Anesthesia Free Dentals
I heard that there are now dental technicians who do anesthesia-free teeth cleaning.
So I checked out a link, which I WILL NOT post here.
If they are truly dental technicians (which are for humans, not animals) then they need to go back to working for a dentist.
I am an advocate for those that have no voice. I do not care about how much proper veterinary care costs you or how scared you are of anesthesia. I care about your pet. Because I care for your pet, I spend a lot of time holding your hand and educating you, reassuring you, and explaining what exactly happens during a routine dental cleaning (a prophy). I tell you about the different planes of anesthesia, how important it is for your pet to receive the anesthesia, pre-anesthetic blood work, why your pet must be intubated, and the reasons why your pet needs a dental and daily dental care.
And still...you seek the magic pill. Friends and neighbors, THERE IS NO MAGIC PILL. Every time you let someone convince you that something will work for your pet and will rid your pet of tartar and/or dental disease by feeding off of your fear of anesthesia, you are cheating your pet out of dental health.
Trust me, if there was a way for me to do away with anesthesia and still give your pet optimum dental care, I WOULD DO IT. Why? BecauseI'm not doing this for YOU, I'm doing it for your pet, but you're a road block to me, you put on the brakes and build up the walls that I run headlong into, and who suffers? YOUR PET! So if I could do it anesthesia free, I would, just to get that roadblock out of the way of your pets' health.
I want to see your pets with clean, healthy mouths. I want to know that their hearts, kidneys and livers are safe and healthy. I want your pet to pant in your face and not have you cringe away from them ... they KNOW when you're repulsed by them, but they don't know why. I want to see your pet dance and be happy and sweet and in a good mood because they aren't hurting anymore, their mouths aren't on fire and they don't feel like they have daggers going through their jaws when they eat.
I do this for your pets. Not you.
So I went to the website with the "tooth fairy," and at first I was angry. Then I was sad.
Sad for all the little dogs and cats that had been put through these "dental cleanings." Ask yourself, why does someone need to hold my dog down while they do this? Why does my cat have to be restrained in a cat bag? Ask yourself, come on...think about it. They use such sweet fluffy words, "get up and go paws" and "bad language," for example. It's crap, it's all advertising fluff so you'll see them as kind sweet dental caregivers. I'm sickened.
This from the site concerns me: "If your pet has health problems, you may decide it’s best the pet be on an anti-biotic prior to the procedure, which your Vet can prescribe."
Two things. 1) if you pet has health problems, why are you doing a cosmetic procedure that is doing nothing about dental disease and why are you trusting someone with no medical training? 2) why are they concerned about bacteria entering the blood stream, they shouldn't be causing bloody gums and if they are they're ARE HURTING YOUR PET. Oooooh...could that be why they have to have the restraint???
So now your pet is scared and in pain.
This from the site referenced:
"It’s important to note that routine teeth cleanings are not a substitute for regular veterinary dental exams."
Dental exams? What? So it's not a substitute for dental exams but it is a substitute for proper dental prophylaxis?
"If the growling is too much, you can ask your vet to prescribe a kitty or doggy muscle relaxant."
Oh puhleeze. The veterinarian is not going to prescribe a "muscle relaxant"... they'll prescribe a SEDATIVE like acepromazine. Yea, I know how much you all love Ace. They may even prescribe some Torbugesic. And ya know what, it isn't gonna help unless you really zork them out with something like valium .. .and it still may not help. I've been bitten by dogs on sedatives.
My biggest complaint about this "anesthesia free" dental cleaning, is that it isn't a real dental cleaning. They use the example of how it's like a routine cleaning that you get at the dentists. THAT IS NOT TRUE! Any dental technician who cleaned your teeth without getting under the gums would have a very short career. Getting under the gums, HURTS. IT HURTS IT HURTS!!! That is why your pet has to be restrained. This is why a professional cleaning by a veterinary technician is done under anesthesia.
I don't know of any credentialed veterinary technician who has any formal training in dental prophylaxis who would support this slap in the face.
posted by Nancy Campbell RVT @ 4:50 PM
33 comments
33 Comments:
Clap clap clap!!!!
I couldn't have said it better myself!
Hi,
Nice blog. This surely a great help to pet owners out there. Know what, I have a blog about dog health care, and I would like to exchange links with you. Visit me and just leave a comment in my welcome post if you agree. Thanks
Thanks for bringing this up. With all of the recent advances in anesthesia, the risks for your average pet should be minimal, and the benefits far outweigh those risks.
What a terrific blog, Nancy. Click treat to you.
And of course, I couldn't agree more.
This is not an isolated situation, though. We actually have a vet in town that performs 'standing dentals'.
We had no clue until a client of theirs' felt uncomfortable and came to us. At first, I was kind of incredulous.
Then, a few weeks later, we received a referral from them. On the med. records it clearly stated, 'dental scaling'. That is it. No anesthesia, no polishing--NOTHING!
The poor cat has Grade 2-3 gingivitis. Not much tartar, though. Woo. Hoo.
How can people get away with this?? The previous client had stated that his 'polishing machine' was broken. What?!
This is malpractice. Yet, there doesn't seem to be much you can do about it.
I,too,am sickened.
