Veterinary Dentistry Requires Anesthesia

Veterinary Dentistry Requires Anesthesia
Anesthesia-free dentistry (AFD), also called non-anesthetic dentistry (NAD), only cleans the visible crown of the tooth and doesn't treat dental disease. (Hryshchyshen Serhii/Shutterstock)
Q: My holistic veterinarian says my 10-year-old cat Moses has rotten teeth, and at least one tooth has fallen out. Because of his age, I don’t want him anesthetized for dental treatment, so the vet said she would clean his teeth using only essential oils and light. I’m concerned about Moses feeling stressed. What should I know about dentistry without anesthesia?
A: We veterinarians have a saying: Age is not a disease. So, as long as a physical exam and lab work show Moses is healthy, anesthesia poses no greater risk for him than it would for a younger cat.

Unfortunately, anesthesia-free dentistry (AFD), also called non-anesthetic dentistry (NAD), doesn’t treat dental disease. It only cleans the visible crown of the tooth, which gives a false sense that Moses’s mouth is healthy.

Most dental disease hides in the roots of the teeth and in the plaque just under the gums. Plaque is a sticky bacterial film that spreads infection to the gums and through the blood to the kidneys, liver, and heart.

Removing plaque beneath the tender gums is a delicate, exacting procedure requiring the use of sharp instruments on a pet that remains still. The only way to do an effective job is with anesthesia, which will spare Moses the stress of being restrained and any procedure-related pain.

Teeth that are too badly damaged to be salvaged will need to be removed so they don’t continue to harbor bacteria and cause pain. Anesthesia is required for dental X-rays and extractions.

Experts who have evaluated the research on AFD/NAD take strong positions against it. The American Animal Hospital Association ( says it is “unacceptable.” The American Veterinary Dental College also opposes AFD/NAD and provides a wealth of helpful information at

If your holistic veterinarian is uncomfortable doing Moses’s anesthesia, dental X-rays, and whatever dental treatments are required, please consult a veterinarian who specializes in dentistry or a general-practice veterinarian who loves dentistry and uses anesthesia. Moses will receive the care he needs without the stress and pain associated with ineffective AFD/NAD.

Q: We adopted Princess, a tiny puppy that is a mix of a few toy breeds. Now about 6 months old, she has extra fangs and probably other teeth. Is this a problem?
A: Yes. Princess’s mouth has room for only one set of teeth, and any additional teeth will cause problems.

It sounds like she has a condition called retained deciduous teeth, which occurs when the baby teeth don’t fall out but persist where the permanent adult teeth should erupt. The fangs, or canine teeth, are most frequently affected, but any deciduous teeth can be retained.

The disorder is very common, especially in toy breeds and other small dogs.

Puppies normally have 28 baby teeth. By 6 or 7 months of age, they should all be gone and the 42 adult teeth should be in place.

When a deciduous tooth remains, the corresponding adult tooth is forced to erupt in an abnormal position, usually to the inside of the deciduous tooth. The exception is the adult canine tooth, which erupts closer to the incisors, the front-most teeth.

Food gets stuck between the overcrowded teeth, causing periodontal disease. In addition, the adult root doesn’t have room to form correctly, so the “permanent” tooth is more likely to fall out.

Make an appointment with your veterinarian now, because retained deciduous teeth are best extracted as early as possible so the adult teeth can develop properly.

Lee Pickett, VMD, practices companion animal medicine in North Carolina. Contact her at Copyright 2021 Lee Pickett, VMD. Distributed by