Addressing pain

For both veterinary professionals and pet owners, the ability to recognize dental pain is limited because dogs and cats often mask overt signs of oral discomfort. Untreated dental pain may be indirectly demonstrated by halitosis, teeth chattering, weight loss, change in eating habits, lethargy, and change in behavior with reluctance to engage in the human–animal bond. A short course of oral pain medication may provide objective improvement to the patient’s quality of life, thus bolstering support for the dental procedure.

It is imperative to recognize the importance of pre-emptive, intraprocedural, and postprocedural dental pain management. The use of pre-emptive multimodal analgesia with synergistic complementary classes of analgesics is obligatory and effective in managing dental procedural pain.

Pre-emptive versus postprocedural nonsteroidal antiinflammatory agents may be most effective but would not be selected for patients with hypovolemia, dehydration, chronic renal disease, azotemia, and other risk factors. Opioids are often used alone or in combination with tranquilizers in the dental patients as preanesthetic medications. Use of anxiolytics and sedatives does not replace primary analgesics but will support analgesic efficacy. Various opioid agonists, opioid agonist-antagonists, and partial agonists have great value.