About AVDC®

The AVDC® endorses the use of systemic antibiotics in veterinary dentistry for treatment of some infectious conditions of the oral cavity. Although culture and susceptibility testing is rarely performed on individual patients that have an infection extending from/to the oral cavity, the selection of an appropriate antibiotic should be based on published data regarding susceptibility testing of the spectra of known oral pathogens.

Patients that are scheduled for an oral procedure may benefit from pre-treatment with an appropriate antibiotic to improve the health of infected oral tissues, however a full course treatment is always recommended.

Bacteremia is a recognized sequela to dental scaling and other oral procedures.

Healthy animals are able to overcome this bacteremia without the use of systemic antibiotics. However, use of a systemically administered antibiotic is recommended to reduce bacteremia for animals that are immune compromised, have underlying systemic disease (such as certain clinically-evident cardiac disease (sub-aortic stenosis), or severe hepatic or renal disease) and/or when severe oral infection is present. Antibiotics should never be considered a monotherapy for treatment of oral infections, and should not be used as preventive management of oral conditions.

Adopted by the Board of Directors, April 2005, revised April 2019

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Veterinary Dental Healthcare Providers

The American Veterinary Dental College® (AVDC® ) has developed this position statement as a means to safeguard the veterinary dental patient and to ensure the qualifications of persons performing veterinary dental procedures.

Primary responsibility for veterinary dental care

The AVDC® defines veterinary dentistry as the art and practice of oral health care in animals other than humans. It is a discipline of veterinary medicine and surgery. The diagnosis, treatment, and management of veterinary oral health care is to be provided and supervised by licensed veterinarians or by veterinarians working within a university or industry.

Who may provide veterinarian-supervised dental care

The AVDC® accepts that the following health care workers may assist the supervising veterinarian in dental procedures or perform professional dental cleanings (cleaning the surfaces of the teeth with an ultrasonic scaler and/or hand tools and polishing the teeth with pumice or flouride paste while the patient is under anesthesia) while under direct supervision by a veterinarian if permitted by local law: licensed, certified or registered veterinary technician or a veterinary assistant with advanced dental training, a human dentist, or registered dental hygienist.

Operative dentistry and oral surgery

The AVDC® considers operative dentistry to be any dental procedure which invades the hard or soft oral tissue including, but not limited to, a procedure that alters the structure of one or more teeth or repairs damaged and diseased teeth. Only a veterinarian should perform operative dentistry and oral surgery.

Extraction of Teeth

The AVDC® considers the extraction of teeth to be included in the practice of veterinary dentistry. Decision making is the responsibility of the supervising veterinarian, with the consent of the pet owner, when electing to extract teeth. Only veterinarians shall determine which teeth are to be extracted and perform extraction procedures.

Dental Tasks Performed by Veterinary Technicians

The AVDC® considers it appropriate for a veterinarian to delegate maintenance dental care and certain dental tasks to a veterinary technician. Tasks appropriately performed by a technician include professional dental cleanings and certain procedures that do not result in altering the shape, structure, or positional location of teeth in the dental arch. The veterinarian may direct an appropriately trained veterinary technician to perform these tasks providing that the veterinarian is physically present and supervising the treatment.

Veterinary Technician Dental Training

The AVDC® supports the advanced training of veterinary technicians to perform additional ancillary dental services: taking impressions, making models, charting veterinary dental pathology, taking, and developing dental radiographs, performing non-surgical subgingival root scaling and periodontal debridement, provided that they do not alter the structure of the tooth.

Further the AVDC® does not support Diplomates training non-licensed veterinarians, veterinary assistants, or veterinary technicians to perform oral surgery, including surgical extraction techniques.

Tasks that may be performed by veterinary assistants (not registered, certified, or licensed)

The AVDC® supports the appropriate training of veterinary assistants to perform the following dental services: supragingival scaling and polishing, taking and developing dental radiographs, directly assisting the veterinarian in oral surgical and dental procedures, and making impressions and models.