Awesome! I am so glad to see your blog and to know that there is a place for us to vent!Bh/CVT
What a load !!While I can't vouch for all non-anesthesia hygenists ,the one who attended to my cat and dogs and many of my health-concious friends pets, was quite thorough.They knew what they were doing was somewhat risky and therefore asked the right pre-op questions unlike most vets.It's a known fact that many pets die "going under"(appropriate name)
and older pets are at even greater risk as are small dogs and cats.
So why so hysterical?If thats what a petowner wants...why not?
I certainly feel no pain when the dentist removes my plaque,why should Frodo ? Do you really think Vets are in it for the "humanity of it all"....in most cases,sadly...no.If they were then they'ed be at their local pound putting in hours there....?
So don't over do-it with the boo-hoo routine ok?
If you're so underappriciated at your job maybe you should try wild animal rescue...God knows we need more techs there!!!
Looks like you vet techs are going to have a challenge here because many of us won't allow you to lambast us the way you think you can.
I agree, I can vouch for most of us who offer this service and give many reason why this is a safe, effective and preferred option, and complimentary to what veterinarians do.
- what about the vet's out there who REFER us to their patients?I can name about 14 veterinarian that refer their clients to me.... Can you ask yourselves "WHY?" Please, let me answer for you... because perhaps many pets are too old and frail to "go under" and the risk of anesthesia- even the safer, newer types are too great to their health?
- Could the pet have a heart murmur and so the anesthesia-free method is safer? Isn't it better to have tartar and plaque removed from pet guardians animals who are deathly afraid of anesthesia (and so veterinarian who DO refer us, and believe me, there are plenty of decent, kind veterinarians who DON"T have just what goes into their pocket- at heart,) then for these pets to live out their lives with tartar and bacteria induced diseases?? Gee, I think I know the answer.
-Everyone knows that Ace-promazine and Valium both have a calming effect on pets, so why not use this to better make the patient more comfortable? I know many people who postpone getting their teeth cleaned for fear of pain and so Nitrous Oxide or oral sedatives are prescribed before their cleanings.. it's a fact that 50% of the population has this fear of dentists. Why shouldn't people experience this fear for their beloved pets as well?
You want a challenge? There are plenty of us who will give you a challenge on this subject. Vet techs, veterinarians, and pet guardians alike. You want a challenge and want to continue to bad mouth us, bring it on sister!
You are correct - anesthesia free dentistry is negligent dentistry.
Several additional points:
1. I have seen far, far, far too may patients that have had this "procedure" only to come into my office months later hand require multiple extractions due to teeth with nearly 100% bone loss and abscess.
2. There have been deaths from "anesthesia free" procedures. However, there is no one keeping track of these individuals.
3. If this was such a great thing why does not 1 of the almost 100 specialists of the American Veterinary Dental Collage (AVDC) perform this procedure? Actually, this was practiced in my office 30 years ago. We gave it up because we realized that by missing more that we were getting we were neglecting our patients. I can remember a “Tooth Fairy” coming in 15 years ago with her own pet that had been suffering silently through the years with abscessed teeth because of her neglect. Fortunately, she stopped providing this “service.”
4. The AVDC has a position statement on the subject. Go to www.avdc.org
5. Why to the pro-anesthesia free comments come from anonymous – something to hide? Or is it that you live in a state where it is ILLEGAL?
I have nothing to hide!
I am
Steven E. Holmstrom, Diplomate, American Veterinary Dental College
At 10:22 PM, Dr O said...
“They knew what they were doing was somewhat risky and therefore asked
the right pre-op questions unlike most vets. It's a known fact that many
pets die "going under"(appropriate name).”
Although the risk exists it’s actually quite small. And a veterinarian is
far better equipped to evaluate that risk than a groomer.
“and older pets are at even greater risk as are small dogs and cats.”
While older pets are at greater risk, the procedure is no riskier for small
dogs and cats than for a large dog. With proper medical management and
trained monitoring, the risk is greatly reduced.
When it comes to older pets, and their fragility, it's even more important
this medical procedure only be done with a trained veterinarian and
veterinary technician on site.
”So why so hysterical?If thats what a petowner wants...why not?”
Whether the pet owner wants it or not has no
bearing on the issue of the procedure's safety or advisability. The bottom
line is, it’s wrong and it’s a horrible disservice. It is a medical service
and only veterinarians can legally perform a dental.
”I certainly feel no pain when the dentist removes my plaque,why should
Frodo?”
I felt a lot of pain when the dental tech was digging under my gumline.
A LOT. Children also feel pain and they’re also fearful, it’s why
special dental techniques for children are implemented and a popular
discussion in the dentistry community. Dogs and cats are a lot like
children when it comes to dental care.
“Do you really think Vets are in it for the "humanity of it all"....in
most cases,sadly...no.If they were then they'ed be at their local pound
putting in hours there....?”
This sounds more like a personal jab at the profession, it has nothing
to do with dental care for pets. I know many vets that put in a whole
lot of free hours and professional care, many spend time in local
shelters, foreign countries and much more.
“If you're so underappriciated at your job maybe you should try wild
animal rescue...God knows we need more techs there!!!”
I would love to not have to support my family and do only volunteer work. As
it is, I'm fortunate that the hospital where I work DOES partake in wildlife
rescue and medicine. It’s a thankless job and the vets have to do
everything on their own time, they aren’t paid a penny for it and neither am
I.
