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Dog dentals

Hello,

I work at an animal shelter where we are constantly sending dogs for dentals. Our dogs eat raw and get the occasional bones so they don't develop dental problems, but we get a lot of dogs that come in with bad teeth. Our vet often recommends dental cleaning procedures. Problem is, we've had some dogs die from the anaesthesia. I understand that that is a risk that comes with anaesthesia, and that dogs can die from the infections they get in their mouths. However, I still feel like we should at least consider other options, so I have a few questions:

What are your thoughts on holistic dental cleanings? I've done some research but got mixed opinions, with some people saying that they only clean the surface but don't actually take care of the infection in the gums.

Are there other alternatives to a vet procedure? I know that if the teeth are rotting, or if the gums are infected we probably don't have any choice, but sometimes it doesn't look/smell too bad but our vets will usually recommend a dental anyway. Which brings me to my next question...

How do I know when a dog really NEEDS a dental? I'm not implying that the vets don't know what they're doing, but sometimes I am just a little suspicious of their motives. Not saying that all vets are like this but just sometimes, some of them seem to recommend unnecessary procedures/tests/vaccines just for the extra profit. I mean, I can say that probably 90% of the dogs that we bring in for check ups/other procedures, they recommend a dental done as well.

Thanks for any help/advice you can give. We get a lot of senior dogs and would really like to cut down on procedures involving anaesthesia if at all possible.

Comments

( 6 comments — Leave a comment )
macula_densa
Aug. 27th, 2011 06:57 am (UTC)
About 95% of the dogs I see really need dentals, so I don't particularly think your vets are being money-grubbing. And yes, it is darn near impossible to clean the teeth appropriately without anesthesia. You cannot get below the gum-line very easily in an awake animal. Talk to any board-certified veterinary dentist, and he/she will tell you the same thing.

On top of that, I really think the severe dental disease we see in so many of our patients really reduces their quality of life, even ignoring whether or not it impinges on their overall health. Dental disease is PAINFUL.

On a sidenote, in my experience anesthetic deaths during dental procedures are exceedingly rare. Yes, they occur, but it's very uncommon. So, if you're seeing them on a more frequent basis than 'exceedingly rare,' I would seriously question whether there isn't an issue with the anesthetic protocol.

Are there other alternatives to a vet procedure? I know that if the teeth are rotting, or if the gums are infected we probably don't have any choice, but sometimes it doesn't look/smell too bad but our vets will usually recommend a dental anyway.

It's better to clean the teeth BEFORE severe infection sets in, not after. When we have an animal that comes in with severe dental disease, it's next to impossible to reverse that with one cleaning.

The biggest tip I ever got on evaluating dental disease was from the board certified dentist here in San Diego: it's not necessarily the tartar that indicates how bad the disease is (although you do want to get rid of this, too, if it is severe). It is the inflammation of the gums. On the flip side, you can sometimes have animals that have almost no tartar that have pretty severe gingivitis -- gums that bleed at even the slightest manipulation and appear really red. This is an indication of infection below the gumline. Oftentimes halitosis is a pretty good indicator, too. If your dog's breath smells like a sewer, most of the time there is a reason having to do with oral health (although sometimes it can be related to GI problems, etc., but this is less common).

So, IMO, dental disease is an extremely underdiagnosed condition in dogs and cats. A lot of vets and owners will ignore its presence because it's a hassle and 'the dog seems fine,' but veterinary patients don't often tell you things hurt until they are extremely severe. Our field is moving in the direction of recognizing and treating dental disease more and more, but it is slow to change and will take some time. However, I suspect if your vet is paying close attention to the dental disease in the animals that come in, that suggests he or she is being very comprehensive about the animals' health and is a CONSCIENTIOUS vet, not a money-grubbing one.
hxgx
Aug. 27th, 2011 04:08 pm (UTC)
This x 1000.
karmahappens
Aug. 29th, 2011 03:25 am (UTC)
Ditto. Especially the pain and discomfort part - chronic dental disease leads to at the VERY least, teeth becoming a source of chronic pain for the pet.

