“The services provided by Pet Dental Services have proven to be invaluable to our practice. Our clients appreciate the safety and convenience that non-anesthetic dentistry provides to their pets. Pet Dental Service’s staff is incredibly kind and patient with the pets in their care. Even some of our fearful patients are able to benefit from a full dental cleaning due to the gentle care provided by the PDS staff.”
POPD Study Rebuts New Dental Mandate From AAHA
In a recent update to their veterinary dentistry standards by the American Animal Hospital Association, the leading association in the US for veterinary practice accreditation, all dental procedures performed on small animals must be executed under general anesthesia with all patients intubated. This is a change from AAHA’s previous ruling that used a point system to allow accredited hospitals, or those seeking accreditation, to determine which companion animals could have a Professional Outpatient Preventive Dentistry (POPD) procedure that does not use anesthesia during the dental cleaning.
According to the official AAHA mandate document, “General anesthesia with intubation is necessary to properly assess and treat the companion animal dental patient. The use of general anesthesia allows for the necessary immobilization without discomfort, periodontal probing, intraoral radiology, and the removal of plaque and tartar above and below the gum line including polishing to ensure patient health and safety.”
This new mandate did not sit well with a number of veterinarians and veterinary practice owners.
“I totally oppose the policy,” said Kristy Lund, DVM, co-owner of Lund Animal Hospital in Boca Raton, Florida in the article “AAHA Dental Anesthesia Mandate Comes Under Fire” of the Sept. 30 edition of Veterinary Practice News. Her practice has been AAHA accredited for more than 25 years and she has offered non-anesthetic dentistry for seven years.
“I’m up for renewal in November and I’m not renewing,” she states.
Other veterinarians appear ready to follow Dr. Lund’s lead and give up accreditation, including Dr. James Davis, who owns AAHA hospitals in Marietta, Georgia and Jupiter, Florida.
In the same article, Davis states, “We’ve seen the benefits these procedures have for patients,” he said. “Because of the lower cost involved, they are able to get their teeth cleaned a lot more often.”
“Bottom line, we clearly have better dental health in our patient base with the non-anesthetic service.”
Anesthesia carries inherent risks, Davis said, using the example of a 7-year-old Cavalier King Charles spaniel, a breed known for elevated odds of heart and dental disease.
“Heart disease can be so severe that there’s no way you’re going to do anesthesia on that dog,” Davis said. “AAHA is telling us that we can do nothing to that dog to clean its teeth, that it’s unethical and that it’s below the standard of care. And that’s unacceptable for us.”
A recent peer-reviewed study, published in the fall issue of the Integrative Veterinary Care Journal, takes a statistical and scientific approach to POPD, an anesthesia-free teeth cleaning performed by trained dental technicians who are qualified and examined by the American Society of Veterinary Dental Technicians. These dental technicians work under a veterinarian’s direct supervision in the vet’s clinic. This differentiates the service from lay practitioners who “clean” companion animal’s teeth in pet stores, grooming shops, and other non-medical facilities.
The study, involving 12 dogs and 12 cats, was designed to evaluate POPD, and whether it can be done safely and effectively. The animals were divided by age groups and history of anesthetic dental procedures and treated with POPD by a trained dental technician. A board-certified veterinary dentist later examined the animals under general anesthesia looking for any calculus remaining below the gumline using compressed air dental equipment, full-mouth dental x-rays, and a complete oral exam. Both the technician and the doctor were also asked to look for other indications of periodontal disease including missing teeth, hyperplasia, resorption, tooth fractures, bone loss, probing depths, and gum recession.
Results of the study showed that both the trained dental technician and the veterinary dentist identified all seven oral conditions. Additionally, none of the dogs or cats had any remaining plaque or calculus on their teeth. A full POPD was completed on 100% of the patients with no post-procedure complications.
According to the researchers, “In summary, the POPD was able to perform a complete prophylaxis, scaling supra- and sub-gingivally thoroughly and safely on all subjects. Although a POPD is NOT intended to be a substitute for anesthetic dentistry, it may prove to be a valuable supplemental treatment.
Pet Dental Services (PDS) helped fund the research, which was conducted by Dr. Mayra Urbieta, the Director of Research for Pet Dental Services Inc., and peer reviewed by W. Jean Dodds, DVM, founder of HemoPet, a blood bank and diagnostic laboratory, and a board member with the American Holistic Veterinary Medical Association. With over 15,000 POPD procedures a year at veterinary clinics in 11 states, PDS is one of the few companies in the US performing anesthesia-free dentistry.