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« Bring the troops home. Do it for the dogs. | Main | Matthew Shephard: Ten years later »

11 October 2008

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Dr Patty Khuly

Somehow I'd missed your first two articles on this. Thanks for addressing it again.



My own dog underwent this "anesthesia-free" dentistry two or three years ago when we were first exposed to it here in Florida. Though the board-certified veterinary dentists we know were appalled at the very thought, all three of the vets in our practice thought it might be cool to see how much they could really do--using my Frenchie Sophie Sue as a model. (btw, They promised polishing and "beneath the gumline" work.)



Sophie is normally a model patient but she struggled under their care and, ultimately, got a pretty crappy job. Three months later she had more tartar on her teeth than ever--most likely because of their inability to properly polish after scraping.



Since then I've properly treated her teeth under anesthesia and have been able to keep the tartar easily under control (as before the "anesthesia-free" procedure) with simple brushing and weekly raw, meaty bones (which I take away after she starts to grind away directly on the bone so as not to risk any dental fractures).



That's MY story but your post raises another issue:



Why is it that when vets like me urge people to stay away from this procedure we're often viewed as selfishly protecting our industry? If I would much rather anesthetize my own pets than risk the discomfort and poor health outcome of "anesthesia-free" dentals I'd think it would be clear: It's just not worth it.



Thanks for offering your own para-industrial take on a procedure I think wastes people's money, plays ruthlessly on their fears and harms our pets. It always helps to have the message come from a non-vet with nothing to gain or lose except her sparkling reputation.

Christie Keith

Suzanne, I understand you are learning to do this procedure, but the picture you paint is a falsely rosey one.



First, virtually all anesthesia free dental cleaning is done not even remotely as you describe, but by groomers. You keep saying, "This is how you imagine it, not how it is," but I'm afraid you've got it backwards.



Most veterinarians and vet techs are horrified at the practice of anesthesia free dental cleanings, and thus don't offer them in their offices, so the "norm" you describe is almost impossible to locate at all, let alone common, let alone "the way it is."



Second, did you read either of the two articles I linked to? Every point you raised was refuted by a board certified veterinary dental specialist or registered vet tech who is also specially certified in both dentistry and anesthesia. I encourage you to scroll back up in this post and click on those links, because what you believe is not accurate.



As Daniel Moynihan famously said, "Everyone is entitled to their own opinion, but not their own facts."

Suzanne CVT

I have to STRONGLY DISAGREE. I am in the process of becoming dental certified, and I think non-anesthesia dentals are great.(although i do think animals should get RADS around 2 incase of any diciduous or non-eruptive teeth) Not only for the high risk patients (heart disease, murmers, liver/kidney disease), but also for any routine dental... why not? If an animal can get the same treatment it needs without anesthisia then why not? Nowaday veterinarians are recommending dentals every 6 MONTHS! For most animals living to 12-15 yrs old that would be going under anesthesia 22-26 times in their life time! The non-anesthetic dental technicians are very knowledgable and patient, with what they do. Most have the new technology necessary to have an effective/safe cleaning done, (like the ceramic tip ultrasonic cleaner ,generating no heat to the tip, and minimizing the amount of water/chlorohex solution needed to adequetly clean) The key to the treatment is patience... most canines/felines that receive the treatment eventually get use to it and simply sit back and relax as we would at the dentist. Most people think of non-anestheitc dental as some one pinning down animal and fighting it until it surrends, but it is completly opposite. During the procedure the technician 1. Charts the mouth 2. Probes 3. Subgingival scaling 4. Ultrasonic scaling 5. Polish 6. Floride 7. Chlorohex and smile! If a technician sees any abnormallities or believes the animal would be a better canidate for anesthetia they will report it to the Veterinarian. What anesthesia free dentistry dose is like no other. Im not saying being under anesthesia is unsafe, if using the right medications and monitroing properly it is 100% effective. But if there is not a need to Do x-rays, have extractions, or any other kind of dental surgery then why? So, next time you go to the dentist for your routine dental, ask what they do when they have a difficult child patient. Im sure he wont say "Put them under Anesthesia!"

