Conscious Dentals - Some Thoughts

I know this is a bit of an RU "can of worms" but I just thought I would share some of my experiences and see what people think.

Prior to having seen any conscious dental work in rabbits, I was of the opinion that all dental work should be done under GA or at least heavy sedation due to a) the risk of damage to the rabbit should it move during the procedure, and the difficulties in treating such problems in a conscious patient, b) the rabbit's perception of fear, discomfort, pain etc when conscious and c) the inability to visualise the all teeth and perform a complete dental procedure on a conscious rabbit.

Now that I have seen quite a number of conscious and unconscious dental procedures in different breeds, ages of rabbits with varying problems, and discussing them with the vets involved, I have made the following observations:

1. For the majority of rabbits undergoing conscious dental work there was little or no apparent pain, discomfort or fear reactions, beyond that expected in an animal being gently restrained and examined. The animals were very well held and the vets and nurses involved have had specialist training and are very experienced. Immediately after the procedure all the rabbits bar one (who was very neglected and not used to being handled at all) acted completely normally - moved their mouths around, were inquisitive about their surroundings, moved around the table, washed etc, and ate and drank normally within minutes.

2. With use of an appropriate dental gag applied correctly, visualisation of the molar teeth is actually quite good and they can be manually rasped very effectively.

3. Many animals that had regular dental work could be examined and work done in under 10 minutes and so didn't require admission to the hospital etc

So...I have to admit that my opinions on conscious dental work has changed. I still believe that a GA gives the best visualisation of molar teeth and is more appropriate for extensive or complicated work. It is also still safer with respect to potential damage to teeth and surrounding structures, particularly in nervous or fractious animals. But conscious dental work would seem appropriate when done by experienced vets (i.e. newer graduates etc should be well practiced at GA dentals before attempting any conscious work) and with experienced and knowledgeable nurses, particularly for trimming incisors. I still think power tooths e.g. burrs etc do a better, cleaner, more thorough job than manual clipping or rasping and that such power tools should NOT be used in conscious animals due to their higher risk use, BUT regular manual work, if this allows the animal to be seen more often and keeps the costs down (which is a necessary consideration in the vast majority of cases) is an adequate alternative.

Thats very interesting reading thank you for posting.

I was having discussions about the pros and cons of concious dentals with my vet a few weeks ago as a few of my lot have very small spurs (not causing problems at the mo luckily) She was very honest and said its not something she has done but was happy with the theory of it in the right bun. Probably not any of mine apart from Dutchie (who has great teeth) because they are too wriggly

Thank you for posting this

I have several buns that need or have needed regular dentals, normally when they first arrive they go for neuter and they have their teeth thoroughly examined at that time and sometimes have work done whilst under the GA, from then on I've been able to have conscious dentals done on most of them

Tilley had head tilt when I first adopted her and she wasn't spayed, my vet advised against putting her under GA because of this and her age, she had about 3 conscious dentals, but because she had not had a through examination it was hard to determine what was going on In June last year she had problems and stopped eating, she was admitted and she was lightly sedated, she came around but within 20 minutes she deteriorated and died So I feel that the vet made the right decision by advising me against spaying her and putting her through a GA otherwise I could have lost her a lot earlier.

I am so glad that my vets are able to do conscious dentals, it's mean't I've been able to adopt a few problem rabbits from rescues

Thats really interesting to read..
I have often wondered when I get my horses teeth done, why the same principles cant be applied to a rabbit.
I have two dental buns and both of them are as still/good as anything at the vets and I would actually prefer to have a conscious dental but have never been offered it.. Maybe I will discuss this with my vet

I have two rabbits who both have had conscious dentals (as well as GA/sedation dentals when required). I do understand the 'controversy' of it and that there are risks and I am sure it is unpleasant for the bunny (I often think of how brave Starbuck is when I am sat in the dentists chair myself).

I can honestly say that for Starbuck and Kenco it has been a godsend that we have a vet who is experienced and confident in doing conscious dentals. I do question the ethics of it all the time, but like you say he is straight home, eating, drinking, running around, munching hay, happy as larry, unlike the time when he came home after sedation and was all over the shop, wobbly and confused. He seems very unphased by the experience, although granted I dont see him when its actually being done.

Having a vet do conscious dentals enabled us to adopt Kenco, who was already 5 nearly 6 when we adopted him and had been in rescue nearly a year, I think he had been overlooked as he was a dental bunny. As he cant be insured, an adopter would be taking on a bunny who could cost them £000s. But with a vet who can do conscious ones means it costs a fraction of the price and meant we could adopt him knowing we could give him all he needed and be able to afford it too.

That said, if he needed a GA dental for any reason, he would have it too.

Thanks for posting this

As a bunneh mummeh with 4 rabbits who need molar dentals every 6 to 8 weeks I was always concerned about the GA v conscious. With one of the buns, Blakey, always reacting badly to even the lightest of sedating my vets got very adept at conscious examining and rasping so we discussed the option of all of them having it done.
I always had the fear of numerous GAs causing strain on them but then also I would consider the stress of a conscious dental on them every month and a half. I let the vets do the work on all of them conscious and they were so much brighter afterwards we decided to keep doing it with a GA once a year so a full burr can be done to keep everything tip top (these buns teeth are just so wayward!) Plus having 4 'drunken' buns to look after was stressful for me as well, trying to ensure there was no stasis etc for 24 hours.
Its nice to get an 'insider' view that confirms I made the right decision.

