Twilight Dental Cleanings?

I have heard of some veterinary clinics starting to do anesthesia free dental’s; or what they call “Twilight Dentals”. We regularly have clients ask us why their pet must be put under anesthesia, and often times will decline regular dental services because they are worried about their pet and anesthesia.

I decided I needed to do a little research to find out about the safety and pros and cons of these procedures.

A Little Background in Veterinary Dentistry:

Everybody knows that pets, just like people, have bacteria in their mouths. Just like people, that bacteria mixes with saliva to produce plaque that lives above and below the gum-line. If plaque remains on the teeth, it begins to mineralize in as little as 24 hours, and turns into tartar. Tartar, unlike plaque, is adhered to the tooth above and below the gum-line and cannot be removed without special dental equipment.

Pets can’t brush their teeth on their own, and it is still somewhat of a novel idea to most pet owners that they should be brushing their pets teeth on a daily basis.A lack in brushing causes plaque and tartar to accumulate to levels that a human dental hygienist would likely loose their lunch over. Along with all that bacteria comes gingivitis and really bad breath.

Traditionally, it has been common practice that if a pet requires a dental cleaning, or any dental work, it must be under full general anesthesia in order to receive the treatment. Since only a licensed veterinarian can administer anesthesia  to a pet, it can be assumed that only veterinary teams can perform dentistry.

However, lately, there has been a rise in anesthesia-free dental cleanings being performed by pet stores, grooming facilities, and even boarding kennels. These non-professional dental cleanings are cleverly marketed to people with older pets and/or tiny budgets, claiming that anesthesia is too risky in mature pets, and too expensive for the everyday pet owner. In 2012, the US ruled that dental cleanings can only be performed by veterinarians, however, now there are some veterinary facilities offering this service.

Safety Concerns:

• Lacerations: dental hand instruments are really sharp, the smallest movement from a pet, even the most cooperative animal, and lead to sliced gums or even fingers of the person using them. Talk about painful!
• Aspiration Pneumonia: there is so much tartar coming off those teeth, that it would be entirely possible for an awake animal to inhale a big chunk and get a raging lung infection. Under general anesthesia, there is an endotracheal tube protecting the pets airway so that this doesn’t happen.
• Choking: an ultra-sonic scaler vibrates at an incredibly high rate that it requires a water drip to keep it cool so that it doesn’t damage the teeth. This mist can easily pool in the mouth and become a choking hazard. Again, an endotracheal tube under general anesthesia prevents this from happening. Not to mention, the ultra-sonic scaler is less traumatic than using dental instruments alone.

Medical Concerns:

• Disease control: it is the tartar and plaque that lies under the gum-line that causes periodontal disease. Reaching these sharp instruments under there to clear away all of it would be very difficult, if not impossible, to do in an awake pet. Therefore, if the tartar under the gum-line isn’t fully cleaned away, you aren’t getting to the root of the dental problem (pardon the pun). That tartar will continue to sit there and oral disease will keep getting worse.
• Full cleaning: this involves, cleaning every surface of every tooth, including the inside surfaces of the teeth (called lingual and palatal surfaces). Have you ever tried to hold your pets mouth open for more than a few seconds? Now try holding it open for about 15-30 minutes while sticking sharp instruments in there.
• Stress: animals, just like people, all display stress differently. Dental instruments make unfamiliar sounds, and create unfamiliar sensations in the mouth, and that can be very stressful to a pet of any age or personality. In fact, some cats won’t move an inch when they are really stressed, making a lot of people think they are being well behaved when they are actually so stressed they can’t move.

I know that I will continue to support the view that veterinary dentistry should always be performed under general anesthesia. There are so many other arguments I could share, but I’ve already gone on long enough. What are your thoughts though? Have you ever taken your pet for dental cleanings with or without anesthesia? What was your expectation and experience?