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Anesthesia Free Dentistry for Pets Especially Dogs and Cats…Malpractice?

Brett — Tue, 21 Dec 2010 01:37:42 +0000

Anesthesia free dentistry (anesthesia-free) in pets particularly in dogs and cats is unfortunately becoming more common. This is a very timely and important post meant to benefit pet parents, veterinarians and most of all our pets.

This case is unfortunately a very common problem these days. In order to avoid general anesthesia, as was the case in this 10 year old dog, the choice was made to to provide regular cleaning without anesthesia. Although this patient received excellent home care including brushing daily profound disease below the gum line was the disastrous result. Is anesthesia free dentistry for our pets the right choice? Please view the pictures of this patient below. Commentary to follow.

The right maxillary premolars and molars only have minor tartar and relatively no gingivitis

Radiograph of the teeth in the picture above. The arrows point to dark areas that represent the profound destruction of bone due to periodontal disease.

The right mandible of the patient above shows little tartar or gingivitis

The arrows point to black voids in the bone destroyed by periodontal disease.

The case above is the rule, not the exception. Disease below the gum line results from plaque accumulation and years of improper “oral hygeine” in the form of anesthesia free dental cleaning.

This bizarre practice originated in grooming facilities as a service to supplement income despite its negative impact on the patient. As sad as it seems some veterinary practices have adopted this practice for similar reasons.

Unfortunately it is very harmful for the enamel by creating more of a rough surface for plaque and tartar to accumulate more quickly and in greater volume. More importantly it does the patient a great injustice by neglecting the only place where periodontal disease is most profound: below the gum line.

Lawsuits against those performing this service are on the rise. Anesthesia free dentistry is cosmetic only, hiding the true disease that exists below the gum line. Seek professional dental care from caring veterinarians who have been properly trained to perform safe dental cleaning, proper oral evaluation, dental probing and x-rays under anesthesia.

The American Veterinary Dental College Position Statement on Companion Animal Dental Scaling Without Anesthesia

Veterinary News Network on Anesthesia Free Dentistry for Pets

Tooth Discoloration in a Dog Requiring Root Canal Therapy.

Brett — Sun, 21 Mar 2010 14:45:58 +0000

This dog belongs to a local law enforcement agency in Atlanta. The officer astutely noticed the discoloration of the canine tooth. Any tooth that is discolored intrinsically as this one is should have root canal therapy or be extracted. The pulp is dead or in the process of dying and will cause problems with bone destruction at the root apex (tip) Notice the wide periodontal ligament space associated with this tooth radiographically. The obturation material consisted of a simplifil plug and Guttaflow.

Jaw Fracture Repair in a Dog Utilizing Titanium Mesh

Brett — Sat, 30 Jan 2010 13:28:01 +0000

This dog had a right mandibular fracture secondary to chronic periodontal disease. The jaw fractured spontaneously. It was repaired utilizing a titanium mesh material and an osteoconductive bone putty. http://www.securos.com/downloads/SI%20VelosityPuttyBrochure5.pdf

Brett Beckman, DVM, FAVD, DAVDC, DAAPM
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The fracture line can be seen overshadowed by the first molar mesial root. The site of the mesial root of the 4th premolar was near fracture. The veterinarian did a great job avoiding fracture when extracting these teeth.

Post extraction the fracture line becomes visible. This was a chronic fracture that had the body had attempted to heal. Fibrous tissue was present around the site and provided minor stability.

View of the right mandible after fitting the titanium mesh. The ventral mandible had considerable fibrous tissue present. Disrupting this would have created more instability. The plate was placed over the fibrous tissue. This gives the appearance on the final radiography that the plate doesn't conform well to the mandible. On the contrary this material is very compliant and fits tightly to the bone with minimal anchorage.

The vestibular aspect of the right mandible, screw placement

You can appreciate the delicate structure in relation to my fingers. The plate placed was about 5 times the size of this peice that was clipped off of the portion utilized in this case.

The final repair preclosure

Postop radiograph showing screw placement. Accomodation of the mesh was excellent. Consequently a lingual screw was not needed

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