Anesthesia Free Dentistry – is it worth it?

Anesthesia Free Dentistry (AFD) or Non-Anesthetic Dentistry (NAD) is becoming more common in pet stores and grooming facilities across the U.S. and in the Phoenix area. But is this a good procedure for your dog? The short answer is no, it’s not good for your dog. Let’s talk about this in more detail.

Anesthesia Free Dentistry is a procedure where a “trained” hygienist cleans the tartar off of your dog’s teeth while they are awake. They use techniques to restrain your dog so they can’t move and use objects like a mouth bar to keep the mouth slightly open to get to the surfaces they can reach. I say “trained” hygienist with quotes because there are no recognized certifications for veterinary hygienists like there are in human dentistry. Anyone can perform an AFD or NAD on your dog. The only thing that is required is that they are supervised by a veterinarian.

There are several reasons that this procedure is not good for your dog. First, you have to understand dental disease. The process of dental disease happens under the gum line and not just on the surface of the tooth. Plaque and bacteria under the gum line cause inflammation and then damage to the tissues that hold the tooth in the socket. This inflammation becomes periodontal disease which can cause root exposure, tooth mobility, abscess, and tooth loss.

If the plaque and bacteria under the gum line are not cleaned, the inflammation and gingivitis will persist. When AFD (Anesthesia Free Dentistry) is performed, the hygienist is unable to sufficiently clean under the gum line, no matter how convinced they are that they can! It hurts to have sharp instruments placed under the gum. You probably can remember a moment when you were having your teeth cleaned and the hygienist had to go deeply into one spot. It can be painful! Dogs can’t understand that they must sit still through that moment of pain and they won’t allow it. Dogs also won’t sit with their mouths wide open like we do, so the operator will be unable to the back side of that last upper molar, or the inside of that lower molar next to the tongue. It’s practically impossible.

So you might ask, what is the harm in at least removing some plaque and tartar? This is the biggest reason why AFD is not good for your dog. If the visible tartar is removed, you as a pet owner and any veterinarian you see in the future may look at your dog’s mouth and say things look really good. But it’s a fraud! The teeth may be clean but the areas where dental disease lurks are still dirty. It does your pet absolutely no good.

Veterinarians who oversee these procedures believe they are good for your pet, and also believe that they can do an awake examination to determine if your dog is a good candidate for AFD. If they see evidence of disease they will refer you for an anesthetized dental procedure. Unfortunately, by the time the disease is visible to the eye on the awake exam, it’s usually very advanced. The purpose of dental cleanings are to prevent disease and this can only be done under anesthesia.

There is the possibility of harm to your dog during AFD (Anesthesia Free Dentistry). There was a reported case in California where a small dog sustained a jaw fracture during AFD. This occurred because the jaw was already weak due to periodontal disease, which the operator did not see. When the jaw was pressed on it fractured. If the pet had been placed under anesthesia and had an evaluation with dental x-rays, this could have been avoided.

Dental x-rays are critical in detecting dental disease under the gum line, along with gentle probing around each tooth. This can only be performed with anesthesia because your dog won’t hold dental x-ray film in the mouth and sit still for dental x-rays.

Several states in the U.S. and one province in Canada have banned AFD and the procedure is considered malpractice. Most veterinary dental specialists across the country feel the procedure is of no benefit. The American Animal Hospital Association (AAHA) and the American Veterinary Dental Society (AVDS) have position statements advising that dental procedures should be performed under anesthesia.

Many pet owners have concerns about anesthesia in pets. This is a valid concern and one that needs a separate blog to go into detail about. However, anesthesia protocols, monitoring and support techniques make anesthesia very safe in animals. We are happy to discuss this further with you during your next appointment with your pet.

We are happy to discuss your pet dental care needs further with you during your next appointment with your pet.

Our recommendation is to avoid AFD and discuss with a veterinarian trained in dentistry about what is right for your dog. Not all veterinarians have an interest in dentistry so it’s important to ask them what kinds of additional training they’ve had. For preventive maintenance between routine anesthetized dental cleaning, tooth brushing at home is by far the best. The soft bristles of a brush can reach under the gum line and remove plaque, and daily cleansing of the teeth prevents plaque from turning into the ugly tartar that you see. Plus it’s safe! We are happy to give you a tooth brushing demonstration for your dog and help you with a home care program.

If you would like to read more about the position statements and dental care guidelines of the AAHA and AVDS they can be found here:

• https://www.aahanet.org
• http://www.avdc.org

Here are links to websites with more information and examples of pets who have had disease progress undiagnosed because of anesthesia-free dentistry:

• AZ Vet Dentists
• wellpets.com
• mypetsdentist.com
• AAHA NET

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