during dental cleanings to reduce the chance of water getting into the cat's lungs.

Is anesthesia safe for my cat?
Overall, yes.  Of course, there are risks with any anesthesia procedure.  Here at Scottsdale Cat Clinic, we take every precaution to minimize those risks, tailoring our general protocols to specifics for each individual cat.  We always start with a pre-operative exam.  During this exam, your cat's weight is verified in order to ensure she is getting her correct dosage of medications.  The pre-operative medications include analgesics (pain relief), which research has shown improves post-operative recovery.  We also place an IV catheter which helps to maintain blood pressure, keeps your cat hydrated during the procedure, and also allows us to administer any additional medications directly into her blood stream.  While your cat is under anesthesia, her vital signs are constantly monitored, both with state-of-the-art equipment and a trained veterinary technician.

Additionally, dental procedures are part of our regular anesthesia procedures.  This means we know what to look for during oral exams and on the dental x-rays.  This adds up to less time for your cat to be under anesthesia while we evaluate her dental health.  If your cat needs extractions, we use nerve blocks to allow us to perform the extraction without having to have your cat at deeper levels of anesthesia.  All of this leads to safe anesthesia while enabling a complete and thorough dental cleaning and exam for your cat.

At Scottsdale Cat Clinic we feel that any dental procedure that isn't performed under anesthesia fails to provide proper care for your cat.  NPDS is absolutely an inadequate treatment for your cat's dental health.  Any cost savings are completely negated by the substandard results and will almost certainly lead to more serious dental problems later in your cat's life.