Tasks that may be performed by human dentists, registered dental hygienists and other dental health care providers
The AVDC® recognizes that human dentists, registered dental hygienists and other dental health care providers in good standing may perform those procedures for which they have been qualified under the direct supervision of the veterinarian. The supervising veterinarian will be responsible for the welfare of the veterinary patient and any treatment performed on the patient.

The AVDC® understands that individual states have regulations that govern the practice of veterinary medicine. This position statement is intended to be a model for veterinary dental practice and does not replace existing law.

Adopted by the Board of Directors April 1998, revised October 1999, revised September 2006, revised 2022

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® In the United States and Canada, only licensed veterinarians can practice veterinary medicine. Veterinary medicine includes veterinary surgery, medicine and dentistry. Anyone providing dental services other than a licensed veterinarian, or a supervised and trained veterinary technician, is practicing veterinary medicine without a license and shall be subject to criminal charges.

This position statement addresses dental scaling procedures performed on pets without anesthesia, often by individuals untrained in veterinary dental techniques. Although the term Anesthesia-Free Dentistry has been used in this context, AVDC® prefers to use the more accurate term Non-Professional Dental Scaling (NPDS) to describe this combination.

Owners of pets naturally are concerned when anesthesia is required for their pet. However, performing NPDS on an unanesthetized pet is inappropriate for the following reasons:

1. Dental tartar is firmly adhered to the surface of the teeth. Scaling to remove tartar is accomplished using ultrasonic and sonic power scalers, plus hand instruments that must have a sharp working edge to be used effectively. Even slight head movement by the patient could result in injury to the oral tissues of the patient, and the operator may be bitten when the patient reacts.

2. Professional dental scaling includes scaling the surfaces of the teeth both above and below the gingival margin (gum line), followed by dental polishing. The most critical part of a dental scaling procedure is scaling the tooth surfaces that are within the gingival pocket (the subgingival space between the gum and the root), where periodontal disease is active. Because the patient cooperates, dental scaling of human teeth performed by a professional trained in the procedures can be completed successfully without anesthesia. However, access to the subgingival area of every tooth is impossible in an unanesthetized canine or feline patient. Removal of dental tartar on the visible surfaces of the teeth has little effect on a pet’s health, and provides a false sense of accomplishment. The effect is purely cosmetic.

3. Inhalation anesthesia using a cuffed endotracheal tube provides three important advantages… the cooperation of the patient with a procedure it does not understand, elimination of pain resulting from examination and treatment of affected dental tissues during the procedure, and protection of the airway and lungs from accidental aspiration.

4. A complete oral examination, which is an important part of a professional dental scaling procedure, is not possible in an unanesthetized patient. The surfaces of the teeth facing the tongue cannot be examined, and areas of disease and discomfort are likely to be missed.

Safe use of an anesthetic or sedative in a dog or cat requires evaluation of the general health and size of the patient to determine the appropriate drug and dose, and continual monitoring of the patient. Veterinarians are trained in all of these procedures. Prescribing or administering anesthetic or sedative drugs by a non-veterinarian can be very dangerous, and is illegal. Although anesthesia will never be 100% risk-free, modern anesthetic and patient evaluation techniques used in veterinary hospitals minimize the risks, and millions of dental scaling procedures are safely performed each year in veterinary hospitals.

To minimize the need for professional dental scaling procedures and to maintain optimal oral health, the AVDC® recommends daily dental home care from an early age. This should include brushing or use of other effective techniques to retard accumulation of dental plaque, such as dental diets and chew materials. This, combined with periodic examination of the patient by a veterinarian and with dental scaling under anesthesia when indicated, will optimize life-long oral health for dogs and cats. The AVDC® supports the Guidelines of safe administration of general anesthesia to animals for dental procedures as outlined by the American College of Veterinary Anesthesiology and Analgesia (ACVAA) found at https://acvaa.org/veterinarians/guidelines/

For general information on performance of dental procedures on veterinary patients, please read the AVDC® Position Statement on Veterinary Dental Healthcare Providers, which is available on the AVDC® web site (www.AVDC®.org). For information on effective oral hygiene products for dogs and cats, visit the Veterinary Oral Health Council web site (www.VOHC.org).

