Your vet may have told you that your dog is in need of a dental cleaning, but you may be concerned about putting your dog under anesthesia; the good news is that vets implement several safety measures to prevent complications of teeth cleaning in older dogs. Dental cleaning in dogs is not a cosmetic ordeal, rather, it has several health benefits. Older dogs are often predisposed to several health risks that come with bad teeth and gums. Cleaning those teeth therefore, not only prevents your dog from losing his teeth but also helps preserve vital organs from the potentially damaging effects of tartar and its associated periodontal disease.
Problems with Tartar
Just like you, after your dog eats, a sticky film of bacteria forms at the gum line. If this sticky film of bacteria is not brushed off on a daily basis, it will keep accumulating and will start hardening transforming into tartar. Tartar, also known as calculus, is basically calcified plaque which glues to the enamel of the dog's teeth and below the gum line.
When this happens, the gums become irritated leading to what's known as gingivitis, the inflammation of the dog's gums. When gingivitis sets in, it causes bad breath and can progress to periodontal disease which can lead to tooth loss.
Even more concerning, periodontal disease can cause damage to a dog's organs such as the dog's heart, kidneys, and possibly, even the dog's liver. Here's a quick rundown on what happens.
When a dog develops periodontal disease, the bacteria in the dog's mouth travels to the dog's blood stream and reaches the whole body. When the bacteria reaches the heart, it can cause damage, leading to bacterial endocarditis, the inflammation of the heart's lining, muscles, and valves.
When the bacteria reaches the dog's kidneys, it may cause damage to its glomerulus membranes, causing changes to the liver. Studies have also revealed that periodontal disease contributes to an increase in insulin resistance. These health problems are concerning, considering that senior dogs are predisposed to them.
"Because of periodontal disease’s effect on overall health, it’s more than a localized problem that leads to bad breath and tooth loss—it’s also the beginning of more severe systemic issues. "~Mary L. Berg, Veterinary Technician Specializing in Dentistry
Dog Teeth Cleaning Complications
While anesthesia is very safe, let's face it, there is no such thing as totally safe anesthesia. What complications may be expected when a dog undergoes a dental cleaning? There may be several, but veterinarians will do everything in their power to minimize them.
For instance, vets can evaluate the dog and determine where he or she stands by the American Society of Anesthesiologists (ASA) physical status classification.
Some dogs may be more at risk than others because of underlying conditions and more precautions may need to be taken. Vets will also run pre-anesthesia bloodwork so to have an idea on the condition of the dog's organs, and if needed, vets will also perform an electrocardiogram (ECG) to check the status of the dog's heart.
When dogs are placed under anesthesia, they are hooked up to monitors that will beep if there are any sign of potential complications. On top of that, these monitors are also monitored by vigilant veterinary staff. Following are some possible complications associated with dental cleanings in old dogs, but several apply to dogs of any age.
" Studies have suggested that the risk of anesthetic death is about 1 in 2,000 for healthy, normal pets. For those pets that may have a pre-existing disease, the number increases to 1 in 500."~ Oriana D. Scislowicz, veterinary technician
This is a very rare occurrence, but one to be aware of. In humans it happens only once in every 5,000 to 25,000 anesthetics. Just as with any medications, it is possible for a dog or person to develop a reaction to the anesthetic. In severe cases, the dog may develop anaphylactic shock which can turn deadly. Affected dogs develop high heart rate and low blood pressure (which should be readily noted by the monitors). Treatment may consist of the quick administration of epinephrine.
Low Blood Pressure
Low blood pressure, also medically known as hypotension, is one of the most common complications associated with anesthesia that may happen even in healthy dogs. The low blood pressure may occur for different reasons such as a reaction to the drugs used in anesthesia, hemorrhage, dehydration, excessive anesthetic depth and underlying heart problems which are more common in elderly dogs. Low blood pressure require swift intervention by reducing the delivery of anesthetics and administering intravenous fluids.
Aspiration of Food
For a good reason vet's orders require that all food is stopped the evening prior to the dental cleaning procedure. When dogs are under anesthesia, their airway is no longer protected. If dogs therefore eat, the food may back up and risk causing aspiration pneumonia and even death in severe cases. Treatment for aspiration consists of a broad spectrum antibiotic.
If your dog is diabetic, you will have to discuss fasting with your vet and what options you have. Your vet may ask you to feed less a few hours prior to procedure. Your vet may provide you with information on how much insulin to give if your dog requires it.
Lowered Body Temperatures
When dogs go under anesthesia, they no longer can warm up as they normally do. A dental cleaning also can predispose dogs to getting chilled out more because of all the rinsing with water that goes on when teeth are cleaned. Senior dogs may get cold during anesthesia and may require more measures to maintain their body temperature.
It has been found that lowered temperatures during anesthesia can prolong recovery time. Vets can remedy this though by keeping the dog as dry as possible and with the use of warming devices and warmed-up fluids. Small dogs are more prone to chilling than larger dogs.
Issues with Compromised Organs
General anesthesia can depress the dog's respiratory, cardiovascular , hepatic (of the liver) and renal (of the kidneys) systems. This is why it's important to run bloodwork prior to the procedure, especially in older dogs.
If there are underlying disorders affecting these organs, complications can set in. Vets though can take several precautions. For instance, in a dog with liver problems, the vet may pick anesthesia drugs that are not metabolized by the liver. Keeping the dog on fluids is also helpful. All dogs undergoing anesthesia should have an IV catheter so emergency medications can be promptly delivered.
Acidic Burns of Esophagus
When a dog goes under anesthesia, the gastroesophageal sphincter relaxes, sometimes to such an extent that stomach acid leaks and reaches the esophagus. Esophageal burns may arise as a result and dogs may feel uncomfortable and start vomiting. And the more these dogs vomit, the more the burns get worse, leading to vicious cycle of repeated vomiting, explains veterinarian Dr. Kara. It's therefore important that affected dogs are given a shot to stop the vomiting and medications such as acid reducers and sulcrafate that can help coat the dog's stomach.
Did you know? According to a study, older dogs were more prone to suffer from reflux and increased gastric acidity when under anesthesia.
Irritation from Tracheal Tube
This is often not really a complication per se, in most cases, but something that can happen with some dogs. When dogs are under anesthesia, an endotracheal tube is placed in their throats. This tube can cause irritation causing dogs to cough, gag, and have problems swallowing after the dental cleaning. The coughing may be more prolonged and pronounced in dogs suffering from tracheal prolapse.
This is just one of those unfortunate instances that can happen during dental procedures. The endotracheal tube can cause irritation and the trachea may develop a mild infection, explains veterinarian Dr. Marie.
Benefits Outweigh Risks
In many cases, the benefits of a dental cleaning in a senior dog outweighs the risks associated with the procedure. In dogs with underlying health problems and bad teeth, it may be worthy using a veterinary hospital with an anesthesiologist on staff. Some medical conditions that can make a dental cleaning done with anesthesia more risky include liver or kidney problems, unregulated diabetes and dehydration, but there are several precautions vets can take to lower risks.
- DVM360: How periodontal disease can affect pets' organs
- DVM360: Senior dental care: Never too old for good dental health
- DVM360: Anesthesia-related hypotension in a small-animal practice
- Galatos AD, Raptopoulos D. Gastro-oesophageal reflux during anaesthesia in the dog: the effect of age, positioning and type of surgical procedure. Veterinary Record. 1995;137:513–516. doi: 10.1136/vr.137.20.513.