I mentioned anesthetic-free dentistry, AKA non-anesthetic dentistry (NAD) in my blog about the changes that have been made in anesthesia safety over the past 50 years. Providing “dental care” to awake animal patients has been promoted as less expensive and less invasive, but in fact, it doesn’t have the therapeutic benefit of procedures performed with an anesthetized patient, and can cause harm to the patient and the person performing the service.
What is Non-anesthetic Dentistry?
The person performing this type of service may be trying to assess the extent of dental disease visible on the tooth surface and above the gum line in areas that can be easily seen and reached. Unfortunately, a diagnosis of dental disease can’t be reached without probing the gingival recess and scaling the adherent tartar under the gum line and taking radiographs. Doing the probe and scaling procedures without the benefit of anesthesia is not safe for the pet
What is the Experience Like for the Pet?
The probe can cause discomfort, and the scaling and polishing processes (with sharp and vibrating instruments) needed to clean the teeth would be very stressful and potentially painful if the pet moves. Dental radiographs are essential for determining the presence of pathology inside the tooth and in the bone below the gumline, but radiographs can’t safely be taken in an awake animal. Significant oral or dental disease can easily be missed in conscious patients. There have been instances of serious injury, including damage to the pet’s mouth and eyes, and serious bites to people when anesthesia-free dental procedures have been attempted.
What is the Legal Status of Non-anesthetic Dentistry?
Some provinces (Ontario and British Columbia) consider non-veterinarians performing or advertising dental cleaning to be illegal, as it constitutes practicing veterinary medicine without a license. The College of Veterinary Professionals states that “anesthesia-free” dental cleaning cannot be promoted as a health benefit, only as a purely cosmetic service (like brushing). For veterinarians in Ontario, performing dental work without anesthesia is considered below the required standard of care (malpractice).
What if Performing any Anesthetic Procedure is Really Too Risky?
The determination of anesthetic risk may be complicated in a geriatric pet with other diseases (co-morbidities), but age alone is not a barrier to treatment. It may be possible to refer to a specialist when particular anesthetic considerations are necessary, but the best advice is to leave the tartar rather than trying to remove it without anesthetic and not address the underlying pathology in the mouth. Oral pain is not created by the visible tarter, but by the disease under the gum and within the bone and tooth, neither of which are addressed by non-anesthetic dentistry. We can be certain that you aren’t getting your money’s worth from non-anesthetic dentistry.