CC

Canine Care has 300+ clinics and is growing in the state of California. Evidently the State Vet Med Board does not care or can not do anything about anesthesia free dental cleaning for cats and dogs. Based on the growth in this business, everyone should get into it. At $30 profit per animal and 20 animals per clinic, the math works out. $600 per clinic means that Cindy Collins makes about $180K per month. Who cares about the government.

Christie Keith

It is very easy because you can get your dogs teeth cleaned AND their haircut all in one day at a reasonable price!



And you think that makes it good medicine?



At best, all they've done is make your dog's teeth look prettier while doing NOTHING AT ALL to improve his dental health or the condition of his teeth under the gums.



At worst, they are covering up dental problems that require x-rays and professional care from a veterinary dentist, because now your dog's teeth are all white and pretty so you can go on as if nothing is wrong. Because if something is, you have no way of knowing.



And they also put your dog at risk of aspirating dental debris or having his blood infected by oral bacteria.



Nothing you said here addresses any of those issues.

Dr. Narda

I agree with Christie. Reports I have had from vets whose clients have gone elsewhere for anesthesia-free "dentistry" (ugh, and my apologies to the actual dentists out there for using that term in this context) have reported the need for more frequent visits, damage to tooth enamel from overzealous scraping, and even injuries to the back and neck from the restraint.



These animals are receiving neither a full veterinary exam in many cases, nor are they given dental radiographs to catch underlying disease, as Christie indicated.



A veterinary colleague told me of sad tale about how someone she knew had put together a demonstration about anesthesia-free teeth cleaning, and she allowed her own dog to serve as the demo dog. This dog arrested during the procedure; that's right, had a cardiac arrest, presumably due to the stress either of the procedure or the restraint, or both. Did the person stop "believing in" anesthesia-free cleanings? No.



This raises an additional question: although some may choose anesthesia-free teeth cleanings to avoid the risk of anesthesia, how well will the patient's cardiovascular system and musculoskeletal structure deal with the stress of the restraint? We know from research that restraint stress alone in experimental animals can markedly alter physiologic variables and skew results.



I remember hearing about cases in which videos were obtained showing how much restraint this one anesthesia-free tooth cleaner used; this person would not ordinarily let anyone watch so there was an investigation. A complaint arose because during one of the restraint procedures, an animal's jaw was fractured.



For those who still insist on taking their animals for these sub-standard cleanings, I think you should at least watch the procedure to see how your animal is doing and intervene if you feel they are being injured, and then take them in for a regular veterinary dental examination afterward to see what was missed.



It may be eye-opening.

Megan

I recently visited one of these clinics that you're talking about to find out about the non anesthesia teeth cleaning, asked questions that got stired up by these comments. 1.) found out that the groomer does not do the teeth cleaning. 2) The technicians have excellent backgrounds in the animal field, human dental field or has a BS in animal science 3) It is very easy because you can get your dogs teeth cleaned AND their haircut all in one day at a reasonable price!



I immediately scheduled an appointment and loved the results. The customers that were coming out that were on the monthly maintenance had nothing but wonderful things to say about this company and their technicians. Some of the customers have been following canine care since it stated in the early 80s.



Christie, I respect how strongly you feel about your opinion. Just as you have yours we are entitled to have our own about this procedure and mine is that it was a wondeful experience. I tell everyone about it and go every six months. Calvin (my dog) is the love of my life and I only want the best for him and his health and what ever I choose for him as being his owner is my right and no one elses, not even the vet boards.

Robert

Non anesthetic detal cleanings are unqestionable and benificial for dogs and cats.Not all are good canidates for this treatment due to certain condtions.This treatment is being offered at thousands of Veternary Hospitals through out the country.Yes non anesthetic detal cleanings.This treatment is incorporated into the traditional dental treatments to offer a the patient the finest dental care possible for their patients.The nonanesthetic treatment includes sonic scaling and polishing above and below the gum line.The idea of nonanesthetic treatments can not be done in a safe and effective manner are false when the treatment is done by Veterinary hospitals all over the country.The problem lies in untrained dental pet store or grooming tecs that are not trained by doctors and have no doctors supervision these people are giving this benificial treatment a bad name.These pet store owners,groomers,and companies offering this treatment with out the supervision of a licenced Veternarian should be fined and have criminal charges filed.This teatment can be performed only by trained dental tecs under the supervision of a Veternarian and have such a benifit to the animal being treated to ensure that the animal is getting the best dental care possible.Seeing is believing

Christie Keith

Non anesthetic detal cleanings are unqestionable



New here?