For further information, send an e-mail message to the AVDC® Executive Director (ExecSec@AVDC®.org).

Adopted by the Board of Directors, April 2004

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When presented with an aggressive animal case where other corrective measures have failed (including but not limited to behavior modification including medical/pharmacologic intervention) the veterinarian at his/her discretion may recommend full mouth extraction, crown reduction (to the gingival margin) or euthanasia.

AVDC® understands that removal of crowns of teeth may be necessary in selected cases.

Full mouth extraction is an invasive procedure. Oral surgical techniques that minimize trauma must be used, and post-operative radiographs must be taken. Effective anesthetic techniques, monitoring, and pre and post-operative pain control measures must be used.

It must be understood that removal or reduction of teeth as a treatment for canine or feline aggression will not absolutely prevent injury (of physical and/or psychological nature) to people or to other animals.

Adopted by the Board of Directors, October, 2009, revised April 2019

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Since 1996 when The American Veterinary Dental College®  Board of Directors ratified their position statement against the amputation (‘cutting’) of canine teeth in sled dogs, not much has changed. Some 27 years later this procedure is still felt to be inhumane and inappropriate as it does not eliminate the potential to cause harm with biting. As importantly, the procedure of grinding or “cutting” down the crown may be very painful for sled dogs and will likely result in infection and death of the tooth. Proper methods such as vital pulp therapy or full -root canal therapy under general anesthesia and with appropriate analgesia are successful procedures to reduce the crown height of a tooth. These procedures are best performed by specialists such as AVDC® diplomates. The current Board of Directors encourages all veterinarians practicing veterinary dentistry to say “no” to inappropriate extraction or treatment of healthy teeth, and to use modern techniques with appropriate anesthesia, analgesia, and dental radiography.

Adopted by the Board of Directors  October 2023

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Orthodontics involves the diagnosis and treatment of abnormalities (malocclusion) of alignment of teeth and jaws.  The goal of orthodontic procedures in companion animals is to provide the animal with a functional, comfortable, and stable occlusion.  A complete conscious oral examination, including assessment of the occlusion of an animal, should be evaluated at all veterinary examinations.  Documentation of the animal’s occlusion and any necessary treatment or intervention should be discussed with the animal’s owner.  Malocclusions require timely treatment, typically within the first 6-8 weeks to 12 months of an animal’s life.  Treatment options for malocclusions are varied, and frequently necessitate specialized treatment.  Orthodontic treatments require a particular and specific skill set as well as advanced experience, thus they should be performed by a Board Certified Veterinary Dentist™ or a veterinarian with equivalent specialist training.  Similar to other procedure recommendations, the risk vs. benefit of each orthodontic treatment option and its potential complications, recovery, follow-up, and monitoring should be reviewed with the animal’s owner.  The American Veterinary Dental college (AVDC®)® supports the American Veterinary Medical Association (AVMA) policy regarding surgery or procedures performed on animals intended to be shown, raced, bred, or sold as breeding animals (see below).  Orthodontic treatment should not be unduly withheld based on neuter status, however.  Sufficient client counseling regarding the potential for an animal’s genetic propagation of undesirable occlusal traits is required and strongly recommended prior to performing any orthodontic treatment.  Orthodontic treatment should not be pursued for cosmetic purposes only.

AVMA: Performance of surgical or other procedures in any species for the purpose of concealing genetic defects in animals to be shown, raced, bred, or sold as breeding animals is misleading to the public and is unethical. However, should the health or welfare of the individual patient require correction of such genetic defects, it is recommended that the patient be rendered incapable of reproduction.

