Maybe you’ve seen a sign for “Teeth cleaning without anesthesia” in your groomer’s shop or on a pet store bulletin board. And you’ve wondered: Would your dog benefit from some quick tartar removal, free from the perceived dangers — and costs — of a professional cleaning under anesthesia at a veterinarian’s office?
“Definitely not,” says Jean Joo, DVM, a veterinary dentist at Tufts Veterinary Emergency Treatment & Specialties in Walpole, Mass. She stresses that the hazards of such services far outweigh any superficial cosmetic benefits. “Not only do these types of cleanings fail to prevent periodontal disease, which takes place below the gum line,” Dr. Joo says, “but they create a false sense of security in the owner because the teeth look clean.”
The results can be devastating. “I had a toy poodle come in with clean, white teeth,” Dr. Joo says. “The groomer scaled her teeth every month, and they had almost no calculus at all. However, when I examined the dog under anesthesia, I saw that her teeth were in terrible shape, many of them loose and diseased. I ended up extracting 16 of them.”
What Happens Under the Gums Stays Under the Gums
Calculus, commonly called tartar, is the hardened form of plaque, the bacteria-laden material that naturally forms on and between teeth. It’s easy to chip tartar off the upper part, or crown, of the tooth — which is why it can be done without anesthesia — but that’s not where problems occur.Painful below-gum scaling is not the only essential cleaning that must be done under anesthesia to be safe and effective. Without the smoothing action of polishing and a final antiseptic rinse — only achievable with suction since dogs can’t be trained to spit — the teeth and gums are even more susceptible to bacterial infection than they are before being scaled. And it’s difficult to perform an in-depth examination or get accurate dental X-rays when the patient is squirming or making sudden moves.
Steven Holmstrom, DVM, board certified in veterinary dentistry, has seen many patients after an anesthesia-free cleaning. “They were better off before the procedure,” he says. “We tried teeth cleaning without anesthesia 35 years ago. If it had been appropriate, we in the AVDC [American Veterinary Dental College] would all be doing it. It would dramatically increase our business.”
Dr. Holmstrom, former president of the AVDC, suggests that anyone contemplating a nonprofessional cleaning read “On Companion Animal Dental Scaling Without Anesthesia,” a position statement posted on the AVDC’s Web site. It details the medical issues involved and points out the legal ones, noting that, “In the United States and Canada, only licensed veterinarians can practice veterinary medicine …. Anyone providing dental services other than a licensed veterinarian, or a supervised and trained veterinary technician, is practicing veterinary medicine without a license and shall be subject to criminal charges.”
What About Anesthesia?
The statement also addresses the fears that many people have about anesthesia — fears that Dr. Joo encounters regularly in her practice. “I never tell clients that there are no risks,” she says. “But they’re greatly reduced by tailoring the anesthetic protocol to each patient. As long as we have current blood work and urinalysis, know the dog’s medical history and are proactive in monitoring and treating the patients while under anesthesia, we can minimize the risks.” Besides, she says, “Anesthesia has become a lot safer now with the use of balanced techniques and inhalant anesthesia.”
Dr. Holstrom concurs, noting that most problems associated with anesthesia date back decades, when barbiturates, which are a lot less predictable, were used. “The effects of today’s anesthetic agents like sevofluorane and propofol are reversed more quickly and the drugs metabolized far more easily than the ones used in the past.”
A Relatively New Discipline
Concerns over anesthesia and the proliferation of nonprofessional teeth cleaning services — which sometimes exaggerate anesthesia’s dangers to drum up business, according to Dr. Holmstrom — reflect widespread public confusion about veterinary dentistry and especially preventive care. The confusion is understandable. The American College of Veterinary Dentistry was established little more than 20 years ago, in 1988, and full recognition of dentistry as an approved specialty in veterinary schools was granted only in 1995. Dr. Joo says, “Today, less than half of the veterinary schools in this country have veterinary dentists on staff.”