Okay, not fair, as I know you are.



NOTHING, NOTHING is unquestionable. That's terrible medicine and frankly, a dangerous attitude to have about anything at all.



That line of thinking is exactly why we have things like the pet food recall. And combating that line of thinking is exactly what I do for a living.



You make a lot of sweeping generalizations and statements awash in meaningless marketing lingo. Bring me some proof of what you say. Evidence. Citations. Something. Anything. I'm perfectly willing to change my mind about something, but you have not addressed any of the concerns I raise about this procedure.



You wanna participate here, you have to do better than that, Robert.

Robert

Hi you are taking my information out of context and taking it in your own direction with you first statement about my knowlege of the nonanethetic dental treatments.I am leading the tecnology of nonanethetic dentals by working with licensed veterinarn in this field.If you would like you to educate your self more on this subject and lose the close minded metality of your terms of a nonanesthetic dental treatment.Its sounds like you are basing your knowledge on the fact that untrained pet store people or groomers who do this treatment make it unbelievable that this treatment cannot be done with out anesthesia.I have a list of Veterinary Hospitals who offer nonanethetic treatments to their patients.Their tecs are vet trained in this treatment with great benifit to their patients.I would like to invite you to one of these hospitals to see this treatment performed by their tecs.I agree we need enforcement on non Vet teeth cleaning in pet stores and groomers.We need to stop them due to their poor training and lack of vet training and supervision.Again nonanethetic treatments are a great benefit to animals who are good canidates for this treatment not all qualify for this.Thats why this treatment should only be done by the supervision of a vet.

Christie Keith

Robert, you didn't include any information for me to take out of or in context. Where is your evidence?



I interviewed vets and vet techs for my article. ALL strongly opposed this practice, as does the certfiying board of American veterinary dentists. You say you have a "list" of veterinarians who do this? You say THOUSANDS of veterinary hospital do this?



Prove it.

Robert

I first would like you to answer these questions.Have you talked to a Veternarian who offers this treatment?Have you ever had a complaint by anyone about a Veternarian who has performed this treatment.?I will prove it by you seeing the treatment for you self at one of these hospitals.

Christie Keith

Robert: This is my house. My rules. You answer my questions first.



However, no. Every vet I know is horrified by this.

Robert

If you have any questions for me about this treatment feel free.It sounds like you need a positive sorce of information supporting this treatment.It sounds like the vets you have interviewed lack the ability or the training to teach the treatment of nonanesthetic dentals to their staff or have the information on how to get this special training for this treatment.As for the medical boards opinion on this matter they are baseing their judgement on negative feed back by patients who have had this treatment done by non vet practitioners.I asure you that the vet board is aware that this treatment is offerd by vets it is just not adoped yet because the majority of vets in this country just dont have the training available to them so they discount it.No vet wants to admit he or she does not have the training for this or not knowing where to get proper training for this treatment.

Robert

If you can speculate that i am not a expert in the animal dental field by my typing skills you are mistaken.I am not digging a hole any of you who can not do research to find a vet who offers this treatment is just very uneducated in this treatment.I will talk to a few of the doctors to set the record strait and to educate you in your lack of information about this treatment that many doctor have been providing this treatment for over fifteen years.I do not believe you are open to the real facts about this treatment.Since all you know is negative feed back by the treatment by non vet practitioners who work for pet groomers.

Lis

Indeed. I'm curious about what he was trying to lure us into, but not curious enough to risk my computer.

Gina Spadafori

I removed his URL link to prevent and possible viral infection to readers' computers.

Gina Spadafori

"Robert," take it somewhere else. You've had multiple chances to cough up some evidence or even identify yourself so we can judge your credentials, and all we've seen is illiterate shilling from an obvious troll.

H. Houlahan

I want to know about this "restraint."



I guess I didn't think about it when I first read this post. I can do a simple tooth-scaling on my own dogs while they practically snooze, with their heads in my lap. The only "restraint" is training and trust. So it didn't occur to me.



How do these people immobilize an uncooperative animal well enough to even get in there?



