Anesthesia continues to be the biggest concern for clients. Much of this fear is a result of misinformation found on the internet, as well as television commercials designed to instill fear in hopes of increasing sales of plaque-removing products.
Anesthesia is necessary to allow a trained veterinarian to inspect and assess tooth problems using periodontal probes and x-rays. It is also necessary for subgingival cleaning, which involves cleansing underneath the gums in order to avoid bacterial, plaque and tarter buildup. This is the single most important procedure we do to prevent periodontal disease and it cannot be properly done unless the pet is asleep.
More than 95% of our patients undergoing “routine cleaning” have some dental problem that requires intervention. As health care professionals we can’t say that anesthetic procedures are not without risk, but the risk of complications are extremely low in healthy patients. Typically the patient is pre-medicated with an analgesic or other drug to relax them, followed by an induction agent such as propofol or ketamine/valium which transitions them into the anesthetized state. The patient is then intubated with an endotracheal tube and placed on a gas anesthetic such as isoflurane or sevoflurane until the procedure is complete.
Intubation is of critical importance because it maintains an open airway and it protects the trachea from fluid or substances entering the respiratory tract. Cleaning the teeth without intubation could result in seeding the respiratory tract with bacteria-laden plaque and other contaminants and could have dire consequences. The depth of anesthesia is regulated by the veterinarian as necessary. All patients undergoing anesthesia are constantly monitored with pulse oximetry to check heart rate and oxygen saturation, blood pressure, and body temperature. The patient’s body temperature is carefully controlled with BAIR HUGGERS heating devices, and if necessary the patient is given intravenous fluid therapy to help with blood pressure control.
For after-dental comfort and to reduce anesthetic depth during the procedure, regional anesthetics such as bupivacaine can be injected locally. Any patient that we categorize as “high risk” due to concurrent diseases, receives a thorough workup prior to the procedure. In high-risk patients, the risk of anesthetic complications may far outweigh the benefit to the patient and there are treatment protocols to reduce complications in these patients. We have many years of experience in dealing with these pets and have had very good outcomes.