The awareness of the impact of dental disease on other body systems, in humans as well as in dogs, is also relatively new. “We are just beginning to find the links between overall health and dental health,” says Dr. Holmstrom, one of fewer than 100 diplomates in veterinary dentistry in the United States. “Studies on humans show that advanced periodontal diseases lowers mortality.”
There’s no question that, if left unhindered, bacteria from the teeth and gums can spread through the bloodstream and infiltrate other parts of the body, including the heart, liver and kidneys. At minimum, periodontal disease causes mouth pain in dogs, and, as a result, difficulty eating.
According to the [link to gross picture on home page alert!] Veterinary Oral Health Council, periodontal disease is the most common clinical condition in companion animals. Most studies indicate that at least 75 percent of dogs show signs of it by the time they’re 2 or 3 years old. And because these statistics rely on a sample of pets who receive regular veterinary care, the percentage is likely higher.
Small Dog Alert!
The disease is particularly rife among small and toy breeds. “They have disproportionately large teeth for their small mouths and jaws, which results in crowding,” Dr. Joo says. “This means that food and debris, which turn into plaque and tartar, get caught on and between teeth. It doesn’t take much before the teeth become loose and for infection to set in. In extreme cases, small dogs have such severe dental disease that they can break their jaws.” This happens when the alveolar bone, which surrounds the tooth sockets, erodes. It weakens the lower jaw so much that a slight trauma — everything from bumping into furniture to chewing on a toy — can cause it to fracture.
In contrast, larger dogs have a more balanced tooth-to-jaw ratio. “When they lose a few milliliters of attachment, it’s not as significant,” Dr. Joo says. Larger dogs also tend to chew on toys and other things that help keep their teeth healthier — as well as some that don’t. These breeds need regular dental checkups because, Dr. Joo cautions, “They have a tendency to break their teeth chewing on hard objects like bones or rocks.”
Also affecting the onset and progression of periodontal disease is a dog’s tendency to pant. The more a dog pants, the drier the mouth and the less saliva available to perform natural dental cleansing, Dr. Joo says.
Although size definitely counts when it comes to the recommended frequency of professional cleanings, each case has to be judged individually. Larger dogs can sometimes go for more than a year without professional care if the owner keeps up with brushing while some smaller dogs may benefit from cleanings twice a year, no matter how assiduous the home care.
Yes, It’s Expensive
It’s not only the lack of knowledge about the prevalence and repercussions of dental disease and the fear of anesthesia that keep people from having their dogs’ teeth cleaned professionally. For many, it’s the cost. No question: Professional cleaning can be expensive. Prices vary across the country, from little more a hundred dollars to more than a thousand.
In part, teeth cleaning rates are based on the cost of living. For example, you can expect to pay more in cities where office space is at a premium. Other factors that impact fees include the experience of those performing the procedure and the quality of the equipment used. “Many practitioners go to continuing education courses to fill the gaps in their knowledge,” Dr. Joo says. “And while some practices have only simple hand scalers, others offer state-of-the-art dental units.”
How do you rationalize spending the money to clean your dog’s teeth? Dr. Joo quotes the proverb “an ounce of prevention is worth a pound of cure,” adding that by providing routine dental care, owners can avoid multiple extractions. Moreover, dental care may pay for itself by mitigating other costly conditions. As an example, Dr. Joo has seen dogs with hard-to-manage diabetes become significantly better once their dental disease had been treated.
The most immediate, direct benefit of a professional cleaning is usually the elimination of canine bad breath. Getting kissed by your dog without wanting to recoil? Priceless.
***
February is National Pet Dental Month. This article was adapted to mark the event from one that I wrote for Your Dog, the newsletter for Cummings School of Veterinary Medicine at Tufts University, in 2009. Now here’s something weird. I spent several hours editing it this weekend, only to discover that I had posted a virtually identical adaptation of it last February. Call me forgetful — but consistent.
Excellent (and very thorough) post about a very important subject. Thank you Edie for highlighting this on your blog. Pet owners may (understandably) be concerned about the costs and/or anesthesia associated with proper dental care for their pets, but knowing the risks and dangers of non-anesthetized ‘cleanings’ AND knowing how to help improve your pet’s anesthetic risk is part of becoming the best advocate for your beloved pets.