I had minor surgery on an eye once, and had to hold perfectly still. I could do that because I'm an adult human who understood and consented to the procedure, and understood the consequences of squirming. Also, could tell the doc when the numbing had taken effect and when it might start to wear off. I don't care how well-trained an animal is, they can't pull that off.



The "restraint" I'm picturing is some combination of Hannibal Lector and Alex DeLarge.

Lis

Robert, surely you can name three veterinarians who perform this service. It's really standing out that so far you've just emoted about how unfair Christie is being, and condescended to her, but not actually provided any hard information at all.



And, of course, repeatedly misspelled "anesthetic" and "veterinarian." Unfair as it probably seems to you, that's the kind of mistake that tends to undermine credibility.

Christie Keith

Robert, let me share a piece of wisdom from my many years on the Interwebz:



The first rule of holes: When you're in one, stop digging.

Gina Spadafori

Seriously, dude, if you can't cough up some actual, you know, facts, you're either a shill or a troll, or both.



And really: Spell-check. Bad spelling isn't always a sign of idiocy, but the smart money can place the bets that way.

H. Houlahan

Based on the ominous warning my Firefox gave me when I clicked onto "Robert's" name-link, he may be significantly worse than a regular commercial troll.

denise

I can't believe how ugly some of you have been in the exchange of dialogue. Everything from troll calling to spelling police. Can you not try kindness instead?

Patricia Doran

I agree. I think tha girls have been a bit hard on Robert. I have been grooming for 31 years and scaling teeth (levels 1&2 only) for more than 25 years. As with many services, from perms to tummy tucks, their are some seriously unskilled people out there and in it only for the money. I WISH non anesthetic cleanings would have to be certified, and they will some day. but for now, pets are being put under anesthesia for simple level 1&2 cleanings as often as every 6 months and that is wrong. During a pets anual checkup, why doesnt the vet include a simple oral xray to determine a problem REQUIRING anesthesia?



Dental ads in my area pop up all the time, just about every issue. I know fist hand that it is big money for the vets and they arent even perfoming the prucedure. One vet offers a $100 bonus for staff that books 7 dentals. Another vet has 3 staff members and not one is a certified vet tech.



I had a client in the other day with her 2 dogs that had just got a non anesthetic teeth cleaning at a local vet.. although I am very happy that they offer the service, the job was insulting and I showed the client her pets teeth and she returned to the vet to get answers. The vet has offered to pay me to "finish" the job and to come to me to learn how to simply scale. I also dont charge these wild amounts. $25 for level 2 and level 1 with grooming doesnt cost a dime. All my clients are told to let their vet know that the teeth are being hand scaled so that their isnt any misconception about how the teeth "appear" clean. It is the vets job to give a thorough examination during a pets checkup.



Non anesthetic teeth cleaning is a terrific service, when performed by a person with true intentions. Many vets are robbing people and their pets these days, included is over vaccinating and selling foods loaded with corn, wheat, and soy. But they have a license to do so.



I suggest a bit of common sence. Brush every day, scale off any visible tartar, annual vet health checkups, and dont put your pet 'under' for simple painless tartar removal.

Patricia Doran

I would like to know... how much time is spent on oral care in vet training? Your average people dentist is roughly 9 years.

Christie Keith

Patricia: You still have no answer for the problem of inhaling of the debris being scaled. You have nothing to say about the inability to polish the teeth after scraping, and the fact that the unpolished surface is more, rather than less, hospitable to bacteria growth and further tartar.



Because even if you were willing to concede there is NOTHING medical about scaling teeth, but it's strictly a cosmetic procedure that a groomer can and should do, it does nothing to change the fact that this procedure is dangerous.



You say your service is better than a crappy service by a vet who clearly doesn't know what he's doing, as if that justifies you doing a substandard and possibly dangerous procedure yourself. It would be better if people took their pets to vets who DO know what they're doing, rather than letting their hairdresser their pet's groomer perform a dentistry on them their pet.

Patricia Doran

After the teeth are scaled (LEVEL 1 OR 2 ONLY) they are then brushed with a flouride base prophy paste and then polished with the polishing compound. If the owner does not keep up with daily brushings then tartar WILL return. The point I am making here is that no animal should be placed under anesthesia for only level 1 or 2 scaling. Period.



