One hundred, or perhaps 150 years ago, dentists and barbers were one and the same. Cowboys in the wild west could ride into town and enjoy one-stop-shopping for a shave, haircut and premolar extraction.

Few people today deny that the separation of human dentistry and cosmetology is a good thing. I wouldn’t dream of going to my barber for dental work. I’d be even less likely to trust my dentist to cut my hair.

Sadly, the animal equivalent of the barber-dentist is alive and well to this day. I am referring to the unlicensed anesthesia-free tooth cleaner.

Yesterday I saw an appalling case. A beautiful sweet orange tabby came to see me. His owner was worried. She had just paid $85 to have the cat’s teeth “cleaned” by an unlicensed anesthesia-free tooth cleaner. The tooth cleaner had warned the client about a cyst on the cat’s lip.

Opening the cat’s mouth was like looking upon a murder scene. True, there wasn’t very much dental calculus (tartar) in the mouth. But the cat had florid periodontal disease. The gums were inflamed and bleeding. Several teeth were loose. Many other teeth had enamel defects called FORLs (short for feline odontoclastic resorptive lesions). FORLs are incredibly painful. The cat’s breath reeked of infection. The poor cat had over a dozen teeth that were compromised beyond hope. Many extractions will be necessary to make him comfortable.

The tooth cleaner had mentioned none of this to the owner. The owner was stunned to learn that anything was wrong with her cat’s mouth, other than the cyst.

And what about that cyst? There was no cyst. Cats normally have a small thickening on their lower lips near the spot where the upper canine tooth rests. The cat in question, an orange tabby, had moderate lentigo simplex (this is how veterinarians say freckles) on his lips and gums. Orange tabbies are redheads. Redheads develop freckles. Orange tabbies therefore develop freckles on their lips. This cat had a freckle overlying the normal thickening on his lower lip which had been misidentified as a cyst. His lips were normal.

The unlicensed tooth cleaner had misidentified a normal, freckled thickening as a cyst. She failed to notice one of the most extreme cases of periodontal disease I have seen in weeks. In other words, the tooth cleaner got everything exactly wrong.

In California, it is illegal for any person to apply any form of dental instrument (other than a toothbrush) to a pet’s teeth unless they are under the direct supervision of a licensed veterinarian. This means that a licensed veterinarian must be on the premises at the time that the instrument is applied to the teeth.

Does this provision of the law exist to safeguard the income of veterinarians? Is it a barrier to entry, designed as a protectionist measure for vets? Please! That is a ridiculous and laughable thought. The state of California couldn’t care less about veterinary income or job security.

Does the provision of the law exist to protect cats from butchery at the hands of incompetent buffoons like the tooth cleaner mentioned in this post? Now we’re getting closer to the answer, but we’re still not there. The state of California cares more about cats than about vets. But it doesn’t really care very much about cats either.

Here is the real reason why the law exists: to protect people like my client from being defrauded out of $85 by people like the tooth cleaner. The state of California cares tremendously about consumer protection. My client paid $85 and received less than nothing in return. That is fraud, and fraud is a big deal in the eyes of the state.

In some instances, anesthesia-free tooth cleaning can benefit pets. The procedure must be performed by a competent practitioner. It must be performed before gingivitis and periodontal disease have set in. It should be performed in conjunction with daily home tooth brushing.

However, if you take your pet to an unlicensed tooth cleaner, how can you know whether he or she is competent? The purpose of licensing is to set standards of competence. I readily confess that some unlicensed tooth cleaners know what they are doing. But how can you tell them from the fraudsters?

After all, as the tooth cleaner mentioned in this post proves, some unlicensed tooth cleaners are totally incompetent. Their services are complete rip offs.

I recommend that you avoid anesthesia-free dental work for your pet. It’s just too risky.

(Going back to the barber-dentist analogy, some people may be tempted to cry hypocrisy since many folks take their pets to the vet to be groomed. Vets that offer grooming services generally employ professional groomers. The vet does not do the grooming. If my barber were to set up a chair in my dentist’s waiting room, I’d be fine with having my hair cut there.)

Photo: Sylvester’s teeth don’t look like they need any work.

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Dr. Barchas:
How often would you recommend professional dental
cleaning by a vet for my pooch? She is 4 and has
had her teeth cleaned already, I brush about 3X
per week and add a rinse to her water- yet she
still has redness at the gum line and a little
bleeding?? I am concerned about this but also
about putting her “under” as well.

Janis
Chatsworth, CA

The answer to this question is different for every pet. There is no formula that can be used to time dental work in all dogs and cats. I am sorry, but the best answer I can give is: pets need dental work when they need dental work.

So, how can you tell when your pet needs dental work? There are several symptoms of dental disease. Bad breath and discolored teeth are common. As well, pets may become lethargic, their coats may smell bad, they may drool, and red gums or loose teeth may be noted. Most pets with dental disease do not lose their appetites.

Dental disease is serious. It is very painful. It has been linked to kidney problems, cancer, heart problems, premature death, diabetes, bladder infections, tooth loss, and many, many other problems.

Vets do themselves a tremendous disservice when they refer to animal dental work as “teeth cleaning”. Sure, we clean the teeth. But we also do a complete intra-oral exam, probe pockets, perform supra- and subgingival scaling, perform root planing, extract or repair teeth, and perform intra-oral radiographs. In the end, the teeth are clean, which is nice. But the fancy-sounding medical procdures are what really help the pet. They make the mouth healthy.

To get back to your situation: if your dog has red, bleeding gums, she almost certainly needs dental work. At the very least, you should have a vet look at her mouth.

And, although no formula can determine how often pets should undergo dental work, there is a simple rule that you can use to make sure your pet’s mouth stays healthy. Go to a good vet for regular checkups every 6 months. Have the vet assess the teeth (as well as the rest of the body!). The vet will be able to tell you if and when dental work is needed, and whether the benefits of dental work outweigh the risks of anesthesia.

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