Dental Disservice

By Bernadine Cruz, DVM

Want to get veterinarians, groomers, and boarding facility management foaming at the mouth like mad dogs? Just bring up the topic of dental cleaning performed outside of the confines of a veterinary hospital. It won’t be a pretty sight… almost as distasteful as the specter found hiding under the lips of most of our cats and dogs. According to the American Veterinary Dental Society, more than 80 percent of dogs and 70 percent of cats develop dental disease by the age of three years. Without proper care, it can lead to much more than doggy and tuna breath. Dental disease can kill.

The controversy arises when the discussion focuses on non-anesthetic dental care. For the record, I am a proponent of this form of cleaning of pets’ teeth. We perform non-anesthetic cleanings at my practice on a daily basis. For the appropriate pet, it provides an excellent service. It can help in protecting the long-term health of my feline and canine patients. There are, however, two main caveats as to whether or not a pet is a candidate for this type of dental prophy.

The degree of dental disease and the pet’s demeanor are deciding factors that must be taken into account. A compliant pet with severe dental disease such as loose teeth, open root canals, or pocketing deep under the gum line will not benefit. Merely cleaning the calculus from the crown of the teeth will give a false sense of well-being to the pet owner. My practice will not perform a non-anesthetic dental cleaning under these circumstances. If, on the other hand, the pet is less than cooperative and the prophy would necessitate brute restraint to remove even mild dental tartar, the psychological and potentially physical harm to the pet makes us look to alternatives such as mild sedatives.

Many veterinarians provide non-anesthetic dental care, so why the hullabaloo? Veterinary dentistry, like surgery, is considered to be part of the practice of veterinary medicine in the United States and Canada. You wouldn’t have your hairdresser clean your teeth. Why allow a non-professional to use sharp instruments of uncertain sterility that could inflict injury and pain on a pet? Veterinary dentistry needs to be performed under direct veterinary supervision. Your hygienist doesn’t set up shop outside of a dentist’s office; our cats and dogs deserve the same level of professionalism and medical safeguards.

It is not uncommon during non-anesthetic dental cleaning procedures at my office for my trained veterinary technician to discover conditions that require dental radiographs, root canals, root planing, or extractions that can only be done under anesthesia. The thought of general anesthesia can cause great angst in the general populace. Though there is always some risk whenever a person or pet undergoes general anesthesia—no matter if they are young, old, healthy, or sick—the frequency of complications has been greatly reduced in the past decade. Anesthetic agents are safer. The ability to monitor veterinary patients during procedures can be just as precise as with human medicine. Pre-anesthetic blood work, EKGs, and other cautionary measures allow even elderly patients to safely reap the benefits of a thorough dental prophylaxis. The “gold standard” of veterinary dentistry will always be cleaning under general anesthesia, but safe alternatives do exist for the properly chosen pet.

Providing dental brushing in addition to your other services is a good money maker and emphasizes the importance you place on overall health. It is essential that pet owners are aware that brushing an animal’s teeth every month or so when they are groomed or boarded is insufficient to deter dental disease. If the only time we brushed our teeth was when we got our hair cut, you can imagine the consequences. Most pet caregivers don’t routinely examine their pet’s teeth. If they do peek at the dentition, it is usually just the teeth we would see when we smiled: the incisors and canines. Though they can be affected by dental disease, those that are toward the back of their mouths are frequently a covert source of pain and infection.

What does a normal tooth look like? The exposed surface of the tooth should be a smooth, creamy white color. The gums should be pink (some pets normally have pigmented areas) and lie tight and smooth against the tooth—not inflamed, swollen, or bleeding. The gum tissue shouldn’t grow over the tooth’s surface. A pet’s breath shouldn’t double as smelling salts.

By educating your clientele about dental disease and proper hygiene, you can set yourself apart from your competition and reinforce their bond to you. Send home a pet health check list with each visit. Cover topics such as weight, lumps, bumps, external parasites, status of ear health, lameness issues, and dental and gum health. Keep a copy in your files. Smart phones and small digital cameras are a marvelous way to document concerns that you uncover. Send home photos with the check list. Unsure of what is normal and what may require immediate medical attention? Ask your local veterinarian for a brief “Pet Health Check Up 101” overview. Don’t worry. They won’t think you are trying to play doctor. Having additional pet wellness team members is always appreciated.

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