I hope you don’t mind if I include a link here to a guest post written on my blog by a friend and board-certified veterinary anesthesiologist. Here, in Part 2, she highlights the questions that every pet owner should ask their veterinarian and veterinary team to minimize their pt’s anesthetic risk (whether they are ‘going under’ for a dental or any other procedure). Its all about choosing a competent vet, with a good support team, and then respecting, trusting, and working with them to affect the best care for your pets.
http://thepreventivevet.tumblr.com/post/17316442095/pet-dental-health-month
As for costs, an improper, misleading, and potentially dangerous ‘non-anesthetized cleaning’ will likely cost people more in the long run. Proper home care, including brushing and other steps are the best ‘in between dentals’ things people can do for their pets… ‘non-anesthetized cleanings’ are not.
Thanks very much again for your excellent reporting and writing. Have a wonderful day.
Jason
Thank you for the nice words, Jason, and thank you for the link to your very informative guest post. I’m always happy to provide additional information on a topic; please don’t ever hesitate to add to the conversation!
Edie
My vet has been lecturing me about cleaning Our Best Friend’s teeth for two years. I know I have to do it, but it just seems so gross. And I don’t know how he’ll take it. He still snaps when very frightened, and I like my fingers!
Still, I don’t have $350 for doggy dental work, so maybe I should gird my loins and get to it!
I wish I could say that it’s an either or proposition but regular teeth cleaning won’t prevent the need for professional work, especially in small breeds; it’ll just help in between. I’m going to post about teeth cleaning later this week — stay tuned.
Frankie is not a fan, I should say…
My tweenie short haired Dachshund, Danny Quinn, was a puppy mill puppy given up to a rescue from whom I adopted him. His teeth are terrible most likely to his momma’s poor diet, his penchant for poop and his small size. He gets a full cleaning at least every year.
This year, his “brother,” Seymour PH, a long haired tweenie Doxie, is getting his second dental in two years; his breath was bad, his teeth are tartared; I don’t do cleaning at home but need to start with these two, knowing they may still need their yearlies.
I have a rescue/adoptable senior Beagle, Pink Floyd, with the MOST atrocious teeth imaginable. We have had him on antibiotics for his mouth and ears for two weeks plus Deramaxx for the pain. He is doing better and goes for his dental on Wednesday. He is HW+ but has no murmur and lungs are clear; his teeth and ears take precedence. The wee booger plays with a tennis ball and chewed on a chewy w/o obvious distress.
Excellent article though my vet and her tech are very tired of dentals this month already :). Looking forward to the teeth cleaning article – these guys won’t be thrilled, either.
Consistency can be good :).
Good for you for getting all those pups’ teeth cleaned! It’s amazing how many people think dental care is an indulgence rather than a health essential (and, when I first got Frankie, I was one of them).
Thank you for approving my consistency, condoning my forgetfulness 😉
Thanks so much for sharing this information with your readers. So many people are unaware of just how risky they are as well as the lack of health benefits.
At the Veterinary News Network, we also created a video that outlines the very real problems with these sorts of procedures. I hope you don’t mind my sharing it here.
http://www.youtube.com/watch?v=tvzaUlDUAhU
Thanks!
Tom
My pleasure — and thank you for the terrific video. I urge everyone to watch it as a visual complement to what I’ve discussed here.
They can live without it, but it’s better if they do it for sure.
How often would you suggest a dog’s teeth should be professionally cleaned? Our vet has never mentioned this type of thing to us and I assumed it was because our dog’s teeth are healthy. But now I am wondering if that’s the case or if she just hasn’t brought it up because we’ve never asked. Is this something a dog should have done at every yearly check-up or only every few years?
Thanks for the great information. Shiva’s annual exam is coming up and it’s great to have more questions to ask!
A vet will always let you know if your dog’s teeth need cleaning, trust me. I avoided it for years because of the expense and because it seemed “unnatural” until I realized the health implications for Frankie.