At 8:31 AM, Anonymous said...
“Looks like you vet techs are going to have a challenge here because
many of us won't allow you to lambast us the way you think you can.”
I feel comfortable with having the law, integrity and professional training
on my side.
At 8:36 AM, Anonymous said...
”- what about the vet's out there who REFER us to their patients?I can
name about 14 veterinarian that refer their clients to me.... “
Fourteen wrongs don’t make a right. Whether you have the support of any
veterinarian means little, or nothing. Those particular veterinarian’s
professionalism is greatly in question and I know that the Academy of
Veterinary Dentistry would agree.
"Can you ask yourselves "WHY?" Please, let me answer for you... because
perhaps many pets are too old and frail to "go under" and the risk of
anesthesia- even the safer, newer types are too great to their health?"
Then you are performing nothing more than a cosmetic procedure that
gives the pet owner a false sense of security.
“(and so veterinarian who DO refer us, and believe me, there are plenty
of decent, kind veterinarians who DON"T have just what goes into their
pocket- at heart,)”
Implying that the only reason a veterinarian would be against this
practice is monetarily motivated is unfair, unjustified and highly
inaccurate. They’re against it because it is WRONG, ILLEGAL and UNSAFE.
“then for these pets to live out their lives with tartar and bacteria
induced diseases?? Gee, I think I know the answer.”
I don’t think you do. And cosmetic tooth scaling does not prevent
bacteria-induced diseases, and may indeed cause them or make them worse.
”-Everyone knows that Ace-promazine and Valium both have a calming
effect on pets, so why not use this to better make the patient more
comfortable?”
This is an example of the danger of unqualified people practicing veterinary
medicine. Ace should be never used in senior dogs and it’s unsafe in some
breeds. Also, using ANY sedative of ANY kind in a dog with health issues,
such as a heart murmur, or other fragility SHOULD NEVER be done without the
DIRECT supervision of a veterinarian. You are giving clients a false sense
of what you’re doing and they have NO IDEA that you are endangering their
pets.
“I know many people who postpone getting their teeth cleaned for fear of
pain and so Nitrous Oxide or oral sedatives are prescribed before their
cleanings.. it's a fact that 50% of the population has this fear of
dentists. Why shouldn't people experience this fear for their beloved
pets as well?”
The promotional language for this service perpetuates that fear, and those
who offer the service profit from it. A veterinarian and a veterinary
technician are far more trained and better able to handle a fragile patient
than a groomer.
”You want a challenge? There are plenty of us who will give you a
challenge on this subject. Vet techs, veterinarians, and pet guardians
alike. You want a challenge and want to continue to bad mouth us, bring
it on sister!”
The challenge is non-existent. You’re breaking the law, you’re
endangering pets and you’re performing a gross disservice. Badmouth?
Not hardly, merely stating the facts.
I've had pets' teeth cleaned at the vet, I've also had the "anashtesia free" cleanings done in my home. I think there is plenty of room for both options in the realm of caring for your pet. As I do a fair amount of rescue work, I see vets more often than most people. I think they (veterinarians) have mostly forgotten why they became vets in the pursuit of the all-important dollar. I suspect a large part of this argument is money motivated. Heaven forbid there might be a reasonable alternative to exorbitant vet bills.
Hello to all...i just wanted to say that i have taken my pets to the vet for teeth cleening and i was never comfortable with putting them under. I had my dogs teeth done just recently with anesthesia-free teeth cleaning and i was very very happy with the results and my dog was happy and the best part she was not groggy all day. So in closing to everyone who is so concerned..give me a break there are to may other important things in this world to worry about.
Lucky for us, that not all people see in black and white and there are many, many shades of gray. Not all veterinarians are against anesthesia-free teeth cleaning, and I think some of the people who do call themselves "Hygienists" are a probably better at what they do than others.. like the people who this vet dentist are referring to. You see, not all hygiensts are trained to know what to look for i.e: FORL's, perio, loose teeth, etc. so therefore don't/can't always have the awarenesss level of what to tell their clients, therefore pet's wind up suffering the price. That is why a veterinary referred Anesthesia-free Hygienist is probably a good idea.
Another case in point too, is that just as in some hygeinists, not all veterinarians know exactly what they are doing. Many times vets unintentionally "kill" their clients pets while under anesthesia and don't even get a slap on the wrist for it. It's very sad.. I can't tell you how many people I know who've lost their pets under anesthesia - and many while having dental prophy's. So why not listen to pet guardians fears? It's not all black and white you see, but I see that there is no reasoning with the techs and other vet(s) on this board. To them, it seems to be black or white. Small minds....
Anesthesia-free teeth cleanings are NOT, by any means against the law. They are not illegal and the Veterinary Board has no jurisdiction over Anesthesia-free teeth cleanings. Do your homework before you say things that are false Nancy and Dr.Steven.
Per WA state law RCW 18.92.010
(http://apps.leg.wa.gov/RCW/default.aspx?cite=18.92.010)
the first line of what qualifies as the practice of veterinary medicine:
"Any person shall be regarded as practicing veterinary medicine, surgery and dentistry..."
By this, performing a dental is practicing veterinary medicine. If you perform this service in this state you are practicing veterinary medicine. If you are not a licensed veterinarian you are breaking the law.