Adopted by the Board of Directors October 2023

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The practice of dentistry is an integral branch of professional veterinary practice. This discipline encompasses all aspects of the evaluation, diagnosis, prognosis, treatment, and prevention of any and all diseases, disorders, and conditions that affect the teeth, oral cavity, mandible, maxillofacial area, and the adjacent and associated structures. Additionally, dentistry includes the evaluation of the presentation and contribution of systemic diseases within the oral cavity and the contribution of oral conditions to the overall health of the individual animal. Companion animals, equines, livestock, and exotic species all have oral and dental needs that are included in the practice of veterinary medicine.

Any surgical procedure of the head or oral cavity; the administration or prescription of sedatives, tranquilizers, analgesics or anesthetics; procedures which are invasive of the tissues of the oral cavity including, but not limited to, removal of sharp enamel points, treatment of malocclusions of premolars, molars, canine teeth and incisors, odontoplasty, the extraction of first premolars and deciduous premolars and incisors; extraction of damaged or diseased teeth; treatment of diseased teeth via restorations or endodontic procedures; periodontal and orthodontic treatments; dental radiography and endoscopy of the oral cavity are veterinary dental procedures and should be performed by a licensed veterinarian. 

In states where the Veterinary Practice Act allows, the AVDC® supports the use of licensed veterinary technicians under the employ and immediate supervision of licensed veterinarians for specific and appropriate veterinary dental procedures as enumerated in that state’s practice act.

Adopted by the Board of Directors, October 2023

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The American Veterinary Dental College® (AVDC®) firmly advocates taking full-mouth intraoral dental radiographs, or analogous full mouth imaging such as cone beam computed tomography scan, during dental procedures.

During a routine visual dental examination, various subclinical pathologies may remain undetected beneath the gumline or within the tooth. In fact, research has shown that radiographs of teeth without clinical lesions yielded incidental or clinically important findings in 41.7 and 27.8% of dogs (Verstraete et al., AJVR 1998). A similar study showed that 42% of cats with clinically normal mouths had clinical pathology found using radiography, and radiographs revealed that 54% of cats with clinically abnormal mouths had additional pathology (Verstraete et al., AJVR 1998).

Dental radiographs effectively facilitate the identification of periodontal disease, endodontic conditions, unerupted teeth, fractures, and resorptive lesions, among other pathologies. For example, a recent study found that nearly 1 in 4 patients with uncomplicated crown fractures had evidence of a periapical lesion on dental radiographs (Goodman et al., JVD 2020). Recognizing and addressing these conditions early can avert our patients’ discomfort, pain, and further complications. Without intraoral radiographs, significant dental pathologies may be overlooked, compromising the thoroughness and efficacy of our veterinary dental interventions and our patients’ quality of life.

Further, peri-operative dental radiographs are essential for proper surgical planning and execution. The AVDC® underscores the importance of obtaining diagnostic imaging before and after every tooth extraction. Before extraction, radiographs aid in planning by revealing aberrant root structures, bone conditions, presence of ankylosis, and adjacent anatomic structures ensuring safer and more predictable procedures. Post-extraction radiographs are indispensable to confirm tooth root removal and identify potential complications such as iatrogenic jaw fractures and retained root remnants. Undiagnosed retained root fragments act as a nidus of ongoing inflammation and infection. It has been shown that 54.7% of incidentally identified retained root fragment had signs of associated inflammation on diagnostic imaging (Ng et al., JAVMA 2020). Not only are post-operative radiographs paramount for patient comfort, but they are also the only legal protection a veterinarian has if an animal develops severe complications post-operatively.

In equine patients, where full anesthesia is not routinely performed for dental procedures and radiation exposure to technical staff is high during dental radiographs, the AVDC® supports that peri-operative radiographs or analogous imaging should always be performed. However, survey radiographs are indicated based on abnormalities identified on comprehensive veterinary dental examination, rather than standard of care.

In conclusion, the AVDC® emphatically supports the routine use of intraoral radiographs or analogous imaging during dental procedures. This practice not only represents the gold standard in veterinary dental care but also ensures that our patients receive the most comprehensive and highest quality care possible.

Adopted by the Board of Directors October 2023

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