Page 3302 - Cote clinical veterinary advisor dogs and cats 4th

Consent to Perform Dental Cleaning

VetBooks.ir Patient name:_________________________________
Pet owner’s name:_____________________________ Med rec #____________
Best contact during/after procedure (e.g., cell phone number):____________________

INTRODUCTION him or her from feeling any pain or discomfort during dental cleaning,
We want to make sure that you understand the planned medical as well as allowing the most thorough dental evaluation possible.
procedure to be performed on your pet. You should know why the Most pets do well under anesthesia; however, there are always
procedure has been suggested, what the potential benefits are for associated risks, including a very small risk of death. The risks of
your pet, and the most common/important risks of the procedure. general anesthesia are increased for animals that have other severe
Alternatives to this procedure, when applicable, will be discussed disease present (such as advanced heart or kidney disease). The
with you. It is also important that you recognize that medicine is decision to perform a dental cleaning is made on the basis that
not an exact science, and that the outcome cannot be guaranteed. the anticipated benefit of the procedure is greater than the risk
We encourage you to ask us as many questions as required for of anesthesia. To make the procedure as safe as possible, blood
you to make a well-informed decision. tests should be run before anesthesia so that problems can be
identified and dealt with appropriately.
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE
Routine dental cleanings (also called dental prophylactic treatment FORESEEABLE RISKS TO THE PROCEDURE
or prophylaxis) are an important part of your pet’s oral (mouth) A dental cleaning under general anesthesia is typically very well
health. Although brushing your pet’s teeth can help delay additional tolerated. If there is severe underlying dental disease, there can
plaque build-up, only a dental cleaning can remove plaque and be loss of bone within the jaw. Depending on the severity of your
calculus that have already accumulated. This procedure is designed pet’s underlying dental disease, teeth may need to be extracted
to help keep your pet’s teeth and gums healthy as well as detect during the procedure; this will prolong the time that your pet is under
problems with the mouth that may have gone undetected during general anesthesia and increase the cost of the procedure. Removal
a routine examination (it is very difficult to fully examine an awake of a tooth in a severely affected area may result in a jaw fracture.
animal’s mouth – they don’t understand that we need them to Although uncommon, a serious complication can be aspiration
hold still!). Therefore, a dental cleaning is performed under general of fluid into the airway and lungs; this can cause pneumonia that
anesthesia (see below). can be very serious or even fatal. There is even a small risk of
anesthetic-related death. This is why additional blood testing may
EXPLANATION OF THE PROCEDURE be recommended prior to general anesthesia – to allow your pet’s
A dental cleaning in pets is very similar to a person’s dental cleaning systemic health to be evaluated in order to best prepare for general
with the exception that your pet will be under general anesthesia anesthesia and minimize these risks.
(unconscious). The entire mouth is carefully evaluated for abnor-
malities. All the teeth and gums are examined for areas of plaque Other anticipated risks specific to your pet:___________________
on the teeth, gum irritation, oral tumors, and diseased or broken
teeth. Usually, intra-oral x-rays of the mouth are performed to look _________________________________________________________
for disease that is below your pet’s gums. Think of your pet’s
teeth like an iceberg floating in the ocean—only a small amount is
visible above the water, with a large portion (two-thirds, actually) ALTERNATIVES TO THE PROCEDURE
hidden under the water. X-rays of your pet’s teeth essentially allow There is no alternative to a dental cleaning under general anesthesia.
us to look “under the water” so that we can assess for broken You may hear about anesthesia-free dental cleanings as an alternative
tooth roots, tooth infections, or dead teeth that are hidden below to general anesthesia, but they are not recommended for several
the gums. A probe is used to assess for pocketing between the reasons. First, a dental cleaning without the use of general anesthesia
gums and teeth, which can be an indicator of more serious dental cannot clean your pet’s teeth below the gumline and does not allow
disease or an indication that a tooth may need to be removed. A for x-rays to be taken, meaning that a large portion of their teeth will
full cleaning of your pet’s teeth will be performed, including below not be cleaned or even evaluated. Problematic conditions such as
the gumline. The plaque is scraped off the teeth with an ultrasonic dead or infected teeth can be missed and may result in more serious
scaler (a tool that vibrates very quickly) or a hand scaler. The and costly procedures down the road. Additionally, your pet’s teeth
teeth are then polished to make the surface of the tooth smooth, do not get polished after they are scaled, leaving the teeth rough
which helps to prevent bacteria and plaque from attaching to the and predisposed for bacteria to attach, subsequently causing even
tooth surface. more plaque formation. Finally, your pet will be uncomfortable and
Additional procedures planned for your pet at the same time possibly in pain if the teeth are cleaned without anesthesia. Most
as the dental cleaning: pets will not allow a painful location to be thoroughly evaluated
without general anesthesia, again causing problems to be missed
____________________________________________________________ or not treated. This cleaning without anesthesia can also cause
them to be head shy and be more resistant to brushing their teeth.
USE OF SEDATIVES OR ANESTHESIA Preventative dental care at home such as teeth brushing and
A thorough dental cleaning requires general anesthesia. General dental chews can be very helpful to prevent further plaque formation,
anesthesia will cause your pet to become unconscious and prevents but they cannot resolve plaque that is already present on the teeth

From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.