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Preventing Rotten Teeth!

I purposely did not put the grossest pictures I have on the top of this post as I find many people, when then the disaster pictures, look at their cat and conclude that she is just fine! But the reality is that about 95% of cats that I see on a regular basis have clinically significant gum infection, called gingivitis. As I mentioned in my last post, Dental Diseases in Cats, gingivitis is a serious preventable health concern. Don’t miss that word, preventable! There is no reason for your cat to have ongoing gingivitis, (this also goes for yourself too.) Gingivitis can be easily prevented.

As you can see in the above photos, the gum above and below the teeth is red, swollen, and in some places shrunken back from its original location. Like any infection in the body, the immune system is supposed to kill the bacteria and restore normal function. In the case of gingivitis, its too difficult for the immune system to win this battle on its own, so eventually, it gives up and admits defeat. It stops trying to fight the infection at that place and tries to win at a deeper spot in the pocket of gum around a tooth. This is called gum recession and it is a permanent change. Nothing we can do will restore that damaged area back to normal.  This slow but permanent progression and the fact that early interventions are relatively easy to do, inspires my passion to get cats to have healthy mouths early in life.

The first time you will see gingivitis in you cat is around 5-7 months of age. As the baby teeth are being replaced by adult teeth, there is a lot of stretching and tearing of the gums. All this trauma is painful as any parent will tell you and it is a time when you may first note that awful odour that I call “mouse mouth!” Although treatment is not required at this time, it will quickly resolve the active inflammation and bad breathcat brushing teeth. After the gums have adapted to the new adult teeth, your pet is usually good for a year or two before the chronic and progressive  gum disease starts in earnest. This is the best time to start long term prevention for your kitten. Your kitten is curious enough at this age AND there is no painful problems going on so your chances of success are much better than if you wait till later. There are several things you can do but the 3 things I advise are teeth brushing, water additives and special dental diets. Some have advocated for treats or supplements that are formulated with everything from seaweed to heavy metal salts with a goal of preventing the calculus accumulation. I believe that if you are able to keep the gingivitis from getting started, you will not have to deal with the severe accumulation of calculus. Not only that, it is the infection from the gum disease that is the major health concern, not the cosmetics of having white teeth!

Teeth Brushing

As you can see from the multiple pictures on the internet of cats chewing on a toothbrush, if you start with a tasty toothpaste, kittens can be trained to accept the feeling of a toothbrush in their mouth. In fact, in my experience, I have found that most kittens are quite keen to chew on things and if you start with putting something tasty on the brush and let him play with it, it is a small step to move from that play to purposeful tooth brushing. Since you have probably missed that golden opportunity for your cat, the next technique is simply to put some tasty substance (tuna, salmon, canned food) on your fore finger finger and after petting a your cat’s cheek a few times, slip your index finger with the treat between the cheek and the back molar. Initially, your cat may be surprised with this tasty interruption, but over time, you will be able to do a bit more than just wiping your finger, moving eventually to a few gentle massaging strokes along the gum line. Once you are able to do this without resentment, you can move on to some flavoured tooth paste products.  For long term benefit you should try to move on to using a knitted glove and then eventually a soft small headed tooth brush. The best prevention that I have found is a product that releases oxygen ions into the gum tissues. The infection that establishes itself in those gum pockets hates oxygen so these oxygen ions naturally select for the healthy bacteria. It can be purchased on-line direct from Oxyfresh or you can come by our hospital to obtain some. For more information click on this link Oxyfresh International – Dental Gel.

Water Additives

Let me be clear, if you are able to brush your cats teeth, that is the best solution and you will not need to do anything else. But, the best laid plans of mice and men are often frustrated by our feline friends. This second level prevention is an option if you have not been able to persuade your tiger that teeth brushing is a good thing. Not all water additives are created equal. There are two broad groups of products available. Some work on the bacteria, some simply try to get rid of the calculus that is the long term result of ongoing bacterial infection in your cats mouth.

The type that work on the calculus alone,  are not my favourite products as the main problem is the gingivitis, not the ugly calculus. The thought of using strange concoctions of seaweed extract or molecular silver salts to get pearly whites visible again just does not make sense to me. I avoid these products.

The products that work on the bacteria are the only ones that I recommend. However, there are many products here that I am not keen on as well. Just like with humans, the way to prevent gingivitis is with good gum hygiene, not with various antibacterial mouth washes. Water additives that contain chlorhexidine will kill some of the bacteria that is causing the gum infection but in my experience, resistance often builds up to this strong antibacterial product and the gum infection returns with a vengeance. Not only that, these products kill both the good bacteria and the bad, leaving the mouth vulnerable to the resistant bacteria when they come around. Some of these water additives contain high levels of various minerals (iodine) that can lead to health issues. Once again, my favourite products in this department are ones that leave the mouth more aerobic, naturally selecting for healthy bacteria. Check our this product from Oxyfresh – Oral Hygiene Solution

Dental Diets

As we make our way down the list of preventive techniques, each one is less effective than the one before. Dental diets have two benefits; mechanical removal of plaque and calculus and sequestration or trapping of minerals that will cling to the bacterial plaque and lead to calculus. As I mentioned above, the calculus is a very late stage in the gingivitis process and although there is a benefit to having clean teeth, having healthy gums is the goal.

Calculus is a hiding place for bacterial infection to thrive so it is a good idea to get rid of it or to prevent it in the first place. On this basis I do recommend the special dental diets. In my experience the best results have been with diets that do both the mineral trapping and the mechanical removal of plaque. My favourite here is from Royal Canin, as it is also a very low calorie diet ; Feline Dental Dry Food. Come by our hospital and talk to us about the best food recommendation for your cat.

Conclusion

Imagine what your mouth would be like if you never brushed your teeth. Worse yet, imagine your partner’s mouth if they never brushed their teeth. Not really the most romantic imagery!  Not only is the bad breath repulsive, that smell is coming from rotting gum tissue and nasty bacterial infection. When these bacteria get into the bloodstream, they can cause problems ranging from strokes, immune system issues and infections in remote parts of the body. In addition, when that gum infection progresses to the point of having loose teeth, it can be quite painful when chewing. All of this so readily prevented. Call us to get a plan in place for your cat as soon as possible!

Thomas

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