A Non-Anesthetic Dentistry (NAD) Nightmare

Deep periodontal pocket on the maxillary left canine (204)

As you know, veterinary dentists are strongly against the practice of anesthesia free dentistry or Non-Anesthetic Dentistry (NAD). There are numerous reasons for this, but mostly because it is a completely ineffective method of pet dental care. Moreover, the single most important step of a prophylaxis (subgingival scaling) cannot be performed without general anesthesia. Patients are often seen following NAD with clean crowns (visible portion of the tooth), but with significant areas of subgingival calculus. This may be the most damaging issue with this service, as it gives the client a false sense that they are improving the dental health of their pet. Dr. Niemiec along with his colleagues regularly have to have hard discussions with clients who are very upset when dental disease is diagnosed despite “clean” crowns. These clients feel that they have “failed” their pet, allowing them to progress to disease despite their well-intentioned efforts.

The following case contains detailed case photographs and video demonstrating the severity of the circumstances and evidence as to the risks of anesthesia free dental cleanings.

This patient had received regular (every other month) NAD. Despite this, she had waxing and waning halitosis. She was eventually referred to Veterinary Dental Specialties and Oral Surgery for a fractured tooth. Upon oral exam, the fractured left maxillary fourth premolar (208) was confirmed; however the teeth were fairly clean, with a few areas of calculus and gingival recession. (Figures 1-3) The patient was placed under anesthesia and oral exam revealed further areas of recession as well as a draining tract over the left maxillary canine (204). (Figure 4).

Periodontal probing revealed numerous periodontal pockets including a very deep pocket on the left canine (Figures 5-8) ad furcation 3 exposure on several teeth (Figure 9). In addition to the advanced periodontal disease, the patient also had tooth resorption, which is a very painful condition.

Finally, watch to see the right maxillary M1 (109) mobile level 3.

Dental radiographs confirmed severe periodontal loss and TRs (Figures 10-14) and surgically 204 had significant bone loss (Figure 15).

The patient was treated with numerus extractions. When the patient returned for the two week recheck, the owner commented that not only was their pet’s breath  greatly improved, but also had far more energy.

All veterinary dentists have cases similar to this in which pets have suffered needlessly due to lack of proper care. NAD only serves to hide periodontal disease as well as other painful and infectious conditions.

We encourage veterinarians to refer their clients to this article as well avdc.org/afd for more education about the risks of anesthesia free dental cleanings and to encourage regular veterinary dental cleanings under anesthesia as part of their pet’s regular care.