Non-Anesthetic Dentistry (NAD) vs Anesthetic Dentistry

Is it worth putting my pet under general anesthesia for a dental procedure?

Due diligence by both our veterinary team and wonderful clients has helped us to raise awareness on the potential severity of dental disease (beyond just a pretty smile). The importance of maintaining a healthy mouth is, appropriately so, becoming more and more a priority. We understand one of the key parts of accomplishing this task is regular dental cleanings and dental radiographs. These require general anesthesia…and anesthesia can be scary! The inner dialogue has changed from thinking dentals aren’t necessary or worth the money, to knowing the benefit but wondering if it’s worth the risk. We must weigh the risk versus the reward on a case by case basis. The overwhelming majority of the time it is worth the risk but each case varies. This is a talk to have one on one with your veterinarian. 

Anesthesia makes me nervous, can you try cleaning his teeth while he’s awake?

From this fear, the practice of performing dentistry in an awake animal, or nonanesthetic dentistry (NAD), has become more and more prevalent. Given the inherit worry involved with anesthesia the popularity is no surprise. Some people have heard of them, others come saying they’ve had them done before. Sometimes it is just curiosity and fear of anesthesia that leads to wondering why we can’t try in a cooperative patient. The fact is NAD really is not a reliable alternative.

What happens during a dental that requires anesthesia?

There are many steps to achieve an effective dental cleaning. They include supragingival scaling (cleaning the crown of the tooth), subgingival scaling (cleaning beneath the gum line), tooth by tooth probing to identify disease, dental radiographs to help identify disease, extraction of any unhealthy teeth identified using diagnostic aids, polishing the teeth, etc. Of all these steps only one can be completed by NAD and that is clearing off debris from the crown. Even this one step is not accomplished well as a moving animal often leads to a rough enamel surface and the inability to polish which greatly increases the rate of recurrence. This is one of the biggest problems with NAD. We have a false sense of security seeing the calculus scraped off our pets teeth. The result is an apparently clean mouth and resolved issue. Meanwhile, we have not even halted the disease process. Underneath the gumline disease continues to progress often times unnoticed as we have temporarily removed signs of dental disease. The result is periodontal disease and the loss of many more teeth than necessary.

Fear of anesthesia is natural and we understand and respect any hesitations you may have. Please be open with us! We are happy to answer any questions you may have. Only the bravest of us (including veterinarians) have no fears when it comes to anesthesia. When my own pets are required to “go under” for a dental or other procedure, despite knowing the minimal risk often associated, there’s always the hidden corner of my mind that’s slightly worried. However, I know it’s worth overcoming that fear when we can improve the quality of our animals lives through improved dental and oral health.

For more information visit the below pet owner resource pages:

American Veterinary Dental College

American Animal Hospital Association