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by Maren Bell Jones DVM, MA 2013
A recent "investigation" by ABC's program 20/20 interviewed a now unlicensed former veterinarian on the topic of "dentals" in pets. He claimed that vets "upsell" dental procedures such as a thorough exam, cleaning, and potentially more extensive treatment such as extractions or root canals as though asking "do you want fries with that?" This insinuated that dental procedures performed by veterinarians are pushed on unsuspecting clients and are unnecessary, expensive, and potentially dangerous due to risks of anesthesia. How true are these allegations?
First is my disclaimer. Well, more of the reverse of a disclaimer. I am a house call veterinarian and I do not perform any dental procedures as a house call vet except showing clients how to examine the teeth and mouth of their pets as well as preventative care for keeping them healthy and pain free. I don't own an anesthetic set up needed to peform these procedures safely or the expensive specialized tools to do dentistry. So if I notice a patient's teeth with tartar, gingivitis, or other signs of periodontal disease, I will explain to clients why it is important to address the problem now and to refer them to a different facility to have these procedures performed safely. In making these recommendations, I don't make a dime.
Consider the current recommendations of most dentists that treat the human species. Most of us know that dentists recommend an exam and cleaning every six months and other procedures such as dental radiographs (x-rays) yearly. They also instruct us to brush twice a day for two minutes minimum and floss once a day. Despite supposedly getting DAILY attention, are your teeth always perfectly clean and healthy when you go to the dentist? Probably not! Can you still have problems and pain in your mouth despite daily brushing and flossing? Absolutely!
Now, be honest...how many times do you brush your pet's teeth? Daily? Once or twice a week? When they get groomed every 6 weeks? Never...?
In addition, how long do you try to brush for? My own dogs give me about 20-30 seconds before they have had enough and they are fairly cooperative even! The cats? Not so much. Even the dogs mostly just let me brush on the surfaces that are on the same side as the cheeks. The side by the tongue is very tricky to get on most awake pets. That being said, daily brushing as well as other preventative measures to keep tabs on your pet's teeth is the best way to keep them healthy.
For those that laugh at daily preventative care as silly or unnecessary, just imagine how bad your teeth would look if you didn't brush for YEARS! Remember that the average lifespan for a wild canine or feline is counted in years on one hand or less. "In the wild," wolves and wild cats fracture teeth, get abcesses (infections) even to the point of the infection invading the bone of their jaws and causing fractured jaws, and have to suffer through tremendous pain. Why? Because if they get to the point where they can't catch prey and eat it, they will die. Our dogs and cats that live 10-15+ years (three or more times as long as their wild cousins!) don't need to suffer this kind of fate. When I show an owner their pet's mouth with obvious dental disease, I often hear "they are still eating okay, it doesn't seem to bother them." Dental pain in humans can be excruciatingly painful as anyone with even a relatively minor toothache can attest. The pain and headaches try even those with the very highest pain tolerance. But do we get to the point where we do not eat and starve ourselves because of the pain before we go to the dentist? Not typically.
For many years, pet owners were taught that kibble is good for the teeth and helps clean it. Well, the vast majority of pet cats and dogs eat dry kibble and studies show over 80% of cats and dogs have significant periodontal disease by the time they are 3 years old. It is not uncommon for me to see tartar build up on a patient's adult teeth they have only had for a few months as a still growing puppy rather than years! So unfortunately, expecting kibble to do the trick does not help. Some have equated it to expecting to get your teeth brushed with your morning toast. Not real effective! In addition, both dogs and cats evolved to tear up meat and swallow it. They tend not to be the best of chewers of kibble.
These are the main reasons dogs and cats may need dental cleanings and exams on a regular basis. The more proactive about your pet's oral care, hopefully the further apart you can space these.
And if you still think your veterinarian is just trying to take advantage of you just for money, consider these two factors. Which procedure is the veterinarian going to make more money on AND which will be safer for your pet?
1) A fairly routine cleaning and exam that requires no extractions and no other diseases or pathology because you and your vet worked as a team for your pet to catch dental disease earlier rather than later
2) A mouth that is full of teeth that are causing significant pain, bad breath, risk of infection, loss of bone in the jaw or worse that may need more diagnostics, more time spent under anesthesia, extractions or other treatments, and more after care?
I can only count the many times a client has come back and told me that having a dental performed has totally changed their pet's attitude for the better now that their mouths are finally more comfortable. As a house call vet, this is all the payment I get out of these procedures since I don't do them myself. But it is well worth it!