Awake Dental?

Anyone ever heard of an awake dental for dogs? The kids had their annual checkups today and the vet told me to call tomorrow and talk to his head vet tech about doing an awake dental on Grace. He said she's calm enough that she'd be a good candidate for it - he doesn't like the build up of plaque and tartar on her teeth, especially her front ones. He did say, of course, that her teeth wouldn't be as clean as if they'd put her under for a full dental. I didn't think to ask why he suggested that instead of a regular dental, since I most likely wouldn't do a regular dental on her unless really necessary because there's some suggestion that anesthesia can cause her DM to progress.

Anyway, I've never heard of the awake dental and thought I'd see if anyone here has.

Rachel,

I think Lisa W has maybe done dentals w/o anesthesia, I remember someone here posting about it. I'm not sure if this is why your vet suggested it, but our vets are also hesitant to put Hooli under with his back issues. Dentals (well any surgery) can be tough on dog's with back end issues because of how they position them during it, and could potential cause more damage-rare, but it can happen. It can be minimized if the vet is extra careful with the positioning, but that's what our vet told me at least. Not sure if that would be the same for Grace, but I'd be interested in hearing about this too! Not that I think Hooli would be a good candidate....

I'd be interested to hear about this as well. I would imagine by "awake", they mean lightly sedated? Makes sense to me that this would work well for calmer dogs.

I'll be sure to post tomorrow after I find out more about it.

I emailed my vet about it, because I thought that this is what we were talking about during Peachy's acupuncture last week. She says that it is only cosmetic, and does nothing for her health. Her opinion is that the dental disease is much much more dangerous to her than the anesthesia and one must take precautions, as with any chronic health condition, . She said she cannot find a shred of scientific evidence that supports that worsening or progression of dm. If you have that link, I would be happy to pass it to her, as she is a pug owner as well. She said that it is not her place to criticize the medicine of other veterinarians, but an NAD is cosmetic, and has no medical benefits. She wanted to share this link. http://www.bizjournals.com/prnewswire/press_releases/2012/02/08/DC50016
ETA: Lavy's pug also had one of these anesthesia free "dentals" last year at the feed store. This year his teeth were so bad that he had an $800 vet bill, which also included a removal of a growth that was inside his mouth. I am not sure how long it had been there.

Rebecca, thank you for the information. I did talk to the vet tech a little while ago - she said it's basically a scaling of her teeth using the ultrasonic scaler and then polishing. She said it is cosmetic. And her concern with Grace is that she's a brachy breed and she'd be concerned about Grace aspirating water into her lungs during the cleaning and then developing aspiration pneumonia. I told her that I didn't think to ask the vet yesterday why he suggested it rather than a normal dental, so she is going to talk to him when he's back in the office tomorrow and see what his thoughts are and then get back to me.

I'll do some digging to find out where I heard the anesthesia/DM thing. It may not have even been anything scientifically - may have just been anecdotal. But I do remember seeing that somewhere when I was first researching it with Kayla. I'm also going to drop a note to Grace's neurologist and see if she has any concerns with anesthesia affecting her DM. If there's no concerns other than typical pug/senior dog/anesthesia concerns, I personally would rather put her under and have a full dental done since it seems to be the more complete procedure.

This was the response that Grace's neurologist sent me with regards to whether anesthesia can hasten the progression of DM:

"I have not read any literature specifically stating that anesthesia speeds up the progression of Degenerative Myelopathy and I haven't heard anything anecdotal about it. Based on my understanding of the disease I can't think of a specific reason why anesthesia would make the disease progress. To put things in perspective, I have some families that I work with who elect to proceed with an MRI first and then submit a DM test. In those patients I don't see a rapid progression in clinical signs after anesthesia. I can ask our anesthesiologist if he has heard any information and can also do some additional research. Since dental procedures often don't take a long time I wouldn't think this should cause Grace to have a rapid progression. I have had patients undergo anesthesia and when they wake up they aren't compensating as well, but generally this subsides within 1-2 day after anesthesia. If I hear anything that would state anesthesia is contraindicated I will let you know."

It helps me feel a little better about putting her under anesthesia for a dental.

I've never heard of a vet recommending an anesthesia-free dental before. Out here, they're performed by "technicians" at those low-cost vaccine clinics they hold on weekends at pet stores. They'll advertise that a "dental professional" will be there (which of course isn't the same as a licensed vet tech or a veterinarian).

My vet says that the anesthesia-free dentals, when performed by a non-vet, can actually make dental issues WORSE. For example, if the "technician" scratches the surface of the teeth while scaling, it can create ridges that plaque will LOVE to adhere to. And she also cites the false sense of security these quickie procedures give owners -- the teeth LOOK good, but an anesthesia-free dental can't even begin to get under the gumline, which is where many of the actual dental problems reside.

Thank you all for your input. After talking to two of the vets at the clinic, the tech who does the "awake" dental and Grace's neurologist, we've decided to try the awake dental. Her vets feel she's higher risk with anesthesia, not because of her DM, but her overall health. She has low proteins, which we've never been able to figure out the cause, plus she has some kidney issues. They feel it's a higher anesthesia risk for her.

So the tech and I agreed to try the awake dental, but I did tell her if it's too stressful on Grace, then we'll stop - I won't let her be unnecessarily stressed. If we can't do the awake dental, then they'll do a regular dental by just "masking" her - giving her just gas. So it's really only a light nap for her while they do the procedure and it's very safe. We're going in on April 27 and we'll see how it goes!

My vet is training to be a licensed vetinary D.M. She travels for training. Although it costs me an arm and a leg whenever she does a dental, in the end it is worth it. I can't speak specifically about Grace, but here are some things to think about dental-wise. When I go to the dentist, I get x-rays to see if there are cavities between the teeth and to see if there are absesses below the gum line. This is what my vet does also. The x-rays show what we can't see below the gums, I have had pugs whose teeth look relatively okay, but they have horrible breath and come to find out there was severe decay below the gum line with rotting and absesses. Since they don't have fillings or root canals for dogs, the only thing is to remove the teeth. I have seen my pugs x-rays and was astonished. The major issue with pugs and brac breeds is that you are cramming teeth into a small space, the teeth get pushed into each other where food can wedge between. Also the roots are cramped below the gum line and cause irriation. I don't know your vet's dental experience, but it might be worth it to investigate for a specialist.

Case in point, Etta (our foster) was spayed at a vet office, then she had another surgery to repair a hernia at another vet office. No one ever said anything about her teeth!!!! I took her to my regular vet-Etta had 20+ broken off teeth at the root. I was horrified. Can you imagine walking around and trying to eat with broken teeth and exposed roots?

Okay, off my dental soap box.

Jana, thank you for the input. I appreciate everyone's thoughts and input on the subject. Although we've decided to try the awake dental, please don't think that I don't appreciate your input and consider it in making my decision. The tough part for me is the risk of putting Grace under anesthesia. If her vets are genuinely concerned about having to put her under and whether she'll survive being under, it really makes me hesitant to do a traditional dental using anesthesia.

As of now, there are no immediate concerns with regard to her dental health. I know there are many dental issues that cannot be found without xrays and a traditional dental, but given that there's nothing concerning that we can see at this point, I think proceeding with the awake dental to at least remove the plaque and tartar for now is our best bet at this time.

Again, I do appreciate everyone's input. If I didn't want advice, or wasn't going to consider it, in making my decision, I certainly would not have asked the question in the first place! I love that we have this board as a resource - to ask questions and get advice - it's such a huge help in evaluating issues and making decisions for our pugs.