New Rules for Cat Teeth-Cleaning

AAHA mandates anesthesia during cat dental work.

By CatChannel News Editors | Posted: August 27, 2013, 12 p.m. EDT

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AAHA-accredited veterinary hospitals must anesthetize and intubate all dental patients under a new standard of care that challenges the practice of anesthesia-free cleanings seen increasingly in the industry.

The rule, part of the updated 2013 AAHA Dental Care Guidelines for Dogs and Cats, applies to cleanings and any other dental procedure.

Find out more on cat dental care >>

"The guidelines state that general anesthesia with intubation is necessary to properly assess and treat the companion animal dental patient,” said Kate Knutson, DVM, president of the American Animal Hospital Association. "Because AAHA practices are expected to practice the highest level of veterinary excellence, AAHA’s leadership felt it necessary to update this dental standard so that they reflect best practices outlined in the guidelines.”

The standard, released publicly today after being disseminated to member hospitals, was approved in June by the AAHA board of directors.

The policy has the support of the American Veterinary Dental College.

"Dental experts agree with and endorse AAHA’s new mandatory standard regarding anesthesia and dentistry,” said AVDC president Jan Bellows, DVM, Dipl. AVDC, Dipl. ABVP.

Any AAHA practice scheduled for an accreditation evaluation on or after Nov. 1 is required to follow the standard. AAHA accredits more than 3,200 hospitals.

The policy shift came under fire from Josh Bazavilvazo, the founder and CEO of Pet Dental Services, which performs 15,000 teeth cleanings a year without anesthesia. He predicted that some AAHA-accredited hospitals he works with would drop their membership in protest.

"The veterinarians are very displeased with the new mandate—being told how to practice veterinary medicine,” Bazavilvazo said. "The AAHA board does not have its finger on the pulse of the everyday practice of medicine.”

Pet Dental Services, based in Costa Mesa, Calif., employs 25 full-time veterinary dental hygienists over 11 states to perform what Bazavilvazo calls "preventive maintenance” in between routine anesthetic procedures with radiographs.

AAHA acknowledged that some members may end their affiliation.

"Whenever we pass new standards there will be members who won’t [abide] and won’t be able to receive accreditation,” communications manager Kate Spencer said. "It won’t necessarily surprise us if not everyone complies.

"The vast majority of what we’ve heard is positive.”

AAHA’s updated guidelines note that intubation is essential to prevent the aspiration of water and debris during dental procedures. They also state that anesthesia ensures patient health and safety by permitting "immobilization without discomfort, periodontal probing, intraoral radiology, and the removal of plaque and tartar above and below the gum line.”

When anesthesia is used, "One trained person is dedicated to continuously monitoring and recording vital parameters, such as body temperature, heart rate and rhythm, respiration, oxygen saturation via pulse oximetry, systemic blood pressure, and end tidal CO2 levels,” according to the guidelines.

Furthermore, warming devices must be used to prevent hypothermia and the caudal oral cavity must be suctioned and packed with gauze to prevent aspiration.

Anesthesia-free dental cleanings are a popular choice of pet owners fearful of putting their cat or dog under the control of powerful sedatives.

Los Angeles-based Houndstooth hires certified veterinary dental technicians to conduct nonanesthetic cleanings both at veterinary clinics and in a client’s home. Operating in eight states, Houndstooth technicians use comfortable positioning, "gentle relaxation techniques” and "pet whispering skills” to ensure results comparable to routine cleanings, according to the company website.

While pets with advanced periodontal disease and other complicated conditions are not candidates, anesthesia-free cleanings are the way to go for the vast majority of cats and dogs, Houndstooth co-owner Kathy Shafer said.

"Let’s be very clear when we talk about anesthesia,” Schafer said. "We are all for anesthesia when it is appropriate.”

She equated anesthesia to life support.

"Would you want your 12-year-old daughter or 14-year-old son put on a life-support system for a routine dental?” she asked. "We have people call us and say, ‘I would let my dog’s teeth rot out of their head before I put them under anesthesia.”

She pointed to the inherent risk of anesthesia as a reason to avoid it when possible.

"Last week a client’s 8-year-old cat flat-lined—died—during a routine dental” while under anesthesia, she said.

Why the cat died is unclear, but Shafer said Houndstooth paid for a necropsy, the results of which are pending.

The American Veterinary Medical Association’s Position on Veterinary Dentistry stops short of requiring the use of anesthesia.

"Sedatives, tranquilizers, anesthetics or analgesics are commonly used during veterinary dental procedures to provide restraint and reduce animal pain and suffering,” the policy states.
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Reader Comments

Janet    Bethlehem, PA

12/15/2013 10:37:08 AM


Bill    Lexington, KY

9/7/2013 12:48:49 PM

I wouldn't be surprised if we don't see some chain-store type anesthesia-based Pet Dental Care Centers in metro areas relatively soon (if they don't exist already--I can't do a lot of research right now as I'm trying to get out the door). If you can find a way to stream-line this particular type of pet health care, you could keep costs low, maintain a well-experienced staff, and make a nice living.

The bigger problem, as I see it, is that this trend in more dental care for pets is going the way of dental service availability in humans. Not everyone can afford proper dental care, much less proper pet dental care.

Bill, Cats With An Altitude Crafts

L.    CC, CA

9/6/2013 9:02:45 AM

One of ours had a dental a couple years ago. Frankly, they are expensive & too expensive for us to do every year or as recommended. Ours let us brush their teeth (one w/ some resistance) but we know it's not enough. I've thought about purchasing a dental tool (scraper) to scrape the tartar off a little myself, but I know that isn't the whole dental.

When our one cat did have the dental, we had him do pre-op testing to make sure he didn't have any preexisiting conditions that made it so he could not handle anesthesia. It was worth the extra $80 on top of the however much we already were spending.

Anesthesia is scary! It is scary even with humans. Having spent time at a spay/neuter clinic, I have seen plenty of dogs & cats flatline & come back. I have only seen one or two die from anesthesia, but that's still too many to me. I kind of think this is just a ploy for veterinarians to ensure their getting more money in their already $75,000 salary pockets; a monopoly on the market, if you will. I think we are just going to spend more time on home care before our next dental. I'd hate to loose one of my babies that way!

Dharma rules    Ventura, CA

9/5/2013 3:54:11 PM

This can lead to kidney failure and is hard on all organs on a healthy cat, I think it's the expertise of the clinic too and many use techs with little knowledge with out telling you. This has happen to me.

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