Most states, if not all, have a similar law on the books.
Take California for another example.
Dental Regulations Define (Practice of veterinary medicine defined)
"Section 4826, Business and Professions Code. Practice of veterinary medicine, surgery, and dentistry, Defined.
Any person practices veterinary medicine, surgery, and dentistry, and the various branches thereof, when he or she does any one of the following:
(a) Represents himself or herself as engaged in the practice of veterinary medicine, veterinary surgery, or veterinary dentistry in any of its branches."
In case that isn't enough, that particular part was preceded with this to define what veterinary dentistry is:
"The term “dental operation” as used in Business and Professions Code section 4826 means:
(1) The application or use of any instrument or device to any portion of an animal’s tooth, gum or any related tissue for the prevention, cure or relief of any wound, fracture, injury or disease of an animal’s tooth, gum or related tissue; and
(2) Preventive dental procedures including, but not limited to, the removal of calculus, soft deposits, plaque, stains or the smoothing, filing or polishing of tooth surfaces.
(3) Nothing in this regulation shall prohibit, however, any person from utilizing cotton swabs, gauze, dental floss, dentifrice, toothbrushes or similar items to clean an animal’s teeth."
Let's check Texas, just for fun. What is the legal definition of veterinary medicine in the state of Texas?
http://www.animallaw.info/statutes/stustx_occ_801_001_509.htm
"(7) "Veterinary medicine" includes veterinary surgery, reproduction and obstetrics, dentistry, ophthalmology, dermatology, cardiology, and any other discipline or specialty of veterinary medicine."
Who can practice "Veterinary medicine" in the state of Texas?
"(6) "Veterinarian" means a person licensed by the board under this chapter to practice veterinary medicine."
In the state of California, there is no definition of dental operation in B&P Code Section 4826 promulgating Regulation 2037 under the Veterinary Practice Act. No court would uphold Regulation 2037, for one it is to vague as to what is prohibited, and it purports to expand the scope of section 4826. THIS MAKES REGULATION 2037 UNCONSTITUTIONALAND UNENFORCEABLE AS WRITTEN. The California Supreme Court has made it clear in dozens of cases regarding this issue, "NO REGULATION IS VALID IF ITS ISSUANCE EXCEEDS THE SCOPE OF THE ENABLING STATUTE."
or so you'd like to believe.
This is absolutely true. Check it out for yourself. I would urge everyone either pro or con anesthesia free teeth cleaning to log onto their states' VMB websites and pull up disciplinary actions against vets.
All over, folks are becoming increasingly angry with the veterinarian profession. This is exactly why people are turning to all the holistic alternatives for their pets. They are tired of over vaccination of their pets, unnecessary surgeries, pulling teeth without notifying the owner, deaths by anesthesia and downright incompetence and greed that they see overtaking the veterinary profession.
Let's face it, very few vets are trained in the area of denistry.
The price quotes that people receive from their vets for the price of a teeth cleaning (under anesthetic) is so exorbitant that no owner in their right mind is going to pay for it. Dental hygiene needs to be performed on animals on a regular basis just like humans. No owner is going to continue to put their animal under anesthesia 1-2 times per year, risk the life of their animal and pay a vet anywhere from $500-$1500. And let's face it, most vets don't clean the animals teeth. Most of the cleaning is done by a $8 per hour vet tech that has no idea what he or she is doing.
I would urge everyone to check out the book, "Shock to the System" by Catherine O'Driscoll. This is an eye opening book about over vaccination of animals. Quite interesting.
I also would urge everyone, pro or con, this issue to do their own checking and investigating and not just take the opinions of two "vet techs."
Anonymous said.."No owner is going to continue to put their animal under anesthesia 1-2 times per year, risk the life of their animal and pay a vet anywhere from $500-$1500."
Not sure where you're located but I've never worked for a vet that the teeth cleaning itself was more than $160. The cost would increase if there were extractions, and if the owner allowed (because owners must be so much more able to determine if their pet needs these medical procedures, they're obviously trained and all) pre-anesthetic bloodwork, iv catheter, iv fluids, special monitoring beyond the standard capnograph and pulse/oximeter. I've never seen the total reach more than $500 unless the pet also received other services such as spay/neuter, mass removal, etc. But like I said, that would depend on where you live. I have no doubt that there are vets in other areas that charge the prices quoted. I can only ever been able to speak from my own experiences.
"And let's face it, most vets don't clean the animals teeth. Most of the cleaning is done by a $8 per hour vet tech that has no idea what he or she is doing."
To be fair, veterinary technicians are specifically trained to do the dental cleanings, but most state laws don't allow us to much more than just the prophy. I spent many hours in school practicing dental prophys and there are programs out there for technicians to become specialists (currently there are only 3 areas a technician can gain a specialty...see http://www.navta.net/career_dev/specialties.php ...similar to a vets "board certfied"). I know for a fact that since much of the public doesn't understand what a vet tech is they especially don't care what their training is and it's up to the public to change that. Pet owners need to demand that anyone that calls themselves a veterinary technician has the training and credentialing to back it up and that their own state has the laws in place that make it so that not anyone hired off the street can call themselves a vet tech. Even my own state, which has made some changes but not enough, is lacking in their distinction between a vet tech and an assistant. The only difference between what that $8/hr ASSISTANT can do and the $12/hr vet tech is the type of "supervision" they receive and only a technician can induce anesthesia. The difference between an assistant and a technician is kinda like the difference between a high school student that wants to be a nurse and a registered nurse, but most states don't bother drawing that line and we just bleed together. Someday pet owners will stand up and demand that technicians be formally trained. So until pet owners and each state makes that distinction between the two, yea, the chances that an untrained veterinary assistant is doing your dogs dental cleaning is pretty good. Pathetic, I agree. Burns my britches.
