More discussion about anesthesia-free teeth cleaning

Dr Riggs started off a conversation last week about why a veterinarian should clean your dog's teeth (Guest Post: Why Have Your Dog's Teeth Cleaned By A Vet Anyway?) and there were some interesting comments about other alternatives. Dr. Riggs asked me to post his response to these comments:

Wow...who would have thought we could stir up this much controversy with a little dental blog!

In response to the comment about Vet Economics:
Veterinary medicine is a business. We do need to make a living through the services we perform. I can assure you the vast majority of vets do not recommend services(or "pad the bill"), such as dentals ,when they are not needed. We need to offer the best medicine and let the owners decide. One of the mottos we follow is, "Always offer what is indicated, nothing that is not". 

In response to the comments about anasthesia-free teeth cleaning:
What people don't realize is that you cannot do a thorough sub gingival curetting without anesthesia. The dogs will not let you. Anesthesia in animals, using the right equipment and agents, is safe. Our veterinary technicians are extensively trained and we use pulse oximeters, blood pressure machines and warming devises (bair huggers) to ensure the patients safely.

Can you do a little scraping under the gums without anesthesia? Sure, but not a true cleaning. The difference with human dentistry and veterinary dentistry is that animals will not open their mouth for you to clean under and around the teeth and gums on all four sides. You must clean all sides of the teeth to clean properly. When you scrap the enamel, you must then polish the teeth to help eliminate the microscopic grooves left in the enamel. This is done with a low speed polishing drill. If not, these grooves act as a scaffolding for tarter to grab hold. This is another step not done by the groomers.

The dentals we do also include dental radiographs. You can not tell tooth root abscesses without radiographs. It is the same reason dentist use dental radiographs on us. These require anesthesia in animals. (some pictures below) 

Finally, one misinterpretation from the article I think, was that you need to do a prophylactic dental each year. You normally do not. If the people brush the dogs teeth regularly often you can wait 3 to 4 years between dental. Owners have a lot of power in determining their pets dental health. We evaluate each animal yearly on their normal vaccine exams.

Rex C. Riggs D.V.M. Best Friends Veterinary Hospital Powell, Ohio. BFVH.org

First picture: The black on the xray is where bone has eroded away. So you can see the roots on the middle tooth is just barely on the bone. If more then 50% of the root is exposed then that tooth need to come out. We removed this tooth.

Second picture: The bottom tooth has total destruction of the roots and now has an infection of the jaw bone. On this xray you cannot rule out even a tumor. we tooth this tooth out and biopsied the jaw. This came back osteomyelitis.

Third picture: This is a good example of a root abscess on two teeth . The big 2nd tooth has the black halo area under the bifurcation. Then the third tooth has the classic halo around the first root. Both of these teeth needed removed.

What do you think?