Dear Dr. Eric,
Why can’t vets use liquid Valium to do dental work for dogs instead of anesthesia? I had all my upper teeth pulled with liquid Valium and it knocked me right out and I didn’t feel a thing or remember anything. I hate the idea of putting my small Yorkies under just to do a dental scaling.
Mary Ellen
Variants on this question have been among the most frequent of my career. It’s no surprise that so many dog owners worry about complications from anesthetic procedures. And, reasonably, they wonder why vets usually recommend general anesthesia for dogs when we frequently undergo dental work with light sedation (using agents such as nitrous oxide or Valium) or, if their dentists are sadistic, no sedation whatsoever.
There are a number of reasons, but they boil down to one major thing: For dogs, unlike people, it’s generally safer to perform dental work under general anesthesia.
First, be aware that a dog’s dental procedure is usually much more involved than ours. Most of us brush our teeth at least twice a day, but the overwhelming majority of dog owners scoff at the notion of brushing their pets’ teeth. People also rarely chew on rocks, tennis balls, and fences. Therefore, when you go to the dentist, the work to be done is usually quite minor. Dogs, however, often have significant dental and gum infections, gum recession, and severely fractured or worn teeth. Correcting these problems is time-consuming — and so painful, in fact, that in most cases doing it without anesthesia would be both inhumane and impossible.
Before I go any further, let’s talk about dietary prevention of dental disease. Any time I recommend tooth brushing, the comments section is filled by angry supporters of some diets who claim that their preferred canine diets eliminate the need to brush the teeth. That, in my experience, is hogwash. I’m delighted for any dog who has great teeth despite not having them brushed, and I’ve seen instances of such dogs who are fed diets ranging from raw to Gravy Train.
I have also seen plenty of examples of severe dental disease in dogs fed every diet. One or even several dogs with good teeth living with someone who likes to write lots of comments on the Internet does not prove that tooth brushing isn’t necessary. The notion that any diet or treat, including a “species-appropriate diet,” can eliminate the need to brush the teeth is simply false, in my experience.
Consider this: I have seen skulls of wild canids that exhibited severe periodontal disease — in fact, some of these wild canids may well have died from complications of it. I have a question for species-appropriate diet promoters: Do you brush your teeth? If a proper diet can eliminate the need in your dog, it should also be able to eliminate the need in you. Do you eat a human-appropriate hunter-gatherer diet? If it works well in dogs, it should work well in people.
Vets recommend anesthesia for dental work not only because it is less painful and humane. It also is safer. Anesthesia eliminates the need for heavy restraint that always stresses and can sometimes injure dogs. And, believe it or not, general anesthesia is also usually safer than heavy sedation (such as might occur with high doses of Valium or other similar drugs) for one major reason: Restrained or sedated dogs may experience relaxation of the throat (or positioning of the head) that can compromise the airway and can lead to suffocation. During general anesthesia, dogs are given breathing tubes that can also be used to assist with breathing if necessary.
The breathing tube also protects against aspiration, whereby bacteria and their by-products from the teeth and roots can be inhaled into the lungs, where they can cause pneumonia.
And don’t forget that modern anesthetic protocols — including safer drugs, proper pre-anesthesia testing, and IV fluids and proper monitoring during procedures — have greatly reduced the frequency of complications over the last two decades. In more than 12 years of regularly treating dogs and cats for dental work, I have never seen an anesthetic complication, even in old or ill animals.
It is true that very, very mild dental calculus can be removed in super-cooperative patients without anesthesia. If you feel that your dog may be a candidate, discuss it with your vet, who will perform a comprehensive oral exam to determine whether more extensive work is necessary.
However, beware of non-vets — groomers, free agents, and pet store staff — who may not have sufficient training. I have seen instances in which animals treated by them came to significant harm. They may not have your pet’s best interests in mind — the ones I have met were business people who were much more interested in making a living than in promoting animal health. (Ironically, non-vets who perform non-anesthetic dental work often try to accuse vets of being profit grubbers. Excuse me, but they’re accusing us of being in it for the money?)
However, there is a simple way to greatly reduce the likelihood that your dog will ever find himself under anesthesia for dental work. Do for your dog what you do for yourself: Brush his teeth.
