Dental

Dental Disease in Cats

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Cat’s Dental Diseases

As I mentioned in an earlier post, I regard that 80% of what I do is associated with either overweight cats or cats with significant dental disease. Since I have given a few pointers on weight management, it’s time to look at the teeth. The range of dental diseases in cats is in some ways similar to humans. Gingivitis or gum disease is quite common. But cavities are very unusual, the cavities cats get start below the gum line and are called Resorbtive Lesions. Calculus, gum recession and tooth abscesses are other common problems encountered. For outdoor cats, chipped fang teeth are quite common as well. Uncommon dental problems include stomatits, retained baby teeth and alignment issues. I will leave the uncommon problems for another day.

Gum Disease

I have seen the statistic that 85% of cats have clinically significant gum disease by age two and 95% by age three! This is the most common disease of cats. Gum disease progresses from a mild redness and swelling at the edge of the gum beside the tooth. Often this will be noted as a red line. This represents bacterial infection of the gum at the edge of the periodontal pocket, signalling that in the delicate balance between the body’s defence mechanisms and the bacteria present in the mouth, the bacteria are starting to win. As they continue to get the upper hand, the bacteria start to produce a gel like film over the area that is called plaque. Simply brushing your cat’s teeth at this stage will totallygingivitis eliminate the disease! But when this plaque stays on the teeth for about 48 hours, it starts to become filled with crystals of various minerals present in the food and in the saliva. Calcium is the predominant one and the resulting crusty buildup is called calculus. This calculus formation can get quite large, creating a nasty environment under it that is very low in oxygen levels. As a result, the bacteria that thrive in low oxygen levels (anaerobic bacteria) become the predominant inhabitants of the area. Unfortunately, these nasty bacteria easily overpower the body’s defences and the result is gum recession. The gum tissue retreats to a lower level in an attempt to leave the nasty bacteria behind and start a new line of defence. Unfortunately, the deeper gum pocket that is the result of this recession, gives an even more attractive home to the anaerobic bacteria. And the cycle continues. Once the gum has receded enough to expose the place where the base of the tooth branches into multiple roots, it is virtually game over for that tooth.

Feline Odontoclastic Resorbtive Lesions

resorbtive-lesion-pic
I call these “Cat Cavities” as that is what they resemble when you look at the tooth. But, that is just the end stage of the disease. For some reason, the body chooses to reject that particular tooth. The process typically starts at the tip of the root, with the bone tissue invading the root, gradually replacing the root with bone until it comes to the top of the tooth, breaking resorbtive-lesion-xraythrough the enamel, usually just at the gum line. These are very painful conditions but cats, being carnivores, do not like to show pain. You may notice your cat eating on one side of his mouth or being hesitant to eat cold canned food out of the fridge. Extraction of the remainder of that tooth and its roots is the only treatment. For an extensive discussion on these “cavities” check out this  website.

Calculus and Gum recession

As you can see in the section “Gum Disease,” calculus and gum recession are just advanced forms of gum disease. Gum disease in its early stages is completely reversible with good oral hygiene – brushing and water additives. However, once the calculus has encompassed the tooth and started to form down into the gum pocket, it can become a disease in its own right. The calculus itself is porous, with many little pockets for bacteria to live in much like a coral reef. These bacteria are able to accelerate the progression of the gum disease. A thorough cleaning of the surface of the tooth AND its associated gum pockets is essential to stop to progression. Beware of any treatments that do not address the calculus deposits under the gum line. This is the reason an anesthetic is required for a thorough cleaning of the affected teeth.

Tooth Abscesses

Most often a tooth abscess is the end result of a broken tooth. The bacterial that live in the mouth are able to penetrate the tooth to the pulp cavity inside the root and this infection migrates to the end of the root and breaks through into the bone of the jaw. Anyone who has seen the movie “Castaway” will remember the figure skate scene! These abscesses are extremely painful. If you see a broken tooth, get medical attention as soon as possible so it can be treated before it becomes an abscess. Believe it or not, root canals and fillings can be performed but most often extraction is the treatment usually performed due to cost factors and duration of the problem.

False Teeth?

Cat’s teeth are the perfect tool for catching and killing small mammals and birds, the wild cat’s normal diet. For our loving housecats, they are actually optional. Even cats eating dry food only chew a small proportion of their diet. If you have ever cleaned up your cat’s vomit you know this first hand. So even multiple extractions are not a problem. False teeth are not necessary! For some conditions, such as stomatitis, all the teeth are extracted. Better no teeth than chronic pain and infection.

Note that the best way to assess your cats teeth is simply to open her mouth and look! If there is a strong odour (I call it “mouse-mouth”:) or if you see build up on the teeth or any redness of the gums, book an appointment to have your cat’s mouth professionally assessed. Early detection, leads to early treatment that almost always saves cost and preserves the teeth to bite you another day.

Thomas

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