Shiva’s teeth may be fine because of her diet or because of her genetics. If you look in her mouth and her teeth look perfectly healthy, she might not need cleaning at all. But it’s always nice to have it confirmed by your vet 😉
Kristine…just to tag on to what Edie has already shared…
I have seen dogs that go many years (4-6) without every needed a prophylactic cleaning and I have seen dogs (especially toy breeds, schnauzers and a few others) that seem to need cleaning every 6 months. A lot will depend, as Edie said, on your pet’s genetic makeup, diet, chewing activities and, of course, what you are doing at home to help prevent plaque and tartar build up.
How old is Shiva right now?
Finally, just a point to bring up…even though your pet’s teeth may LOOK healthy, it’s usually a good idea to get a baseline set of dental radiographs done. 28% of dogs and 42% of cats that have “normal” looking mouths actually have significant dental disease under the gumline. Good luck with Shiva’s annual exam!!
Tom
Thanks, Tom, much appreciated.
Well, I am glad to hear the answer “definitely not”. I am not familiar how it is in the US but over here in Denmark dental care is only affordable by the rich. For humans and pets alike. I don’t brush Kenzo & Viva’s teeth (they don’t seem to have any problems on the surface). I didn’t know brushing had that little effect before reading this. They get dental sticks that seem to work very well. Lets hope that keeps dental (and financial) problems at bay.
As with anything, dental prevention is cheaper than resolution. Being a dog owner comes with certain responsibilities to the dog and cleaning their teeth properly is one of them. Start saving now and get it done. We had a stray cat that adopted us 10 years ago (still with us!) we took him in to get his teeth cleaned and they had to extract all but one to keep his jaw together. If his name wasn’t already Scrappy we would have called him Snaggletooth. He can only eat soft food (or at least that’s what he tells us) and the extraction was the cost of a cleaning.
Are we rich? Hell no. We just have to prioritize for our awesome over-sized fur distributor.
Our vet in Austin does 0% interest payment plans on dental work. Hopefully, if you’re strapped, you can find one that does too.
Products like Plaque Attack are good but don’t rely on them.
I also agree with Tomcat, that it will depend on your dog. Please don’t think your vet will be offended if you get a second opinion. Our vet encourages a 2nd opinion. If you have a better offer let them know, they may cut you a price break.
Thanks for weighing in here. I just followed your link to Plaque Attack — which I know you said not to rely on — but I should say I noticed some pretty scary comments about the product in the review section on Amazon.
Yikes! You’re right. There are others out there that might be better. We don’t use them, because we do a regular dental visit once a year. I would consult a vet about a supplement. It is for sure not a replacement for a dental visit. I know they suck and they are expensive and your dog will probably hate you but the alternative is way worse. Love your blog!
Thanks on all counts, John. It’s tough to get one’s head around the dental visit — I’m just paying off last year’s, in fact — but I know how important it is.
I have a 2 year old spaniel and I actually took my dog into get her teeth cleaned for the first time. Even if you have a vet that you continue to go to, be sure to call up for prices! I had found that the vet down the road from the vet that I always use was almost $50 cheaper.
An eye opening blog Edie. Didn’t know the importance of dental health for dogs.
Awesome post here, teeth cleaning services are very important, even in animals. This is a informative blog. Thanks for sharing!
Indeed, some breeds develop early symptoms of dental problems. But the most difficult ones to treat are the small dogs because they also have small teeth. Regular pet dental should be done, along with radiographic evaluation.
Wonderfully well put. Thank you so much for writing this!
Thanks for letting me know that dogs are more susceptible to bacterial infection since dogs can’t spit. Since I got my puppy, I’ve been wondering if I should bring him in for any dental cleanings. Now that I know that my dog is more likely to get a bacterial infection in his mouth, I’ll be sure to bring him to the vet for a dental cleaning as soon as possible.
Thank you for pointing out that the teeth and gums are very susceptible to bacterial infection. My dog is like a child to me and I want to do everything I can to keep her healthy. I’ll have to look into different places that offer teeth cleaning for her.