Thats really interesting to read, Lola and Charlie are both my problem buns at the moment but I worry so much about the GA, I asked my vet if it would be possible for a conscious dental and she was 100% against it but after reading your post it makes me feel a little more at ease with the idea. I would be more than willing to travel miles with Lola or Charlie than have them under GA!

Thank you for posting this. Cheeky has just had her 2nd dental under GA and again I have the problem of a poorly bunny not eating so there is the stress of trying to give her meds plus a broken bond with Tilly I will definitely be discussing the feasibility of conscious treatment with her vet next appointment.

This is a really good post and I hope it will let people know that there are options for their rabbits, should they require regular dentals

thankyou for this post. im personally still quite undecided i do understand there are times it can be benificial to a bun to have a concious dental but unless as a last resort i think my buns will always opt to have done as under GA i cant imagine how frightened my own bunnies would be if held over firmly and a gag placed in their mouths while concious. especially as one of them has siezures and another has aggression and confinement issues, (that is not to say there arent bunnies who can cope with this)
iv also heard horror stories but that may be the particular vet doing it.

in addition to this i think its mad that some vets wont consider concious x rays i have had a few older buns done conciously and it was much better for them
obviously a rabbit who is likely to jump cant be x ray'd conciously but for mine it was much easier to be done concious.

Willow used to have conscious dentals every month. He was in a poor state when I got him so his first dental was done under GA to assess and follow up ones were done conscious. I would hold him whilst me vet did the work. My vets ability to do this certainly prolonged his life as I'm sure I wouldn't have wanted him to have a GA every month. I've seen other vets who were not willing to perform conscious dentals and I can't understand why as I think the benefits definitely outweigh the risks.

More vets should be capable of performing conscious dentals.

A good post Vikki and maybe it will balance people's views on dental work

It may also help some members to consider taking on a dental bun if they know the risks and costs can be lower

A very interesting post and very informative for those who do hold reservations.

For the last 4 years Homer has had conscious dentals and also when necessary under GA for a more thorough dental. He would come back from the vet and go straight out on the grass after a conscious dental.

My problem now is that my vet has left and there is no one I can find in our area that does conscious dentals. I can understand vets reluctance (and owners) due to the risk, but there are risks with GA too. My heart has always been in my mouth whichever it is.

I do also think it depends on the bunny.

bunny babe said:

A very interesting post and very informative for those who do hold reservations.

For the last 4 years Homer has had conscious dentals and also when necessary under GA for a more thorough dental. He would come back from the vet and go straight out on the grass after a conscious dental.

My problem now is that my vet has left and there is no one I can find in our area that does conscious dentals. I can understand vets reluctance (and owners) due to the risk, but there are risks with GA too. My heart has always been in my mouth whichever it is.

I do also think it depends on the bunny.

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Agree completely

A great post Vikki :wave:

honeybunny said:

A good post Vikki and maybe it will balance people's views on dental work

It may also help some members to consider taking on a dental bun if they know the risks and costs can be lower

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I'm so grateful to my vets being able to do conscious dentals It's allowed me to adopt a few dental buns

interesting.

my own vet will not consider a conscious dental. eric needs them regularly and its a nerve-wracking time. esme has had 2 ga's whilst in my care and reacted badly both times - last year i nearly lost her.

possibly food for thought.

excellent post on a controversial subject.

Our little nethie Thistle eneded up with bad alignment after a jaw problem and had to have dentals once every 2 weeks. She could not have GA at all because she has very little healthy lung tissue (suspected pastuerella before we got her from rescue), so it was conscious dentals or PTS. She was great with all of them . . . despite often turning purple from lack of oxygen when she panics in the vets waiting room . . strangely the actual dentals were fine!!!

However in the end it got to every 10 days and we took the HUGE risk of putting her under for incisor removal - which the vet did in record time . . and she is now happilly toofless!!

Interesting post

Personally I will still take the advice of the Exotics Specialists/Dental Specialists both on here and elsewhere ie I would not opt for a 'Conscious Dental' for any of my Rabbits.

But I am sure it is always useful to hear opposing opinions to enable people to make an informed choice for their own Rabbits

Just to add
because a vet offers conscious dentals doesn't mean they will be able to do every rabbit this way, or even every time on a placid bun

If a rabbit is stressed they may give it just a whiff of gas to calm it down..or they will tell the owner it will have to have a ga for its own safety

Again, if the problem is severe, they again will recommend a ga to deal with the teeth, maybe just the first time with conscious dentals later in the rabbits life

The vets I've met who are anti conscious are those who have never seen them done, but I do understand people's fears and the misconception that a dental can be done without a ga every time.

The rabbits we've had done have all been eating within half an hour of the dental and we've never had a problem ..the only bun we've lost during a dental was one that was given a ga

The price of a conscious along with the lack of aftercare needed, oftens means people when finding their new bun has problems..won't take the pts option due to funds and stress but can keep the rabbit
Conscious dentals often save lives..simple

I personally think it would be helpful if a distinction could be made on this thread between:
Conscious dentals for incisor trimming, and conscious dentals for molar trimming and reshaping.

I have no problem with conscious dentals for incisor burring if the rabbit isn't too flighty, but there is no way on god's earth I would ever agree to any rabbit of mine having molar work done consciously. I personally don't feel the benefits outweigh the risks having read the opinion of both exotic vets on this forum and that of David Crossley a leading vet dentist.