Thursday, October 24, 2013

Is General Anesthesia Really Necessary for Dental Cleanings?

By:  Matthew Lemmons, DVM, DAVDC

The American Animal Hospital Association (AAHA) recently made a requirement that all of its member hospitals only perform dental cleanings under general anesthesia with an endotracheal tube in place, AAHA Dental Guidelines.  This decision has come under fire from groups who perform dental cleanings without anesthesia.  Fairly, we should look at each side’s concerns.

The groups who perform dental cleanings without general anesthesia argue that their trained staff can safely and completely clean the teeth without general anesthesia.  They also correctly state that there is an inherent risk whenever general anesthesia is performed.  Some of these groups only recommend non-anesthetic dental cleanings (NADs) in between complete cleanings under general anesthesia as preventative maintenance.  Some believe general anesthesia is only required if there is a need for extractions or other involved treatments.

Those who believe general anesthesia is required state that scaling of all the teeth surfaces and cleaning below the gum line is not possible when a patient is awake.  Additionally complete diagnostics including periodontal probing and dental x-rays cannot be adequately performed in an awake patient.   One group taking this stance is the American Veterinary Dental College, who are the only group of veterinary dental specialists recognized by the American Veterinary Medical Association.  The College’s position can be found here, Dental Scaling Without Anesthesia.

I believe that some of the groups supporting NAD do have the pet’s best intention in mind.  Their thought is that the risk of an adverse reaction under general anesthesia is too high to justify an anesthetized cleaning.  I agree that if general anesthesia is not properly performed, the risk of a problem occurring is high.  However if the right precautions are made, the risk of an event under general anesthesia is minuscule in a healthy pet.

Adequate dental care can not be provided on an awake patient in the vast majority of cases.  Most of the patients I see have some degree of gum recession and bone loss which requires more than simple scaling and polishing.  As well, a number of patients I see who have had a recent anesthetized dental cleaning have large amounts of dental tartar left behind.  If dental tartar is left behind in some anesthetized patients, how can it be completely removed in an awake, uncooperative patient?

In conclusion, adequate dental scaling and polishing does require balanced and monitored general anesthesia.  It is my opinion that cleaning teeth without general anesthesia is simply cosmetic and not therapeutic.  It is a disservice to the pet and client.

 

 

Friday, October 11, 2013

The Great Greta



Remember The Great Gatsby, a legendary novel about the Roaring 20’s full of glamor and the romance of noble deeds?  Well, today we share the tale of The Great Greta, a Terrier who followed a young man home one day and worked her way into a community’s heart.
 
The name, Greta, means “Pearl” and just like a pearl, Greta dazzles everyone she meets.   So, when Greta suffered a debilitating back injury, her family did not have to think twice about getting help for her.  Greta underwent back surgery with Dr. Rebecca Ball, DACVS, and has begun a series of physical rehabilitation treatments with Dr. Karen Hull and Dr. Kelly Fisher, CCRP.   
Greta enjoys a picnic lunch with
Technicians, Stephanie and Kim

Along with the support of her family and medical team at Circle City Veterinary Specialty & Emergency Hospital, Greta has developed a significant fan base because she has accompanied one of her favorite people, her dad, Ben, on his travels around town. Her glittering personality charmed the masses and get well wishes flow in as word of her injury spreads.   On October 23, the Tomlinson Tap Room will host a Tap Takeover & Fundraiser for Greta with the Fountain Square Brewing Company donating one of their favorite brews and affectionately renaming it, “Puppy Pilsner”. 

Grandma Cathy with Greta
during a rehabilitation session
Take a few minutes to meet Greta and make a toast on her behalf.  Her sparkle remains in spite of her circumstance and we will bring you back to her story as her rehabilitation continues.