Thursday, January 19, 2012

Anesthesia-Free Dental Cleaning

by Nancy Kay, DVM 

It’s natural to have concerns about general anesthesia, whether for ourselves or for our beloved dogs. After all, no matter how young and healthy the patient, there is always some associated risk. For this reason, anesthesia-free dental cleaning for dogs has become more and more popular. And with no anesthesia, the cost of cleaning Fido’s or Fluffy’s teeth is significantly reduced- clearly another attractive feature.

Anesthesia-free dental cleaning for your dog sounds rather tempting, doesn’t it?

Before you jump on this bandwagon I encourage you to consider whether or not this option truly serves your dog’s or your cat’s best health interest.

I’m a big believer in regularly brushing your pet’s teeth at home.

Thoroughly removing dental tartar on an awake animal, however, is a whole 'nother ball game! 

Even with highly skilled hands and a super-cooperative animal, it is impossible to successfully and painlessly remove tartar from underneath the gum lines and along the inner surfaces of the teeth (the surfaces in closest proximity to the tongue).

And, if the end result of cleaning is anything other than polished, super smooth, dental surfaces, tartar will quickly reaccumulate. 

Anesthesia-free dental cleaning definitely gives the outer surfaces of the teeth a cleaner look. While this may be pleasing to your eye, there is no significant benefit to your dog’s health. For all of these reasons, if and when dental cleaning is warranted for your dog or cat, I strongly encourage that it be performed with the aid of general anesthesia.

Now, there are some caveats that accompany my recommendation. 

For some animals, the risks associated with general anesthesia clearly outweigh the benefits, for example a dog or cat with advanced heart disease or kidney failure. Even for the healthiest animals, general anesthesia should be accompanied by careful monitoring of the patient’s status at all times. A list of important questions to ask your veterinarian about general anesthesia can be found in Speaking for Spot within the chapter called “Important Questions to Ask Your Vet…and How to Ask Them.”

The American Veterinary Dental College also advises against anesthesia-free dental cleaning. Here is an excerpt from their recently drafted position statement:

“Owners of dogs naturally are concerned when anesthesia is required for their dog. However, performing nonprofessional dental scaling on an unanesthetized dog is inappropriate for the following reasons:
  1. Dental tartar is firmly adhered to the surface of the teeth. Scaling to remove tartar is accomplished using ultrasonic and sonic power scalers, plus hand instruments that must have a sharp working edge to be used effectively. Even slight head movement by the patient could result in injury to the oral tissues of the patient, and the operator may be bitten when the patient reacts.
  2. Professional dental scaling includes scaling the surfaces of the teeth both above and below the gingival margin (gum line), followed by dental polishing. The most critical part of a dental scaling procedure is scaling the tooth surfaces that are within the gingival pocket (the subgingival space between the gum and the root), where periodontal disease is active. Because the patient cooperates, dental scaling of human teeth performed by a professional trained in the procedures can be completed successfully without anesthesia. However, access to the subgingival area of every tooth is impossible in an unanesthetized canine or feline patient. Removal of dental tartar on the visible surfaces of the teeth has little effect on a pet’s health and provides a false sense of accomplishment. The effect is purely cosmetic.
  3. Inhalation anesthesia using a cuffed endotracheal tube provides three important advantages- the cooperation of the patient with a procedure it does not understand, elimination of pain resulting from examination and treatment of affected dental tissues during the procedure, and protection of the airway and lungs from accidental aspiration.
  4. A complete oral examination, which is an important part of a professional dental scaling procedure, is not possible in an unanesthetized patient. The surfaces of the teeth facing the tongue cannot be examined, and areas of disease and discomfort are likely to be missed.”

How do you feel about anesthesia-free versus anesthetized dental cleaning? 

Keep in mind, for some folks this is a rather heated topic. Let’s keep the conversation civilized!


Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at, local bookstores, and your favorite online book seller.

Articles by Dr. Kay:
Reasonable Expectations: The Ability to Discuss Your Internet Research With Your Vet
Finding Dr. Wonderful And Your Mutt's Mayo Clinic: Getting Started
Even The Best Veterinarian Can Make A Mistake
A Different Way to Spay
Making Tough Medical Decisions For Your Dog: Lily's Story

Related articles:
Speaking For Spot: The Single Most Important Dog Book You Will Ever Read


