Anesthetic-free dentistry for pets remains controversial

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Veterinary practices -- even dog groomers -- are now offering anesthetic-free dentistry for dogs and cats. And the procedure has caught on. However, cleaning a pet's mouth without anesthesia is not without controversy. Among the detractors are specialists in the veterinary dentistry.

Dr. Jan Bellows, president of the American College of Veterinary Dentistry, doesn't mince words: "Anesthetic-free dentals are a waste of money; the public is being bamboozled," he says.

Last month, the American Animal Hospital Association (AAHA) officially added its voice to the conversation with an unequivocal position statement, which leaves little wiggle room, stating opposition to anesthetic-free dentistry and questioning the procedure's effectiveness and safety.

Anesthetic-free cleanings began several years ago as a means to both lower the cost of cleanings and to address safety issues involving anesthesia.

Bellows says that anesthesia is, in fact, safe, assuming it's being administered and monitored by a qualified professional, with problems occurring somewhere between one in every 5,000 to 10,000 procedures.

Anesthetic-free cleanings are offered by a wide range of professionals, including veterinarians and their technicians at clinics, dog groomers and even some human dental technicians and veterinary technicians setting up shop at pet stores, boarding facilities, and even in their garages.

"Would you go to your hairdresser to have your teeth cleaned?" asks AAHA President Dr. Kate Knutson. "A pet's mouth isn't the same as a human one, and requires veterinary expertise." Besides, doing a veterinary procedure without veterinary oversight is against the law in many states, though the public may be unaware of this.

Josh Bazavilvazo, CEO of Pet Dental Services, agrees that anesthetic-free dentistry should only be conducted at veterinary clinics with trained professionals using cutting-edge equipment and special training. His company does just that, training those professionals.

"We're actually proponents of dentals with anesthesia," he says. "The anesthetic-free dentals are for in between, to keep mouths in shape. What we do is being misinterpreted by some. Imagine what your mouth what would like be if you didn't brush -- and the reality is that most pet owners don't brush their pets' teeth. I argue we can get ahead of problems. If a mouth looks really bad, we simply don't do an anesthetic-free (dental) and advise the pet be anesthetized for the dental."

Knutson says the problem is that it's impossible to know what's really going on in any pet's mouth without x-rays, since 60 percent of what's happening is below the gum line. Bazavilvazo agrees that x-rays are ideal, but many practices don't have the equipment, or pet owners are not willing to pay the fee. He insists that his technicians can conduct effective cleanings and also alert veterinary staff to any additional issues.

Bazavilvazo says he has scientific evidence showing that anesthetic-free dentistry for pets is effective. Bazavilvazo says his trained professionals can identify abnormalities which require additional treatment, which most likely would be done under anesthesia. And also, following his dentals, no residual calculus is found above or below the gum line. In other words, the anesthetic-free dentals are effective when trained experts do them. To prove it, he conducted a double-blind study in conjunction with a veterinary dentist, set to be published in a peer-reviewed journal, though Bazavilvazo wouldn't offer the name of the journal or the veterinary dentist he worked with.

It turns out Bellows was that dentist, and according Bellows, that's not at all how he interpreted the findings, and Bellows ultimately disassociated himself from the study.

Bellows says that after the anesthetic-free dentals, fractured teeth, abscesses and various other problems were discovered. And calculus was discovered above and especially below the gum line.

Another concern is animal welfare.

"Imagine undergoing a tooth cleaning but not being able to raise your hand when you're in awful pain," Knutson says.

Some pets are clearly in pain as they enter a clinic, as observed by the owner, or as the pet is indicating, and such animals are not candidates for anesthetic-free dentals, at least from those trained through Bazavilvazo's Pet Dental Services company. Bazavilvazo also says the practitioners he trains assess if a pet is in pain before or during a tooth-cleaning procedure, and if so, the procedure is not performed. However, Bellows notes that many animals effectively mask pain, so there's simply no way to know their pain level for certain

Knutson says there's no doubt that when done well, a pet's teeth look nice after an anesthetic-free procedure, but what's happening below the gum line isn't addressed.

"Clients think the teeth look nice," she says. "But anesthetic-free dentistry provides clients with a false sense of security. Eventually, they find out their four-legged fur baby has been in pain all along with 20 undiscovered abscesses. They are horrified that their pet has been in pain and they feel taken advantage of. And in the end (treatment) costs more."

Bazavilvazo insists such a scenario is unlikely to occur when highly skilled professionals are conducting a dental.

"The problem with the statement in opposition to anesthetic-free dentistry is that it will still be the Wild West out there -- with all sorts of people doing it, preying on the public," he says. "I think there should be standardization and even certification to qualify professions to conduct anesthetic-free dentistry."

Bellows, an author of the AAHA "Dental Care Guidelines for Dogs and Cats," concedes Bazavilvazo's professionals are well trained.

"The problem is that certifying people to do something for which there's no benefit doesn't make common sense," he says.

(Steve Dale welcomes questions/comments from readers. Although he can't answer all of them individually, he'll answer those of general interest in his column Send e-mail to PETWORLD(at)STEVE DALE.TV. Include your name, city and state. Steve's website is http://www.stevedalepetworld.com; he also hosts the nationally syndicated "Steve Dale's Pet World" and "The Pet Minute." He's also a contributing editor to USA Weekend.)

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