As for grabbing at straws.. inhaling debri?? Clearley you have never hand scaled before. Kindly give it a try sometime. Mark my words, there will be a law against placing pets under for no good reason, in our lifetime.



I am not addressing pockets, tumors, broken teeth... I am addressing simple tartar (LEVEL 1 OR 2) removal that takes lest than 5 minutes to remove.



Vets have found a legal curtain to stand behind and are robbing people of their money and pets of their health. Why dont you guys focus on why a pet developes an alergy instead of repeatedly taking expensive blood samples just to deliver NO answers and then temp cover up the problem with harmful cortizone shots? Veterinary practice has become a big money scam. 1 out of 10 vets are truly in the profession to help pet health, not a mercedes purchase. You know exactly what I am talking about. Been 'round the block far too many times.

Christie Keith

Patricia, please provide the evidence behind your very specific statistical assertions.



And also, while you're out finding those citations, tell me what the medical benefit is if scraping tartar off a dog's teeth.



By the way, I have a friend who aspirated a little piece of spinach that was stuck in her teeth. I had a dog who was injured and was eating and drinking lying down, choked, and got aspiration pneumonia on her food. And you think a dog cannot aspirate scraped tartar?

Patricia Doran

Your right Cristie. Thank God you are here for all of us. My nefhew will be born this June and I am going to suggest that he be fed by IV just to be sure he never chokes. Gosh... I cant thank you enough Cristie, that could have been a real close one.

Gratefully yours...



ps, pick up an issue of Colorado dog, and do some unbiased research yourself instead of displaying uneducated oppinions.

Pam

Patricia, who makes the determination of level 1 or 2 tartar? You? How do you know there is no tartar below the gum line? If you can say vets don't get the same training as dentists, then I can say groomers don't get the same training as dental hygienists. And dental hygienists use a suction tube to remove the particulates so the patient doesn't aspirate them.



No, I don't think groomers should be doing veterinary procedures. And I personally wouldn't take my pets to a groomer who has such major hostility against vets.

Patricia Doran

Pam, I would not take my pet to a groomer for a veterinary procedure iether. Level 1 and 2 (doesnt take a rocket scientist to determine this) is not, should not, and eventually legally will not, be considered a veterinary procedure.



Again, my point being.. level 1&2 should not be considered a medical procedure.

Gina Spadafori

Sorry, but you're not posting links to bad medicine on our blog. They've been removed. I feel sorry for your clients, with your hateful attitude towards veterinarians and your callous disregard for the health of your client's pets.



My dog is having a dentistry Friday. By his veterinarian, not his hair dressergroomer.



You've been been given ample opportunity to come up with some peer-reviewed research to back up your claims. You haven't, so it's don't-let-the-door-hit-you-in-the-ass time.

Mike

Just researching this NAD. My vet actually recommended anesthesia-free dentistry to me today, they now offer it in their office in additon to the traditional service. We bruch our dogs teeth reguarly and he seemed to think the results were quote good. Still doing my own research though.

H. Houlahan

The real Heroes are us CVTs RVTs LVTs.



You want a parade?



Otherwise, not sure what might be the point of this illiterate rant.



Sure doesn't make me want to hand my dog over to you for a tooth-scraping under "restraint." Or otherwise.

Rachael cvt

You people are so critical and ridiculous. Maybe get a life? I just have to say something because in reality. People love to make a big stink about anything. Some spend their whole lives complaining about shit. I guess it fills their lives in some way.

Ok on the subject of NADs. It's very simple. The choice of nonanesthesia or to put them under is the choice of the owner. Pure and simple. Brushing daily. Up to owner. Handle health issues. Up to owner. Feed good dog food. Up to owner. We can only suggest things. That's it. Whether or not they follow thru is up to them.

I've do dentals at a vet clinic under anesthesia and NADs. They are both beneficial for the right candidate. My good friend does NADs independently and refers people to us daily. If the tech is in it to improve the animals health then it's beneficial. There's many dogs who don't have periodontal disease and do great with yearly to six month cleanings(NADs). And my friend still insist clients get regular checks at the vet also. If anything looks suspicious. Gum irritation. 3 mm pockets. Or severe gum recession and gingivitis.

