This Trendy Pet Dental Procedure May Do More Harm than Good

By Dr. Karen Becker

Nonprofessional dental scaling (NPDS), also known as anesthesia-free dentistry, is gaining popularity with an increasing number of dog and cat owners. These are well-meaning pet guardians who may be fearful of anesthesia or may not be able to afford professional veterinary dental care. They want to provide some form of oral care for their pets, so they opt for NPDS.

However, anesthesia-free dentistry is essentially a cosmetic procedure that addresses only the parts of your pet's teeth you can see. The question many pet healthcare professionals are asking is whether NPDS procedures are doing more harm than good. One of the biggest concerns many veterinarians have with just scraping teeth is that the mouth is full of blood vessels, which can launch oral bacteria into the bloodstream. Once the bacteria is in the bloodstream it can infect other organs like the valves of the heart, resulting in a disease known as vegetative valvular endocarditis.

Read the American Veterinary Dental College's (AVDC) position statement on dental scaling without anesthesia.

Why Anesthesia is Used for Dental Procedures

The fact is, a truly thorough oral exam and cleaning can't be accomplished on a pet that is awake. Anesthesia has several benefits when it comes to caring for your pet's mouth, including:

· Immobilizing your dog or cat to insure his safety and cooperation during a procedure he doesn't understand and is stressed about.

· Allows for a thorough exam of all the surfaces inside the mouth and the taking of x-rays.

· Allows for scaling below the gum line where periodontal disease is most active.

· Pain management.

A dog or cat who isn't sedated simply won't tolerate a thorough inspection of his mouth. He'll move around a lot, making the use of sharp instruments extra dangerous. Cleaning below the gum line of a fully alert animal is something that should never be attempted. Pets won't stand for it because not only does the procedure cause tremendous stress, it's also extremely painful. And if tooth extractions are necessary, they are out of the question for un-anesthetized pets.

How Anesthesia-Free Dental Procedures Might Do More Harm than Good

Non-professional dental scaling can potentially give pet owners a false sense of security about the state of their dog's or cat’s oral health. Even though your pet's teeth – what you can see of them – may look clean and fresh after an anesthesia-free dental procedure, what you can't see is actually more important. Problems like tartar buildup below the gum line and gingivitis aren't addressed during a procedure that only scrapes and polishes the teeth. Most oral disease happens below the visible surfaces of your dog's or cat's mouth.

NPDS is an aesthetic procedure that doesn't deal with gum problems or other risks to your pet's overall health that can develop from disease that starts in the mouth. It doesn't allow for probing of the gums to look for the presence of deepening periodontal pockets or bone destruction resulting from gum disease.

The majority of older dogs that have undergone anesthesia-free dental procedures for years wind up with significant dental disease requiring multiple extractions as they age.

With all that said, there are certainly situations in which I remove plaque and tartar from a pet's teeth without using anesthesia. Each pet and situation is different. I don't do it in lieu of a thorough dental exam, and I don't do it on pets for which I have no dental history. But if, for example, I have a pet with a large chunk of tartar that is irritating his mouth, I'll remove that tartar without anesthesia if I can do it easily and without stressing out the patient.

When Putting Your Pet 'Under' is a Concern

The prospect of making a beloved pet unconscious with anesthesia is a distressing worry for many people. If you are among them, Dr. Brett Beckman, writing for dvm360, offers this advice:

Veterinary practices that routinely perform dental radiography and probing on all dental patients practice at an advanced level of care. They're also likely to be well-equipped to safely monitor patients and handle any problems they encounter.

Administration of premedications and nerve blocks enables patients to be kept at anesthetic depths consistent with that of a light general anesthesia. This keeps patients close to waking, even when extractions or other invasive procedures are needed, thus maximizing cardiac output and tissue perfusion and maintaining blood pressure.

Story at-a-glance

· Non-professional dental scaling (NPDS) for pets is becoming increasingly popular, however it is a purely cosmetic procedure that doesn’t address any dental problems below the gum line. A truly thorough oral exam and cleaning can’t be accomplished on a pet who is awake.

· Anesthesia is an important component to a thorough dental exam, and should be used for most dental procedures performed on your pet.

· Pet owners worried about putting their animals ‘under’ can arm themselves with the latest information and advice about safe veterinary anesthesia.

· At-home dental care is also very important to your pet’s oral health.

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What is Laser Therapy?

Laser therapy is the use of specific wavelengths of light (red and infrared light) to achieve therapeutic effects. The goals of laser therapy include faster healing time, decreased pain, improved circulation and decreased inflammation. Laser therapy is a fairly new treatment modality in the United States, but has been widely used in Europe since the 1970s by physical therapists, nurses and doctors. Now, after FDA clearance in 2002, laser therapy is being used extensively in the United States in both the medical and veterinary medical fields.

Has laser therapy’s effectiveness been documented scientifically?

Yes, there are thousands of published studies that demonstrate the clinical effectiveness of laser therapy. Among these, there are more than one hundred rigorously-controlled scientific studies that document the effectiveness of laser therapy for treating many clinical conditions.

What are the effects of laser therapy on body cells?

During laser treatment, the infrared laser light interacts with tissues on a cellular level. Tiny particles of light called photons activate the mitochondria, which are the “powerhouses” of body cells. This leads to an increase in metabolic activity within the cell, improving the transport of nutrients across the cell membrane. This then initiates the increased production of cellular energy called ATP and thus a cascade of beneficial effects. Ultimately, laser therapy leads to increased cell function, health and healing.

What do these changes mean therapeutically for my pet?