"I would urge everyone to check out the book, "Shock to the System" by Catherine O'Driscoll. This is an eye opening book about over vaccination of animals. Quite interesting."
I am all for less vaccinations and strongly support clients that put the brakes on over-vaccinating their pets, holistic medicine practiced by veterinarians, species appropriate diets, etc. O'Driscoll's book is "ok" I'm sure, I haven't read this one yet but have read her first one so I can't comment. I prefer other "holistic" minded authors especially those written by DVM's like Dr. Pitcairn. If you'll notice I haven't written any articles on vaccines, diet or alternative medicine. But meet me on the yahoo group K9Nutrition, we'll talk. :-)
"I also would urge everyone, pro or con, this issue to do their own checking and investigating and not just take the opinions of two "vet techs.""
I also urge people to do their own research, please do and make the changes in the system that need to be made to better serve your pet! I support you. I too agree that veterinarians and veterinary technicians need to be held up to the light. I agree that people need to demand that vets especially be held to a higher standard. That's why I prefer to work with vets that strive for the gold standard in care and have a genuine compassion for pets. It's why I left my last employer. Mediocrity is the standard for every profession and it's sad. I'll never deny that. But it's up to US to demand better.
I'd like to point out that this is not the opinion of two veterinary technicians. For one, I'm the only veterinary technician that writes the articles on this blog. Secondly, it's not just my opinion, it's facts supported by the positions of the AVMA, AVDC, every board certified veterinary dentist and nearly every state's veterinary board and written into the laws regarding veterinary medicine.
Another point is that the majority of Veterinarians leave the technician unattended during a dental prophy and never check on the patient during the procedure, which is illegal. But how many vet's do this? Probably more than 80% and get away with it.
No, I'm sorry, but it isn't illegal. The veterinarian is not required to stand by the tech while they do the dental prophy. You have to understand the different levels of supervision, which are spelled out by the law. Here in the state of Washington
First the definitions of the types of supervision, VERY important.
http://apps.leg.wa.gov/WAC/default.aspx?cite=246-935-010:
WAC 246-935-010
(2) "Direct supervision" means the supervisor is on the premises, is quickly and easily available and the animal has been examined by a veterinarian at such times as acceptable veterinary medical practice requires, consistent with the particular delegated animal health care task.
(4) "Immediate supervision" means the supervisor is in audible and visual range of the animal patient and the person treating the patient.
(5) "Indirect supervision" means the supervisor is not on the premises, but has given either written or oral instructions for treatment of the animal patient and the animal has been examined by a veterinarian at such times as acceptable veterinary medical practice requires, consistent with the particular delegated animal health care task and the animal is not anesthetized.
Now take the time to read what a technician can do in this state (and most states are very similar)and under what kind of supervision they can do it. Especially note where dental prophys are located.
WAC 246-935-050
http://apps.leg.wa.gov/WAC/default.aspx?cite=246-935-050
Animal health care tasks.
First Immediate supervision. These are the only tasks that require the vet be in audible and visual range of the technician performing the task.
(a) Immediate supervision. A veterinary technician may perform the following tasks only under the immediate supervision of a veterinarian:
(i) Assist veterinarian in surgery by tissue handling;
(ii) Assist veterinarian in surgery by instrument handling;
(iii) Dental extractions.
So as you can see...the only things that a vet needs to be standing RIGHT THERE is during surgery (duh) and if the technician extracts teeth.
Now let's look at direct supervision, this means the vet must be in the building and easily accessible. He or she can be in their office, they can be in an exam room, they can be sitting on the toilet. But they do NOT have to be standing by. Pay special attention to (xi).
(b) Direct supervision. A veterinary technician may perform the following tasks under the direct supervision of a veterinarian:
(i) Endotracheal intubation;
(ii) Blood administration;
(iii) Fluid aspiration, including cystocentesis;
(iv) Intraperitoneal injections;
(v) Monitoring of vital signs of anesthetized patient;
(vi) Application of splints;
(vii) Induce anesthesia by intravenous, intramuscular, or subcutaneous injection or by inhalation;
(viii) Administration of immunological agents including rabies vaccination;
(ix) Catheterization of the unobstructed bladder;
(x) Ophthalmological procedure including:
(A) Tear production testing
(B) Topical anesthetic application
(C) Fluorescein staining of the cornea
(D) Tonometry;
(xi) Teeth cleaning, provided an oral examination of the anesthetized patient has been conducted by the veterinarian;
(xii) Microchip implantation;
(xiii) Floating teeth;
(xiv) Removal of partially exposed foxtails and porcupine quills;
(xv) Provide massage.
Next is indirect supervision, I'm only including this because I thought it only right that I do. These are things that a vet tech can do when there is not a vet on the premises AT ALL.