You act as if we push people to get these NADs done. It just seems strange to not think of all aspects of the subject since you're so biased. If you would really research vet clinics that offer NADs. You'd find them everywhere since you're so good at investigating shit. If you know any research projects you make sure to cover all bases.

And on the subject of having a vet present for all dental cleanings. Come on. Anyone who's worked for a vet knows they're never always there. The real Heroes are us CVTs RVTs LVTs. And lots of techs no each other and we know how hard it is working for vets. They rush you to hurry up w the dentals and get the show on the road. A lot of times. It's the easy $500-600 he makes off each dog. Finding a vet who cares for the animals and haven't lost their love for vet medicine. Is difficult.

Ultimately what I'm saying is there's good and bad to both. I do believe in questioning everything. It's healthy. But maybe we should question how good science diet is that is sold at tons of vet clinics. Maybe vets have a deal with the company that makes science diet? I'm just saying. The things you rely on aren't always as good as you'd assume. I'm speaking on behalf of vet techs who do both types of dentals. Now everyone relax! Meditate. Do some yoga and pull the stick out of your asses! Mahalo!

Evelyn

What a "compliment"--"The Bitches Who Run This Site". Glad to have gutsy and well-informed Gina and Christie run this site than numskulls. :)

ericka

this post "The choice of nonanesthesia or to put them under is the choice of the owner." Geez, what a chip on your shoulder. Are you seriously thinking you are more knowledgeable than a vet?



wow. I am glad I let my vet make the choice, as they should.



Put this into perspective...should I tell my surgeon that "I decided" I don't need anesthesia?



Um, no. They are the boss. Vets are the boss. Just like pilots are the boss when they are flying.



The lay person, or vet tech, or pet owner...should let people who have earned their degrees and skills to do their job.

Gina Spadafori

Just got off the phone with Christie, who couldn't stop laughing. I think she likes the idea of us being "The Bitches Who Run This Site." We may get cards made up.

H. Houlahan

Interesting, the sense of entitlement that the hit 'n' run commenters on this post seem to bring.



As if The Pet Connection were some kind of spontaneously generated public property that you Bitches had somehow appropriated. They're just all about takin' back this site from those who have unjustly reigned here. For The People, natch.



Weird -- don't think I've ever seen a topic that elicits this underlying delusion -- not even puppymillers are so entitled.



What the hell are they "teaching" them in vet tech school?

Gina Spadafori

Patricia, Ms. Houlahan is referring to the comment immediately above hers, not the main post. That's the "illiterate rant" to which she was referring.



As for the "Bitches that run this site" ... you can only barely imagine how little we care for your opinion, since our interest is in helping pets get better care, not scaring pet-owners into patronizing people like you.



Again, take your BS somewhere else.

Eucritta

I wasn't going to say anything, I really wasn't, but I can't resist.



She called them 'NADs.'



Acronym Fail.

patricia doran

right on, Houlahan! Cant believe this site allowed your comment, as they banned me! I was so happy to see your comment. These Bitches that run this site should be sent packing.

H. Houlahan

T-shirts, man. Need T-shirts.

Lis

Yeah, you gotta have tshirts!

Leslie K

Tshirts could be a great fundraiser ! Its never ending too, the bitches who donate dog beds, cat beds ,shelter beds ,the possibilities are endless ! You should be thanking those hit & run posters for the idea. [probably the only good 1 they've had in a while too !].

Sandi K

ROFL! Well said, Leslie K.

JenniferJ

"Troll farm"



I love it!



I am picturing them skulking around behind bushes. popping out occasionally to shriek in indignation at random intervals then scuttle off



Oops, pardon. That ought to be SHRIEK

Gina Spadafori

Thanks for the catch. I deleted the link.

Cait

There's a new product being shilled right now on some of the grooming lists I'm on and it looks like basically what amounts to a WaterPik for dogs and an enzyematic cleaner rinse stuff. Any thoughts?



I have recently started offering tooth-brushing services (added to nail trimming) to a couple of my training clients. :P However, I consider it a training issue- it's the regular old pet toothbrush + the nasty chicken toothpaste and while the initial goal is getting pets' teeth some regular care, the longer term goal is getting them to allow their owners to do it.

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