SVA Position Statement on Veterinary Dentistry by Non-Veterinarians and Veterinary Dentistry without Anaesthesia

This SVA Position Paper on Veterinary Dentistry was first published in 2017 on the old version of the SVA website:

This Singapore Veterinary Association Position Statement addresses the performance of veterinary dentistry on domestic pets (particularly cats and dogs) without anaesthesia and veterinary dentistry by non-veterinary professionals.

Veterinary dentistry includes:

• Cleaning (Scaling and Polishing)
• Adjustment
• Filing
• Extraction
• Repair, and
• All other aspects of diagnostic, medical, therapeutic and/or operative oral health care in animals

Veterinary dentistry requires the assessment of dental or oral health, diagnosis of disease states, and appropriate dental treatment. Detailed knowledge of anatomy, anaesthesiology, pharmacology, physiology, pathology, radiology, neurology, medicine and surgery is vital to perform veterinary dentistry effectively. In addition, the use of antibiotics, anti-inflammatory and pain relief medication may also be required. The issues of pain and infection cannot be properly addressed without professional veterinary attention. Hence, the performance of dentistry on animals as defined above is considered part of the practice of veterinary medicine.

It is possible that some pet owners may be concerned about anaesthetic risk when their pet requires a dental procedure. However, performing any veterinary dental procedure on an unanaesthetised animal is inappropriate for the following reasons:

• A complete oral examination is important for the correct diagnoses of dental disease(s) as well as the recognition of other serious disease(s) that can mimic dental problems in animals. It is impossible to perform a complete oral examination on an unanaesthetised small animal patient.
• Ultrasonic, sonic-power scalers and sharp hand instruments are used in dental scaling procedures to effectively remove dental tartar. Injury can result to the oral tissues of the animal and/or the operator with any movement or reaction in an unanaesthetised small animal patient.
• Professional dental scaling includes scaling of all the surfaces of the teeth, including the inner and outer surfaces, as well as above and below the gum line (gingival margin). This is followed by dental polishing to remove residual plaque and to create a smooth surface that is easier to keep clean. It is crucial that the tooth surfaces in the deep gingival pockets, where periodontal disease occurs, are also scaled. Access to the subgingival areas of every tooth is impossible in an unanaesthetised animal patient.
• This is unlike dental scaling in humans, where patient cooperation enables a professional trained in the procedures to complete the task effectively without anaesthesia. Removal of dental tartar only on the visible surfaces of the teeth is purely aesthetic, and has minimal to no effect on health maintenance and disease prevention associated with dental problems in pets.
• Sedatives, tranquillisers, anaesthetics, and/or analgesics are commonly used and necessary during veterinary dental procedures to provide restraint and eliminate or reduce the pain resulting from examination and treatment of affected dental tissues during the procedure.
• During inhalation anaesthesia, a cuffed endotracheal tube is used. This ensures that the airway is secure and prevents the accidental inhalation of saliva and water as well as debris and tartar which is inevitably produced during the dental scaling procedure. Such inhalation – known as aspiration – can result in severe respiratory disease.

Concluding Statement

The practice of veterinary dentistry should be performed by AVA-licensed veterinary surgeons (or trained veterinary technicians/nurses under direct veterinary supervision) at AVA licensed premises or veterinary establishments. The veterinary surgeon will be responsible for the welfare of the patient and all treatments performed on the patient.

Professional veterinary dental procedures require anaesthesia. To ensure safe anaesthesia, the animal patient should be evaluated by a veterinary surgeon for general health prior to the procedure, with continual monitoring of the pet during the procedure. Although anaesthesia may never be 100% risk-free, modern anaesthetic techniques, proper patient evaluation and patient care can minimise the risk. Many thousands of dental scaling procedures are performed safely in Singapore every year.

To minimise the need for frequent professional dental scaling procedures and to maintain optimal oral health, daily dental home care (such as brushing or other effective techniques to retard accumulation of dental plaque, specialised dental diets, chew materials from an early age) is recommended. In combination with routine, regular examination of the animal patient by a veterinary surgeon, and with dental scaling under anaesthesia when indicated, life-long oral health can be optimised for our pets.

As with other areas of veterinary practice, veterinary dentistry requires a veterinarian-client- patient relationship to protect the health, safety and welfare of animals.

For further information, please contact the Singapore Veterinary Association.