You may have heard of anesthesia-free dental cleanings from your veterinarian or groomer. Non-anesthetic dental scaling commonly referred to as NADS has been a very controversial topic for over a decade. They sound great; your pet does not need to go “under” and the cost is significantly less, but is it right for your pet?
What is an anesthesia-free dental cleaning?
Anesthesia-free dental cleaning involves scaling the teeth with a curette or ultrasonic device without anesthesia or sedation.
This service is sometimes offered through a third-party at your veterinarian’s office. It is meant to be screening or maintenance care for your dog or cat’s teeth in between anesthetized cleanings. But is it safe, or does it cause more harm than good?
Animal Dental Care is based in California, and has NADS technicians in several cities. They are a leader in the anesthesia-free field and have been providing preventative oral screening and cleanings since 1992. Their techs travel to veterinary offices and provide cleanings under the “supervision of a veterinarian”. This does not mean the vet is in the room while the procedure is taking place, or even that the vet is in the office that day. It means the veterinarian approved this provider.
The Animal Dental Care website says small breeds need preventative cleanings every 3-4 months and large breeds every 4-6 months. Their technicians are trained in behavior modification to help to calm your pet. If they detect any issues, the technician will not continue with the procedure and will urge you to schedule a traditional anesthetized cleaning.
So far, it all sounds great, right? Especially when so many of us are apprehensive at best, about putting our pets under general anesthesia. Especially if the pet is a senior.
What is the downside of anesthesia-free dental cleanings?
Know that anesthesia-free cleanings are purely cosmetic. The end result may look pretty, but white teeth do not necessarily mean a healthy mouth. If there is an underlying issue, it often goes undetected. When your pet’s teeth look pretty, you are often left with a false sense of security that all is good in your pet’s mouth.
In reality, young dogs with minor build-up are probably better candidates for NADS than seniors who are more likely to have underlying issues.
X-rays are key
Even if you brush your pet’s teeth every day, which few people actually do, it’s important to maintain good oral health and understand what’s going on beyond the surface of the tooth.
Radiographs are an integral part of understanding your pet’s oral health. Unfortunately, it’s impossible to get dental x-rays while your pet is awake. X-rays require that your pet hold completely still, and that’s just not going to happen without anesthesia or sedation.
In the state of Nevada, it is illegal to perform any pet dental procedure without radiographs and anesthesia.
Going under the gumline
Anesthesia-free procedures may or may not involve going under the gumline. If it’s done by a groomer, it’s highly unlikely that they are going beneath the surface. If done by a NADS trained technician, they often do go under the gumline. That sounds reassuring, but going under the gumline doesn’t feel good to your pet and that’s where problems can occur. Restraint of some type is often necessary, and wiggling or head jerks can occur, which can result in gum laceration, neck injuries or even jaw fractures.
The American Veterinary Dental College feels so strongly about warning pet owners of the dangers of anesthesia-free procedures, they have created a website that is dedicated to educating people, both owners and veterinarians, about the risks. They deem the practice below the standard of care.
The importance of polishing
A big issue with non-anesthesia dental cleaning that is not often understood, is that polishing does not take place. Without this procedure, the curette can leave grooves in the teeth, which makes them more vulnerable to bacteria and periodontal disease.
Periodontal disease is the most common clinical condition in pets. There are often no visible signs and bone loss and can occur beneath the gumline. 60% of each of your dog’s teeth is below the gumline. This leaves openings for bacteria to travel into your pet’s bloodstream. This can be especially harmful to internal organs like the heart, kidneys and liver.
Is anesthesia safe for my pet?
Before going under anesthesia, bloodwork is done to make sure your pet is able to safely go under the procedure. Anesthesia always has risks associated with it, but when done properly and properly monitored, the procedure is very safe.
The average mortality rate resulting from anesthesia in a veterinary practice is .1%, which translates to 1 in every 1,000 pets. It’s important to remember this is an average. It does not take into account how the procedure was done. Interestingly, in human medicine, the mortality rate is .001% or 1:1,000,000. Why the vast difference? In human medicine, anesthesia is administered by people who are trained and dedicated to that endeavor. They are also impeccable about the use of monitoring equipment.
If your pet is an at-risk individual you may want to request ACVAA Board-Certified Anesthesiologist if possible. Not every clinic has one, but if you are lucky enough to have one in your area, it may put our mind at ease. There will likely be an additional cost, but it may be worth it to you for peace of mind.
Some veterinary technicians are certified in anesthesiology. Be sure to ask who will be doing the anesthesia and what protocols they follow.
It’s perfectly acceptable to ask what method is being used and do your research to understand it. You also want to ask if your pet will be constantly monitored through the process as well as after. Don’t let anyone make you feel like you are asking too many questions. As your pet’s guardian, you have the right and the responsibility to know.
According to a statement made by AVDC in 2004, anesthesia provides “the cooperation of the patient with a procedure it does not understand, elimination of pain resulting from examination and treatment of affected dental tissues during the procedure, and protection of the airway and lungs from accidental aspiration.”
What takes place during a professional anesthetized dental cleaning?
During an anesthetized procedure, your pet will have a complete oral exam and radiographs. This will detect if there are any underlying issues before they become a bigger problem. Painful areas such as a broken, abscessed, dead or infected tooth are identified. Root issues are also identified.
A full cleaning then takes place, this includes under the gumline as well as the crown, or visible part, or the tooth. Any extractions that are necessary are done. If your dog has gone under a root canal in the past, the caps are evaluated to ensure they are still secured and intact.
Scaling removes plaque and tartar build-up. As a final step, polishing of the crown is done, which leaves the surface of the tooth nice and smooth, which is an important step to discourage plaque and bacteria from adhering to the surface.
When anesthesia-free dental cleaning the right choice?
Anesthesia-free dental technicians are more discriminating than they used to be. They turn away many potential patients that they do not feel they can benefit, whether it be for behavior issues or obvious dental issues that need to be addressed beyond a surface cleaning.
Some would say it’s never the right choice. Others say that if used purely as a preventative measure in between anesthetized cleanings, there is a benefit in reducing buildup.
When something so controversial it’s always hard to know what the right thing is for your pet. You may have different veterinarians that you trust telling you different things. In the end, it’s up to you and what feels right in your gut. Trust what you truly believe will be the most beneficial and cause your pet the least amount of harm.