Dental Dilemma

Clean teeth aren’t just cosmetic; they’re essential to good health.

My parents have a 12-year-old toy poodle named Spike whom they love dearly. Spike is as cute as he can be, but boy, does he have bad breath. My dad won’t get his teeth cleaned, though, because that means putting him under anesthesia, and he’s afraid Spike will die.

That’s a common fear. Many places try to counter it by offering non-anesthetic dental cleanings. In other words, they scrape the visible plaque and tartar off the teeth. And it’s not like the recent dental cleaning I had, which involved lying back in a comfy chair and watching Anthony Bourdain eat his way through Sicily. Pets must be restrained during the process, which can be distressing for them, or even cause injury if they squirm at the wrong moment and are accidentally jabbed with a sharp scaling device.

Pet dentals are done under anesthesia for many reasons. The aforementioned squirming, for one. Anesthesia ensures that pets remain still and don’t experience fear, pain or discomfort during the procedure. Besides reduced pain and stress for pets, anesthesia allows the veterinarian to better perform a complete examination of the mouth, clean tooth surfaces thoroughly, get beneath the gumline where bacteria hide, and take X-rays of teeth to ensure no damage or infection is lurking.

By the numbers, anesthesia is a low-risk procedure. The risk of death associated with general anesthesia in both healthy and sick dogs and cats is approximately 1 in 500, says Bruno H. Pypendop, DVM, a professor and veterinary anesthesiology specialist at the University of California at Davis School of Veterinary Medicine. In the case of healthy animals, the risk drops to 1 in 2,000.

“Many factors have improved anesthesia safety over the years,” Dr. Pypendop says. “These likely include drugs with more consistent and predictable effects, better knowledge of the effects of drugs on vital function, better ability to monitor and therefore prevent or treat abnormalities and better pre-anesthetic screening.”

Your pet won’t have the option to watch Animal Planet while he’s worked on, but pre-anesthetic blood work ensures that he doesn’t have any underlying health conditions that could be affected by anesthesia. Monitoring of blood pressure, blood oxygen saturation, respiratory rate, body temperature and other vital signs during the procedure helps all pets stay safe and comfortable.

“More advanced equipment for monitoring pets during anesthesia allows for thorough assessment of the pet’s status during the procedure,” says Cheryl Blaze, assistant professor of anesthesia at Tufts Cummings School of Veterinary Medicine. “There has also been increased emphasis on continuing education training for technicians to increase their skills.”

Sedation beforehand, in the form of drugs such as trazodone or gabapentin, help him relax before the procedure, and a local nerve block minimizes pain if extractions are necessary. Long-acting medications provide pain relief after the procedure.

Why the assortment of drugs? Pain travels the body through multiple pathways and involves different neurotransmitters and receptors. Using a combination of medications, known as multimodal pain management, ensures that as many routes of pain to the brain as possible are blocked.

If your pet is a senior or has health problems, your veterinarian may consult a specialist in anesthesiology about the best ways to minimize risk and manage pain.

“Even older animals can be safely anesthetized when a thorough pre-anesthetic evaluation and dedicated monitoring during anesthesia are consistently done,” Dr. Blaze says.

Ask to see a practice’s anesthetic safety record. There is always some risk when a pet (or person) goes under anesthesia, but advanced anesthesia drugs and techniques used help to ensure that all goes well.

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