Feline dental disease is one of the most common conditions encountered by veterinarians. Not a day went by where I didn’t see a cat with some sort of dental issue in my feline veterinary hospital. In fact, more than half of all cats above the age of 3 have some type of dental disorder.
Oral bacteria can also enter the bloodstream through diseased oral tissues, affecting other organs, most notably the heart valves and kidneys.
Because of their secretive nature, it can be tricky to tell if a cat has a painful mouth. Occasionally, cats display oral pain by pawing at their mouths, drooling or intentionally turning their heads to one side when they eat, to avoid chewing on the side that hurts. In many cats, however, the signs are subtle. For example, a cat may stop eating dry kibble and only eat wet food. These cats are often derided as being “finicky.” In actuality, they would love to eat the dry food, but they can’t because it’s now painful to crunch. Sadly, some cats completely stop eating due to dental pain.
Periodontal disease, an inflammation of the tissues surrounding the teeth, is the most common dental disorder encountered in veterinary practice. It is caused by plaque, a sticky bacterialaden coating on the surface of the tooth, and by the body’s response to those bacteria. As the immune system responds to the plaque, the gums become inflamed. This results in gingivitis, the first phase of periodontal disease. As the inflammation progresses, the second phase — periodontitis — occurs. Periodontitis affects the bony tissues in addition to the soft tissues, and cats may develop receding gums and bone loss. Over time, plaque mineralizes into tartar (also called calculus), requiring professional removal.
Fortunately, the first stage (gingivitis) is reversible if a professional cleaning is performed and home care is instituted. Periodontitis, the more serious second phase, is irreversible; however, the progression of the disorder can be slowed or halted with a dental cleaning and consistent home care.
Tooth resorption is a common dental problem in cats. For reasons still not determined, some cats develop erosions in their teeth, especially at the gum line. It’s tempting to call these erosions “cavities,” but because they’re not caused by bacterial enzymes and decay, they technically aren’t cavities. Rather, they’re the result of the cat’s own body reabsorbing the teeth. In the early stages, cats seem unbothered by them, but as the erosions progress into the pulp cavity (where the nerves reside), the affected teeth become sensitive to heat, cold and touch, and are painful.
Helping dental disease
First, a thorough oral exam is performed to determine how advanced the periodontal disease is. Next, dental X-rays are necessary to reveal the presence and degree of any bone loss, abscesses, root fractures and resorptive lesions. These X-rays often determine whether a tooth can be saved or needs to be extracted.
Then a professional dental cleaning is done, which requires general anesthesia. During the cleaning, the plaque and calculus are removed, and the surfaces of the tooth roots are cleaned using hand instruments as well as ultrasonic equipment. Some teeth, especially those with resorptive lesions, may need to be extracted. Antibiotics are usually given a few days prior to the dental procedure and are continued a few days after the procedure.
Controlling the development of dental plaque is the best way to prevent periodontal disease. This is best achieved by brushing the teeth. In a perfect world, we would be brushing our cats’ teeth daily. In reality, this is nearly impossible to do, and every other day or three times a week is a more realistic goal.
Dental home care should be introduced during kittenhood, so cats become used to having their lips lifted, their mouths and gums touched and handled, and their teeth brushed. Three years ago, when my cat Glitter was a tiny kitten, I wisely made sure she understood that human fingers in her mouth were going to be a regular part of her life. She actually enjoys having her mouth manipulated, but she’s always been a bit of an oddball.
Finger brushes are quite popular to use when brushing cats’s teeth. These brushes fit over your finger like a thimble and have small bristles on one side. An enzymatic toothpaste is applied to the brush and is then brushed onto the teeth. The toothpastes are flavored for cats. (The “poultry” flavor got rave reviews in my practice.) Some cats will simply not allow brushing; however, there is a wealth of dental hygiene products such as gels, oral rinses and sprays, allowing more options for cat owners.
Dental diets are designed to help remove plaque on the teeth and prevent additional plaque from accumulating. Normal dry cat food crumbles with minimal pressure, allowing the food to be swallowed easily, but provides no real abrasive action on the tooth. Prescription dental diets have a fiber matrix that imparts a notable firmness to the food, requiring the cat to bite through it several times before the pieces are small enough to swallow. This helps remove the plaque and calculus off the surface of the tooth. These diets can be fed as the primary meal, or they can be given as treats.
Dental disease can cause great distress to your cat. By taking care of your cat’s teeth, you’re helping care for his overall health. Regular veterinary checkups will help detect oral problems in their early stages, and conscientious home care will help to maintain good dental health.
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