(c) Indirect supervision. A veterinary technician may perform the following tasks under the indirect supervision of a veterinarian. If the animal is anesthetized, these tasks require the direct supervision of a veterinarian.:
(i) Enema;
(ii) Electrocardiography;
(iii) Application of bandages;
(iv) Gavage;
(v) Ear flush;
(vi) Radiology;
(A) Patient positioning;
(B) Operation of radiograph machines;
(C) Oral and rectal administration of radio-opaque materials;
(vii) Placement and securing of an intravenous catheter;
(viii) Injections of medications not otherwise prohibited:
(A) Intramuscular, excluding immunological agents
(B) Subcutaneous, excluding immunological agents
(C) Intravenous, including giving medication through an established intravenous catheter;
(ix) Oral medications;
(x) Topical medications;
(xi) Laboratory (specimen collections):
(A) Collection of tissue during or after a veterinarian has performed a necropsy
(B) Urine, except cystocentesis
(C) Blood
(D) Parasitology
(E) Exfoliative cytology
(F) Microbiology
(G) Fecal material
(xii) Laboratory (specimen testing):
(A) Urinalysis
(B) Hematology
(C) Serology
(D) Chemistries
(E) Endocrinology
(F) Parasitology
(G) Exfoliative cytology
(H) Microbiology
(I) Fecal analysis;
(xiii) Administration of preanesthetic drugs;
(xiv) Oxygen therapy;
(xv) Euthanasia in all circumstances as otherwise allowed by law;
(xvi) Removal of sutures;
(xvii) Indirect blood pressure measurement;
(xviii) Obtaining a general history from a client of a patient and the client's concerns regarding that patient;
(xix) Preliminary physical examination including temperature, pulse and respiration;
(xx) Behavioral consultation with clients;
(xxi) Dietary consultation with clients.
___________________________________________________________________
I was told to do my research, I think those that comment should do the same, eh? ;-)
Just for fun go read what assistants in this state can do under what type of supervision...same site: (http://apps.leg.wa.gov/WAC/default.aspx?cite=246-935-050)
The real issue here is whether or not having the anesthesia-free dentistry actually does any good. All of my own research, and the anecdotal evidence I have seen in dozens of others' pets is that it *does not* get deeply enough under the gumline to prevent or deal with bacteria or disease. So, you pay half the price, but get none of the benefits. What's the point of that? Pearly whites on top don't do much good if the tooth is rotting below the gumline....and to top it off, the animal had to endure this frightening procedure simply to make the owner feel like they took some action. That's worse than worthless....its unfair as well as useless.
I know of plenty of pets that had this done, only to have the bacteria in their mouths get *worse* afterwards because the real problem not only couldn't be addressed by the procedure, it couldn't even be *diagnosed* via that procedure. That's not only not helpful, that sort of false security is dangerous.
Outside of making money without having to be licensed, I don't really see the point in promoting this procedure. It doesn't positively impact the health of the animal, it still costs good money, and it puts the animal through hell. I just don't get it.
I have worked as a vet assistant since '85,in the S.F. bay area (CA). I have done dental scaling on all my own pets, and they have never had the problems associated with poor dental care that I see at work. None of my animals are restrained with any meds. or devices. When they have a dental problem, they see the Veterinary Dentist.
I also do non-anes. scaling under the supervision of a veterinarian. I would say 1/2 of my clients want the "cheapest" possible route. Their pets have awful mouths, and are usually in need of extractions. I explain to them the importance of seeing a vet and having their pets mouth attended to properly. Other pets (although very few in my experience) are too frightened or aggressive, and would be better off with chemical restraint.
The other 1/2 of the people I see want to maintain their pets healthy mouth. On these animals I am able to easily scale their teeth, and polish. I use a CET oral rinse after each procedure.
I ask about each animals medical past. If they appear in any way fragile, or if they do not have a regular vet, I will refuse these clients. I try to explain to them that dental cleanings are important, and so is the pre-procedure work up. The average cost I am told they are quoted is in the $400.00 range.
Now I am in total agreement with doing what is best for the animal, but many people who see their vet regularly, and have young pets with very minimal dental tartar build up are being bullied into getting cleanings. These people have established relationships with their vet, and are made to feel as though they are neglecting their pet if they don't have a dental preformed.
Most of these clients are going to one of the "big" vet hospitals, not small private veterinarians.
I think the big deal that is made of the pre-procedure labwork, and the big price tag scare people. Many ask me, "If it is so safe to put my pet under, why are they so worried about all the testing before they do it? It must not be so safe."
The 15 minute exam they get from their vet, doesn't provide enough time to explain things fully. I explain to these people what their vet, or one of the assistants/techs should have. Once it makes more sense to them they are much more open to the cost factor.
I see the benefit of both veterinary dentistry, and dental scaling done correctly.
I have had dental work done, and I do not find it all that painful. I have seen many animals with awful teeth and gums who are still eating and acting normal. So I think they usually put up with more pain than most humans would.
I agree we shouldn't "cowboy" them and extract teeth while they are awake, but come on, how many dogs stand still for a nail trim?
I understand why people are interested in this service; I am one of them. Veterinarians who specialize in dentistry are not necessarily safe or careful for all of their credentials and technology.
Recently a veterinary dental specialty hospital came to my town, specializing in only dentistry with vets who do only that. I was referred to this place, because I am nervous about my pets going under anesthesia and I figured if any place was safe it would be this one. WRONG.
