I just wanted to clarify why anesthesia is required for effective, therapeutic
dental cleaning. Removing tartar while the patient is awake has COSMETIC benefit,
but no MEDICAL benefit. This is because the pathogenic plaque bacteria which cause
gingivitis and bone destruction live _under_ the gumline. In order to remove the
subgingival plaque, scaling below the gumline is required (which is what your dental
hygienist does at your semi-annual dental appointment). Although humans tolerate
this somewhat uncomfortable procedure, in animals it cannot be accomplished without
general anesthesia.

We had a client come in last week with her 10-year-old dog. She'd been hand-scaling
its teeth about once every 6 weeks since it was a puppy. He had never been
anesthetized for professional cleaning. The teeth looked pretty good on the physical
exam but there was some gingivitis and bad breath...a hallmark of periodontal
disease. When we anesthetized him, took x-rays, and performed periodontal probing,
there was tremendous bone loss around many teeth. Several teeth had lost more than
50% of their bony support and had to be extracted. The client was very sad because
she thought she was doing the right thing by keeping the teeth clean. But looking
clean and being healthy are not synonymous.

Incidentally, if a patient is awake while the tartar is being removed, she could
accidentally inhale some of the tartar (and billions of bacteria within it) and
develop pneumonia. During full anesthesia, the tube placed in the trachea to deliver
the gas helps to prevent this.

Anesthesia also allows the veterinary team to perform a complete oral examination;
this will detect areas of bone loss, feline odontoclastic resorption lesions
("feline cavities", painful areas of tooth destruction present in about 50% of pet
cats), fractured teeth, and other potential problems which cannot be seen without
the patient anesthetized.

A final caveat about awake dental scaling is that it leaves scratches in the enamel,
which leads to more rapid plaque accumulation. Polishing is required to minimize
enamel scratches after dental cleaning.

Anesthesia is safer today than it was 10 years ago, due to safer anesthetic agents
and better monitoring. The risks can be minimized by performing blood tests before
the procedure, and by monitoring heart rate, respiratory rate, blood pressure,
oxygen saturation of the blood, and EKG throughout the procedure. Ignoring oral
disease in order to avoid anesthesia can leave your pet with a painful mouth for the
rest of its life. In addition, the bacteria in the mouth can spread to the heart,
liver, kidneys and lungs, causing disease there and shortening your pet's lifespan.
Preventing and treating oral disease will improve your pet's quality of life.

Daily tooth-brushing is the best way to prevent dental disease and to prolong the
time between professional dental treatments. As many of us have learned, in cats
this can be difficult if not impossible. The next best thing is feeding one of the
dental diets; they have been shown to be more effective than twice-weekly
tooth-brushing. Hill's T/D and Friskies Dental Diet have been proven to reduce
plaque and tartar accumulation compared to other dry foods. As of April 2000, they
are the only diets approved by the Veterinary Oral Health Council for the purpose of
reducing plaque and tartar.

Milinda Lommer, DVM
Dentistry and Oral Surgery Service
Veterinary Medical Teaching Hospital
University of California, Davis