Our human dentists recommend that we have cleanings and evaluations every 6-12 months...we can get away with not doing it for a while, but I guarantee that you're going to have problems if you let it slip for too long. Remember that the same thing happens to your pets.

I agree with everyone else's sentiments regarding anesthesia also... if you're having a lot of complications with anesthesia, you should be reconsidering your protocols.
lsarabethl
Aug. 27th, 2011 12:43 pm (UTC)

I agree with everything said above about how common dental disease really is and how it's pretty much impossible to fix without a thorough cleaning with anesthesia.

In three years of practice doing between 6-10 dental cleanings a week I can count on one hand the number of anesthesia deaths we have seen. Actually now that I think about it, all of them actually recovered fine but succumbed later to conditions that decompensated after the procedure like kidney failure or heart disease. It could be argued that if the teeth never got that bad, they may not have even had the cardio/renal disease in the first place. The reason I say this is because if you are seeing anything more than an "exceedingly rare" fatality, as Sarah put it, then I would be seriously concerned about what type of anesthesia protocols are being followed.

Are we using iv catheters? What induction agent and gas combo? Pre medications? Good heat support? Monitoring? Fluids? How long is a procedure taking? Now I don't have a specific article to site but I have seen the figure "one in a thousand" in multiple veterinary magazine type publications as the approximate fatality rate for routine anesthetic procedures. I realize that this isn't the most reliable or well studied type of figure, but the general idea is that death from anesthesia should be very very very rare.

Pease pardon any autocorrect typos, I'm posting from my iPad.

yummykit
Aug. 27th, 2011 02:39 pm (UTC)
i'm not a vet, but i feel the need to post because i have spent the past 11 years dealing with a dog who has/had very severe dental disease. it appeared to be something genetic for him, as he developed pretty bad dental disease before he even hit one year of age. we struggled through cleaning after cleaning, extraction after extraction (more like 7+ extractions per cleaning). i knew it needed to be done because he went through periods where he would stop eating -- his mouth hurt!

i had a vet in another city who spent the past couple of years insisting that he did NOT need a dental. i kept asking and asking because i knew his history and i knew he should at least have a preventative dental, even if his teeth and gums seemed "okay," but she said no. unnecessary.

when we moved back home and saw our regular vet, we scheduled a dental. come to find out, he needed the remainder of his teeth pulled (except for canines) because there really was no bone left. his teeth LOOKED okay, but really they were falling apart on the inside and continuing to cause gum disease.

the vet removed nearly all of his teeth (leaving only the canines) and it was amazing to notice the change in his breath. i don't think i remember a time where he didn't have bad breath, even after dental cleanings....and i think it's because he just always had infection and disease brewing. now it's a completely different story and the dog is 100% happy even without his teeth. he eats very well and even eats dry kibble sometimes! plays tug-of-war and does all the normal doggy things.

anyway...my point is to say that there are likely a lot of dogs in similar situations out there. with my dog, it was not always possible to tell from looking at his teeth how bad they were, but i am positive that if we had not kept on top of the cleanings, he would have ended up with kidney or heart disease or something. instead, he is still very healthy despite the loss of teeth.

for what it's worth. :)
yummykit
Aug. 27th, 2011 02:41 pm (UTC)
oh and i meant to add about anesthesia --

i've always been very nervous with anesthesia because my dog is a sighthound and they are sensitive to anesthesia and sometimes die during it. i think the key is finding a vet who is known to do well with anesthesia and to be cautious in amount and in monitoring. my vet was recommended by the local greyhound rescue, which made me feel more comfortable with him and with his skills. he has never had ANY trouble with my dogs being under anesthesia.

it is something that always makes me nervous, but i think it's worth it to know that we're taking steps to avoid some major chronic disease states.
( 6 comments — Leave a comment )