Anesthesia versus Non-Anesthesia
Welcome to Woof Gang The Villages first BLOG article.
While we offer Non Anesthesia Dental Scaling (NADS), in the store, under direct supervision of a Veterinarian, it is imperative that our pet parents have all the information I can provide before making important health choices for their pets. The facts of this debate will be discussed in detail so you can decide what is best for your pet
I will begin by pointing out the obvious, I am not a veterinarian, nor should any information we provide to our pet parents replace the advice you receive from your veterinarian. While I believe knowledge is power, conversations such as this is meant to send you on your own educational journey, reading, gathering information and discussing with your veterinarian before making any decisions.
In 2004 The American Veterinary Dental College published a position statement entitled, “Companion Animal Dental Scaling Without Anesthesia” (NADS).
The Dental College position was clear in their belief that NADS was “inappropriate “ for a number of reasons:
· Beginning with the inability to perform the most important and basic portion of the cleaning, the oral exam, complete with x-rays. It is their position that a complete, comprehensive oral exam is impossible if the animal is awake and not anesthetized under general anesthesia.
· Access to the area under the gum line is not possible in a conscious animal.
· Concern, that the slightest head movement by an awake animal can result in oral injury and a possible bite to the health professional performing the cleaning.
· Finally, stress on the pet is considered a valid health consequence for the animal restrained while awake during a procedure that may be painful and he has no understanding of.
· Another important consideration when choosing between NADS and conventional dental cleaning is the value of intubation in protecting the animal’s airway from potential inhalation of debris, water and secretions during the procedure. This is a powerful, valid argument when considering what is best for your animal. The veterinary community also provides reassurance to pet parents afraid of anesthesia complications, stating almost any pet can be anesthetized safely today.
As the battle raged on in the veterinary community, in 2013 The American Animal Hospital Association published their guidelines “AAHA Dental Care Guideline for Dogs and Cats”.
The AAHA felt so strongly that all dental cleaning be performed under anesthesia that veterinary practices compliance was mandatory in order to obtain accreditation by the AAHA.
AAHA supports the administration of anesthesia for the exact reasons mirrored by those of the AVDC with a few additional caveats. AAHA considers NADS to be purely a cosmetic procedure. That while the teeth appear clean and visibly whiter, there is no ability to clean beneath the gum line where bacteria lives and causes periodontal disease. Additionally, without x-rays there is no way to evaluate the majority of dental pathology that cannot be appreciated on visual exam.
Ok, so now we get it…. Dental cleaning with anesthesia is the only way to go.
NOT SO FAST!!!
Where is the science? Are there any comparative studies to validate, that NADS is an inadequate means of dental cleaning when compared to cleaning the teeth while under anesthesia??
The only study to my knowledge was performed in 2013 and published in The Journal of Integrative Veterinary Care.
The study was initiated by Dr. Joshua Bazavilvazo the founder of Pet Dental, a NADS service. Dr. Bazavilvazo, Dr. Mayra Urbeta, Dr. Stephanie Sur and several others compared 12 dogs and 12 cats where NADS was performed. The animals were then anesthetized and examined. Eureka!!….No evidence of residual plaque or tarter was detected IN ANY OF THE ANIMALS. Success of the NADS is dependent on the skill level of the practitioner performing the procedures and to date, there are no standards for instruction, testing or certification.
Two harsh critics of NADS, Dr. Kate Knutson who was an AAHA delegate and Dr. John de Jong became believers after seeing numerous NADS performed and both believe NADS has a valid place in routine oral care for our companion animals, landing somewhere between screening and detection. Dr. de Jong has gone so far as to say, conscious dental cleaning can be a valuable adjunct to complete and thorough oral health care.
Ok, so where do we land???
Experts on either side, even those who perform NADS and those that have seen it’s value, believe all companion animals should have routine dental cleaning under anesthesia where x-rays and deep cleaning and examination can be performed. How often will depend on the propensity of your pet to develop plaque and tarter, your wallet and a belief system that it is totally necessary to put my dog out. NADS is certainly valuable for in -between cleanings, for owners that absolutely will not anesthetize their pets for this procedure or for owners where the procedure itself is cost prohibitive. The AAHA statement is clear: it’s all or nothing. That leaves a large number of pets suffering from severe dental disease. Hopefully, as larger studies are performed, the entire Veterinary Dental community will make pet owners decisions easier and will accept the usefulness of NADS as an adjunct to routine dental cleaning under anesthesia.