Lady (not me) takes in her 14 year old dog for a dental. They keep the dog, who is elderly, under anesthesia for 3+ hours, extracting every single one of his teeth. Of course, he died on the table, never made it out of anesthesia.
Whether or not all his teeth needed to come out or not, it seems obvious to me that you DO NOT keep a senior dog under anesthesia for 3+ hours. You are just asking for the dog to die on the table if you do that. And these are the EXPERTS. So if you can't trust them, who can you trust?
Great Blog, I'm a tech and a dog trainer. My biggest problem with the vets that I work for is that I never hear them say anything about preventative oral care! Brushing everyday from puppyhood is the best prevention. Also...raw bones(for dogs...not just any old chicken bone from your table) Are great at scraping off existing plaque.
My dog has very white teeth =)
keep on blogging!
-kate w., dog trainer and unregistered veterinary "assistant"
(They call me a tech at work)...also..I hate how some vets wont hire RVTs because it costs more...I just got lucky and got a job out of it.
You should be ashamed trying to scare people away from anesthesia free dentistry for their dogs! I have been having all three of my dogs dentistrys performed anesthesia free for years and couldn't be happier! Their teeth and gums look great and they are healthy! I nearly lost one of my dogs during a dentitry performed under anesthesia by a vet and my sister, in fact, did lose her little Yorkie during the same procedure even though all the pre-anesthesia blood work, etc. was done. My former vet also insisted on giving them anesthesia because he couldn't be bothered to learn something new (and by the way, many vets hand over dental cleaning WITH ANESTHESIA to their techs once you leave their office). Because, once you leave your pet there ALL DAY, you don't know who's doing what to your dog. My new vet who convinced me to switch to anesthesia free invited me to watch the procedure done on one of my dogs and it was awesome! The techs were professional, knew what they were doing, handled my dog very well (I couldn't believe how well) and within 20 minutes they were done! No recovery from anesthesia, no vomitting, no withholding food, no all-day-at-the-vet trauma, no I.V. pain, nothing! I for one am sold and will never go back to the archaic practice of unnecessarily anesthetizing my dogs to have their teeth cleaned!
If you want to believe you're doing the right thing, that's your business. However I do feel any shame for my opinion that is based on facts. I really don't care how many posts try to convince me that anesthesia free dentals are a good thing, my opinion which is based on facts, is not going to change.
Enough already.
How about young pets that have healthy gums, teeth brushed daily, owners that take good care of their oral health etc... but still have a tiny bit of tartar on their back teeth, from those months in their lives where they were waiting for adoption?
Scraping off the tartar without anesthesia sounds reasonable then, no? Would an anesthesia be really justified for this? I am aware of the necessity to get plaque out of below the gumline, especially for gingivitis, but what if the pet has healthy gums? Put him under all the same?
PS: This is a real question, not some kind of rhetorical reasoning :)
That sounds more like "maintenance", which I encourage. I love to hear of owners that help to maintain the health of their pet's teeth. But if you're paying for someone to give your pet an "anesthesia free dental" for this you're being ripped off.
The point I've tried to make over and over and over, is that just the mouth LOOKS healthy does not mean that they are, I know because I've experienced the surprise of finding an abscessed tooth in a mouth that looked PERFECT to my eyes.
As I sit here and read all of this I have now gone from generally ill and extremely anxious to needing to be put on something to calm down. Several days ago, I brought my 14 year old Sheltie in to see a Vet for an absessed tooth/teeth. I was referred to this vet by a Holistic/Traditional Vet next door who referred me. I just moved here so I hadn't yet even brought my dog to him, which I was about to when the teeth situation got out of hand. Without going into a long history, suffice to say my little girl dog has been through enough, is maintaining a healthy life on Hydrocodone and Theophylline. And yes, since her surviving her pericardial effusions and sac removal I have avoided the DREADED anesthesia for her teeth as well as a tumor mass on her mammary to avoid further trauma to this poor little dog who has now been doing very well considering for 3 years. When the vet went to look at her mouth it became apparent that my dog would not let her and became hysterical yelping because of the pain which she had never had like that until that day. The vet said that we might as well schedule her for surgery and she would be able to look at them because the teeth that she could see look really bad as well as the gums. She put my dog on antibiotics and scheduled her for a few days later, this Monday, which doesn't seem like enough time for the antibiotics to really kick in. It's usually a week on antibiotics, isn't it?
