Recently “20/20” aired a segment with a veterinarian from Canada who admitted to padding his services with unnecessary dental cleanings in order to raise revenue due to pressures of operational costs. He mentioned giving injections and a few other things that he admitted to doing, and now saw fit to “come clean” and “tell all.” Sadly, the veterinary profession is not immune to unscrupulous practitioners who might take advantage of clients’ good intentions. But to generalize that more than the rare veterinarian would risk anesthetizing a healthy pet for an unnecessary procedure, and assume that liability, would be a mistake. Another disappointing aspect of this segment is that it ignores the important and likely more common occurrence, where guardians do not take the gravity of dental disease seriously enough. With National Dental Health Month just around the corner, we hope you will take the opportunity to evaluate the benefits of oral hygiene for your pet on an individual basis.
A thorough prophylaxis, or cleaning, performed on a routine basis, when tartar and plaque accumulation threaten to develop into periodontal and gum disease, can be very helpful in preserving teeth for the lifetime of our pets. This will also prevent infection from spreading to other areas of the body, potentially resulting in secondary endocarditis (heart valve infection), urinary tract infections or liver infections. A typical cleaning at our practice will have “before” and “after” photos like this:
While our preference is to clean the teeth prior to heavy tartar accumulation, often this is when owners are noticing bad breath and appreciate more the value of the cleaning. Even with less tartar you can start to get gingivitis, as indicated by the redness along the gum line and between the larger molar and premolar on the bottom, seen even after cleaning here:
Worse situations may develop when tartar and plaque lead to gum recession or root infection, and the tooth has to be extracted, as in this example:
Here the gums and gingiva are very inflamed and infected, making the extraction more of a health risk for spreading bacteria throughout the body, or worse, developing a blood born bacterial infection. In cases of multi-rooted teeth, the surgical extraction can also be difficult and expensive. The surrounding tissue and bone is also infected in this case, causing irritation to the tissue left behind even after the extraction.
Non-anesthetic dentistry is also being offered at some clinics and through some pet stores. Please be aware that all dental cleanings involving scaling instruments are illegal without the supervision of a veterinarian on site in the state of California. In some cases, there have been companies that offer veterinary supervised cleanings without anesthesia. For the most part, these procedures are not considered appropriate by the vast majority of the veterinary community, because adequate cleaning and probing cannot be done without anesthesia. “AAHA [American Animal Hospital Association] and the AVDC [American Veterinary Dental College], along with many others in the veterinary community, agree that the procedure isn’t thorough enough, could cause more damage and does a disservice to patients – and to their owners, who think their pets’ teeth are getting cleaned at an appropriate level.”
There are a number of home care options that can minimize the need for dental work under anesthesia. Brushing daily with an edible paste for dogs and cats, e.g., CET paste, is highly recommended. Appropriate chew toys, diets and treats can also minimize the rate of tartar accumulation. But for the majority of pets, at some point, a deeper cleaning under anesthesia is warranted. Your veterinarian should be able to help you determine when that will be, and what the risks are for both not doing it, and doing it. Then you can decide for your pet. Like children, they depend on their guardians to take care of them. We hope to help you make the best informed decision possible, in line with your own health care philosophy, budget and practical application.
 Dvm360, November 2013, page 13