During each treatment, laser energy increases circulation, by causing water, oxygen and nutrients to go to damaged areas of the body, even in chronic conditions. This change creates an optimal healing environment that reduces inflammation, muscle spasms, stiffness and pain.

What should I expect?

There is no sedation or restraint required and the experience is usually pleasant and comforting to most pets. Most pets do not need to have any hair clipped or any special preparation for treatment.

Although improvement is often seen after the first visit, most patients require several treatments (between 3-8 treatments, and sometimes more) for the greatest benefit to be seen. This is due to a cumulative effect that laser therapy has on affected areas of the body. An example of a treatment plan:

o Every other day for one week (3 treatments)

o Twice the second week (2 treatments)

o Once the third week (1 treatment)

o Boosters as needed (often monthly or every few months)

Treatments are customized for your pet and vary in length depending on the affected area(s). Most treatments take between 2-8 minutes. A majority of patients exhibit greater comfort and mobility within 12-24 hours after a laser treatment.

Frequently Asked Questions

Does laser therapy hurt? What does a treatment feel like?

There is little to no sensation during treatment. Occasionally, the patient may feel a mild, soothing, warm or tingling feeling. Areas of pain or inflammation may be sensitive briefly before pain reduction.

Are there any side effects or associated risks that I should be aware of?

During more than twenty years of use by human healthcare providers, very few side effects have been reported. Occasionally, some old injuries or pain syndromes may feel aggravated for a few days, due to the healing response being more active following treatment. This may be evident in your pet as a mild sleepiness or stiffness.

How long does each treatment take?

Most treatments take only 3 to 8 minutes, depending on the size of the area that is being treated.

How often should my pet be treated and how many treatments are required?

Most acute conditions may be treated daily or every other day, especially if they are accompanied by significant pain or discomfort. More chronic problems respond better when treatments are received two to three times a week, tapering to once every week or two (or perhaps monthly) as improvement is seen. The number of treatments required depends of the nature of the particular condition being treated. For many acute conditions, 1-2 treatments may be sufficient. Conditions of a more chronic nature may require 5-8 (or more) treatments. Some conditions may require ongoing periodic care to control pain.

How long until results are noticeable?

Your pet may feel improvement in their condition (pain reduction especially) after the first treatment. Sometimes, it may take a few treatments (often 4-5 treatments in chronic conditions) until a noticeable effect is seen. Each treatment is cumulative and is helping with the healing process and pain management.

Can laser therapy be used in conjunction with other forms of treatment?

Yes, laser therapy is often used with other forms of pain management and physical therapy. Other treatment modalities are complementary, and can be used with laser therapy to help increase the effectiveness of treatment.

What are the costs associated with laser treatment?

We currently are offering packages of 6 laser treatments, for most chronic conditions that need treatment. We also offer individual treatments. Please ask us for pricing and scheduling information.

Stem cell therapy is a recently developed technology for use in our pets.  Stem cells have been a hot topic of debate in human medicine due to use of embryos to harvest them.  The technology in pets, however, is slightly different.  We use adult stem cells harvested from your own pet’s fat to inject into your pet’s painful, arthritic joints.

How does this work?  Well first, we must know what stem cells are and what they do.  Stem cells are pregenitor cells.  They can differentiate into many different types of tissues, including muscles, nerves, cartilage, bone, fat, liver, as well as others.  These cells are drawn to areas of damage within the body, where they help to repair damage that has occurred.  In the case of arthritis treatment, the cells are injected straight into the joint.  Studies have shown that these stem cells help repair damaged cartilage, decrease inflammation, prevent damaged cells from dying, heal these damaged cells, and promote active tissue regeneration.

How do we treat your pet with stem cells?  First, we have to harvest fat from your animal.  This is done with a brief anesthetic procedure and surgery.  The fat is collected and shipped to the lab to have the stem cells harvested.  The most common area for fat collection is just behind the shoulder blade.  The lab then harvests the cells and ships them back within 24 hours, for a total turnaround time of 36 to 48 hours.  When we have the cells, your pet is lightly sedated and the cells are injected into the damaged joint.  Rest is important for 30 days after the procedure, at which time exercise and physical therapy are encouraged.  We will provide specific exercises to perform with your pet based off of which joint or joints have been treated.

Studies have shown that 80 to 90% of dogs have an improved quality of life. One third of all dogs treated in the clinical trials were able to completely stop giving non-steroidal anti-inflammatory drugs, and another 28% were able to decrease the dosage after just 90 days.  Dogs treated with stem cells were also shown to have increased range of motion in affected joints, decreased lameness, and decreased overall pain.

Is stem cell therapy safe?  There is minimal risk involved in stem cell therapy for several reasons.  First, the cells we are injecting into your pet came from your pet! This minimizes any chances for a tissue reaction or rejection of the cells.  Second, the cells that are collected are not changed in any way.  The lab does not manipulate the cells or modify the cells.  They simply collect them from the fat and send them back to us in an injectable form.  In addition, there have been numerous publications supporting the safety of stem cell therapy in animals.  The total number of adverse events in the clinical trials was less than 1%, and the events were related to the harvesting of the fat or the injection itself rather than the use of stem cells.

Does my pet need stem cells?  Currently, stem cell usage is limited to arthritis and orthopedic soft tissue damage, including ligaments, tendons, and fractures.  Studies are ongoing with liver disease, kidney disease, and some auto-immune diseases.  Stem cells cannot be used for cancer or in the case of active infections.

Stem cell therapy presents us with an exciting, cutting edge technology that can greatly benefit many pets.  If you wish to pursue stem cell therapy for your pet, contact us and we can set up an appointment to discuss your pet’s condition.  We would be happy to answer any additional questions regarding stem cells!