Anyhow, I left and went home and began doing research and the board certified vet dental specialist in my area was closed on Friday so I couldn't consult, get a quote from him, etc. I called the vet back to find out more information on them since they will be putting my dog under and doing surgery on her and it would be nice to know a little bit about their background. I asked if they have a separate anesthesiologist and they said no, the doctor does it with the assistance of a tech. When asked I found out no one is board certified in anesthesiology or veterinary dentistry and they didn't even offer any supportive information on who they are or their experience, Nothing! I basically had to "pull teeth" to get information and at the time of the original appt. the vet barely said anything to me after deciding to schedule surgery. I just went up an paid my bill and they handed me the antibiotic and instructions and an appointment card. So now I have been on the computer looking, calling specialty vet hospitals, clinics across the country for 2 days straight and STILL cannot seem to get an answer about whether or not I would be crazy to bring my little dog there for surgery. The vet said she would do blood work the morning of to determine my dog's eligibility to go ahead with it, she also said she could take out a tumorous mass in one of her mammary glands since it seemed to be surface and not deep while she was under. When I asked if that would pose a risk for being under longer she said it would only take an extra 15 minutes for that. Also - she DOES NOT DO X-RAYS beforehand so how does she know if she will even have time to do the tumor mass if she doesn't know how many teeth need to be extracted? I am also worried about jaw bone loss and would prefer a root canal, which I understand she cannot perform. But I can't get anyone to even give me a ball park on the cost of what that would run to determine if I could even afford that as an option. I realize that there are only really 4 eligible teeth in a dog's mouth for root canals but if I could possibly save some of them, wouldn't that be better and less pain and recuperative time?! I NEED TO MAKE AN EDUCATED DECISION ABOUT MY DOG WITH VERY LITTLE TIME LEFT TO DO SO AND EVERYONE IS CLOSED ON THE WEEKENDS AND THIS VET IS TIGHT LIPPED AND NOT EXACTLY OFFERING UP INFO ON WHAT TO EXPECT, OPTIONS, REASSURANCE OF HER COMPETENCE, ETC.! Can ANYONE give me any advice on what to do? My tendancy is to always go to the Vet Specialists Centers and get THE PERSON who is the best in the state but it is always so expensive and I just don't know how I will do it without a payment plan, which they never have. Is it NORMAL for a Vet to just work with a tech and not have a board certified or anesthesiologist on site and not be board certified herself? What are the different levels of anesthesiologists, techs and their experience? She didn't even try to reassure me and say ANYTHING about the competence of the people who would be working on my dog or offer any information, especially when I phoned with obvious concerns and jitters? Wouldn't that be the time to fill me in and say how long everyone there has been doing what they're doing?! So now I have been on the fence for 2 days about what to do, scared to death for my dog, trying to decide if I should cancel the surgery and go to a specialist which I had gotten a little attitude from the vet who said I should if that's what I want...??? All the while my dog's mouth needs attention now. Help!
I think there are problems with both systems to be honest. Veterinary anesthesia is a progressing field and it's getting better and safer as we speak. However I think pet owners should know what kind of care their pets are getting. Unfortunately it's a money issue there ... they see a dollar sign and it's suddenly in one ear and out the other.
I have a pet with a heart murmur... I've been scared of anesthesia... but you know what, I'd be more scared of all that funk under her gumlines going straight to her heart (can we say endocarditis?)
I've seen "handscales" and CRINGED! It's not fun for ANYONE involved. It looks much better afterward... yes, but that's about it, it's still infected if they have progressed to periodontitis.
I've also had my pets have professional dental cleanings at different vets and was not happy with both. One of them had one tech watching my pet and cleaning, she was intubated and had a pulse ox on... that was it. The other had her pre-op bloodwork done, pre-meds on board, a tech intubated and cleaned while the other monitored every 5 minutes recording the vitals keeping a close eye on her temperature to make recovery faster and a catheter for easy access and fluids running. And post monitoring in the clinic.
Anyway... I'm glad you said it and not me. I just promote the hell out of home dental care now and show disgusting mouths to owners right away... saves the speech for later.
Just as a last thought.. I'm a pet owner, I'm only now entering the veterinary field (about 1 year ago, work for a Holistic Vet) and you learn the difference between the two procedures QUICK!
If that pet is really your child and not just an accessory, why not listen to the professionals? Even Dr. Pitcairn recommends professional ultrasonic dentals.
For all you morons who are sitting here with your OPINIONS you should really stop trying to pass them off as facts. The truth is there is nothing illegal about a anesthesia free dental. The main reason dentals are done under anesthesia are because the doctor or person performing the procedure are not confident in being able to do it to a non sedated animal because there is no licensing required to preform this procedure, kind of like there is no licensing required to be a vet tech so stop pretending your doctors. The only other reason anesthesia should be used is if deep cleaning is necessary (in most cases its not with proper dental care at home) or in the case of an extraction or a uncooperative pet. Anesthesia is not only over used by most veterinarians but much more risky than they will let you know. I know of many vets who will not clip a pets nails unless its sedated, I have also seen instances of pets being sedated for other minor procedures where it is not necessary. If your veterinarian insists on your pet being under anesthesia for dentals or any other frivolous procedure it is probably not for the pets well being but for the dollars. Anesthesia is not only dangerous for any pet; especially pets with health problems that have not been previously diagnosed but it is a good way to pump some extra money out of unsuspecting pet parents. The rampant use of potentially fatal drugs on our pets by these hacks makes me sick. These people do not care about you or your pet they only care about the money. Does your dentist knock you out every time you get your teeth cleaned? I didn't thing so a human dentist wouldn't even risk gas anesthesia for an extraction or a root canal which is much less risky on humans, don't let these people risk the health of your pet. Anesthesia free dentals are just as beneficial to your pet as a routine cleaning is to you. Don't fall for these lies, the last thing any pet parent would want is to take your loved one in for a routine dental cleaning and receive a call that your pet has passed away. I have seen it happen while you can't always blame the doctor or the techs (who in most states require no training at all to work on your pet)you can blame the person who made you think anesthesia was the only solution.
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