What are The Risks?

Anesthesia-Related Risks:

Anesthetic agents and postop pain medications can cause short-term dysphoria, disorientation, whining or howling incoordination, and short-term loss of control of the bladder or bowels. Possible severe anesthetic complications (infrequent) include aspiration leading to pneumonia, low blood pressure leading to kidney failure, auto-immune thrombocytopenia or hemolytic anemia, loss of vision or hearing, or persistent nerve-tingling (which may cause pawing at the mouth). The risk of a patient dying under anesthesia is minimal. Our anesthetic safety measures include individualized drug protocols, IV catheter and fluids, local anesthetics to reduce the need for inhaled gases, and continuous presence of a technician who monitors heart rate and rhythm (ECG), rate and quality of respiration (end-tidal CO2 and SpO2), indirect blood pressure, and body temperature. A board-certified anesthesiologist is on site and rotates through operating rooms. Anesthesia-related mortality rates (based on Brodbelt & Bille studies): for ASA class 1 canine patients, mortality rate = 0.05% (5 of 10,000); for class 1 feline patients, mortality rate = 0.1% (1 of 1,000). For ASA class 2 patients, mortality rate = 0.1-0.2% (1-2 of 1,000). The mortality rate for ASA class 3 patients is just under 3% (3 of 100).

Surgery-Related Risks:

Although rare, complications after oral surgery include swelling, severe bleeding, infection, and dehiscence (opening of the surgical sites). Possible long-term oral surgery complications are persistent drooling, inability to chew large treats or certain foods, and decreased ability to pick up toys. Patients with no remaining teeth should not be fed chunky foods, as these pose a choking hazard.

These risks are far outweighed by the benefits of restoring oral health to a pet suffering in silence. In addition to chronic pain, untreated, periodontal disease or abscessed teeth* can cause kidney disease, abscesses in the liver, pneumonia, and bacterial endocarditis (heart infection, often fatal).

*Dental abscesses can be periodontal (from disease around the tooth) or endodontic (from the disease within the tooth). Periodontitis results from the immune response to plaque bacteria on the teeth. The immune response starts by causing inflammation in the gums (gingivitis) and progresses to involve the bone. When the bone that supports the teeth is destroyed, teeth become loose. The gum may or may not recede. Eventually, the teeth will fall out, but allowing this to happen jeopardizes Atticus’s general health (constant infection and immune stimulation) and risks possible spontaneous jaw fracture. Periodontitis is a chronic disease that can be managed but not cured. Endodontic disease results from pulp exposure, which in dogs is most often due to a fracture of the crown of the tooth. An endodontic abscess can also result from severe periodontal bone loss, affecting the entire root and allowing bacteria to enter the pulp at the root tip. Concussive trauma can also cause the pulp inside a tooth to die and result in an endodontic abscess (also called a “tooth root abscess” or “periapical abscess”).