  1. I think that anesthesia free dentistry procedures have provided non-veterinary businesses a new revenue stream and allows them to target and address a growing group of pet owners. While a good cleaning might seem beneficial, when it is only superficially (without going below the gum surface) it is hardly as effective. And places that use manual scalers but do not polish the teeth are just leaving microscopic grooves on the teeth that allow more plaque and tartar to adhere to the gum surface. It's not so much the cleanliness of the teeth that is importnat - it is the health of the entire oral cavity (gums, beneath the gums...etc). As the mom to a toy poodle and a sheltie I am no stranger to the high costs and risks associated with veterinary dental procedures but I can say with confidence that it is worth every penny. And with modern anesthetic protocols and monitoring equipment the risks associated with anesthesia are greatly minimized. I think anesthesia free cleanings give pet owners a false sense of security - they think they are providing good dental care when, in fact, they are not. For those that are strapped for cash this type of procedure might seem like a good idea (it's better than nothing, after all) but I worry that many pet parents will think that these two procedures are equivalent, which they are not.

    1. Hi Jen, thank you for your comment!

      Yes, I agree with that, though it certainly would be nice to be able to have the teeth cleaned without anesthesia. It certainly sounds tempting but one needs to really do their homework to see whether or not such things will benefit our dogs or not.

  2. When we got Teegan, one of the first things we did was schedule her a dental - in the future, considering her reactivity and such. After using something called Plaque-Off for about a month of two, we cancelled. The vet agreed with us - her teeth look good.
    In any case, we'll still need a dental eventually, so the whole anesthesia thing is still a concern, even though she's a healthy candidate SO FAR AS WE KNOW.
    I wonder.... But. All I can do is go armed with knowledge and enough questions to make vets want to throw themselves on the floor ... and make the best decision I can for the dogs. =]

  3. Do you usually have the vets throw themselves on the floor? (I can just see that happening LOL)

    Technically, dogs need dental unless to take care of issues. If there are not issues present than dental is not needed. It is true that some problems might be "hiding" but generally the vet can see whether the mouth needs urgent help or not.

    If you were able to get the teeth clean with the product you used, that's great. Bruin's teeth did well on the t/d and he never needed a dental. (whether I would feed t/d to my dog today is another story)

  4. Yeah, that is interesting. I was always thinking I liked the anesthesia-free dental cleaning for my dog. But now I see why this wouldn't be best for him. Even though he is such a good boy and tolerant, it would not be very comfortable for him and he would not get a good cleaning. Thankfully, his teeth and gums seem pretty healthy so far and I definitely do not brush his teeth - and I know I should! My cat Beamer has some nasty teeth and needs a cleaning. The poor guy is going to need some teeth pulled I'm sure. There's no way someone could humanely clean a cat's teeth without anesthesia.

    1. The idea is certainly attractive, I agree. Sometimes one has to look "past the surface" though.

      Aah, poor Beamer, if the teeth look bad, it is indeed likely some will have to come out. Daughter's Chi lost well over half of her teeth when she finally get it done for her!

  5. Thanks for sharing that article. Its so interesting! K9 Dental

  6. I appreciate the information provided here as well as the opinions in the comments. I see the pros and cons of both methods.

    My problem lies in that I have a high-risk dog when it comes to anesthesia. She is 14 yrs old and has congenitive heart disease, a heart murmur and has been diagnosed with chemodectoma (heart tumour.) She also has undergone anesthesia within the last year (2011) and had complications due to her being a brachycephalic breed.

    So where does she fit in? I understand that in order to get 100% of all the nooks and crannies, anesthesia is the easier method, but for me the cons outweigh perfect cleaning.

    Before anyone asks, yes, I brush her teeth every day, I also apply veterinarian supplied enzymatic cream for her gums (yes, I have spoken with my vet), she gets raw bones and toys to chew and still she has quite a lot of tartar built up, bad breath and gum disease present.

    So in my case isn't kinda clean better than no clean at all? Would she achieve any benefits at all from non-anesthetic cleaning?

    Also, I feel I should point out she is definitely the "super-cooperative animal" as mentioned above. I also am not one of those people who are afraid to spend money on my 'pet.' When it comes to Jewels I don't even blink at the bill. Cost is not a factor, her health is #1 to me and I feel her teeth need to be addressed.

    1. Hi JewelzyBug, I appreciate your problem having high-risk dog when it comes to anesthesia.

      I do believe, though, that the superficial cleaning does not really address the real problem.

      It will make the teeth LOOK clean but doesn't clean the areas most affected and might score the teeth to actually worsen the problem in the long run. So I don't believe that the anesthesia-free dental cleaning would be of true benefit to her.

      You're doing a lot of great things for her teeth, the only thing that might be behind problem would be her diet. What type of food is she on?

  7. The difference between human and veterinary dental practice is that we can tell the dentist when there is a discomfort, but the animals are not like that. So it requires thorough oral examination under anesthesia and dental radiography to identify the underlying pathology.