How common is dental disease in cats?
Dental disease is one of the most common medical conditions seen by veterinarians. Approximately two-thirds of cats over three years of age have some degree of dental disease. The most common problems are due to periodontal disease, gingivitis and cervical neck lesions, also called oral resorptive lesions.
What are the clinical signs of dental disease?
Certain signs should alert you to the presence of dental disease or other oral problems in your cat. Your cat may show a decreased interest in food or approach the food bowl and then show a reluctance to eat. It may chew with obvious discomfort, drop food from the mouth, or swallow with difficulty. The cat may drool excessively, and the saliva may contain blood. The cat may have halitosis, or an unpleasant breath odor. In some cases, cats may paw at their mouths or shake their heads. A reluctance to eat may lead to weight loss, which can become quite marked. Many cats will refuse dry food and demonstrate a preference for moist or canned foods. Dental disease and oral pain may account for the "finicky appetites" that some cats display.
What causes dental disease?
The most common cause of dental disease in cats is tartar and calculus accumulation on the teeth. The tooth surfaces are a home to thousands of bacteria that multiply and produce a layer of plaque. Some of this plaque is naturally removed during eating or by the action of the cat's tongue. However, the remaining plaque quickly mineralizes, forming tartar and calculus. The bacterial products and decaying food stuck to tartar are one potential cause of bad breath.
Tartar is easily identified by its tan or brown color. It normally starts at the gum edge, especially on the back teeth called the premolars and molars. In severe cases, tartar and calculus may cover the entire tooth.
"If gingivitis is allowed to persist untreated, then irreversible periodontal disease will occur."
The accumulation of tartar and bacteria on the tooth surfaces leads to infection and gingivitis or inflammation of the gums. If the disease is caught at an early stage and a thorough veterinary dental scaling and polishing performed, most of the teeth and gums will have a full recovery. However, if gingivitis is allowed to persist untreated, then irreversible periodontal disease will occur. Periodontal disease is an inflammation or infection of the bone and ligaments that support the tooth; as it progresses these tissues are destroyed, leading to excessive tooth mobility and eventual tooth loss. Bacteria can spread deep into the tooth socket creating an abscess or even more severe problems such as osteomyelitis.
Once periodontal disease starts the degenerative changes to the tooth and its support structures cannot be reversed. These changes make it easier for more plaque and tartar to collect, resulting in further disease.
Is gingivitis always associated with dental disease?
A slight degree of redness seen as a thin line along the edge of the gum may be normal in some kittens and adult cats with no evidence of dental disease.
Some cats develop severe gingivitis with minimal signs of accompanying dental disease. The affected areas may extend beyond the gums to other areas of the mouth, such as the throat or tongue. The cause of this condition is poorly understood, but it is likely to be multi-factorial and may differ between individual cases. This condition is often very difficult to control and may require repeated or constant treatment, and its accurate diagnosis can involve extensive investigative procedures.
What are cervical neck lesions?
"These lesions are intensely painful, and the only effective and humane treatment is to extract the tooth."
Cervical neck lesions result from a progressive destruction of the enamel resulting in slowly deepening "holes" (cavities or caries) in affected teeth. Once the sensitive parts of the tooth are exposed, these lesions are intensely painful, and the only effective and humane treatment is to extract the tooth. The cause of this disease is unknown; however, poor oral hygiene may play a role in the disease process. (see handout "Feline Oral Resorptive Lesions").
What should I do if my cat has signs of dental problems?
If you see that your cat has evidence of tartar accumulation, gingivitis or is exhibiting any signs of mouth pain or discomfort, you should take it to your veterinarian for an examination. You will be advised of the most appropriate course of treatment, which may involve having the cat's teeth examined and professionally cleaned under general anesthesia.
The rate of tartar accumulation is very variable between individual cats, and in some cases, this may necessitate professional cleaning on a regular basis such as every six to twelve months.
Do not try to remove tartar from the teeth yourself using any form of metallic instrument. Aside from potentially harming your cat's mouth or the cat harming you, you will damage the tooth surface by creating microscopic scratches; these will provide areas for bacteria to cling to and encourage more rapid plaque formation, thus making the problem worse. (This is the reason why your dental hygienist always polishes your teeth after removing the tartar with dental instruments).
What can I do to help prevent dental disease in my cat?
The best way prevent dental disease is to keep the mouth as hygienic as possible and to reduce the rate at which tartar builds up on the teeth.
Recent advances in pet nutrition have resulted in diets that reduce tartar accumulation. Your veterinarian can give you specific dietary recommendations that will benefit your cat's dental health.
"With gentleness, patience and perseverance it is possible to brush some cats' teeth."
However, the most effective way of reducing plaque and tartar is to brush the teeth. A number of toothbrushes are specially designed for a cat's mouth. Never use human toothpaste on cats. These are foaming products and contain ingredients that should not be swallowed and could cause internal problems. Numerous pet toothpastes that are non-foaming and safe to be swallowed are available in flavors that are appealing to cats. With gentleness, patience and perseverance it is possible to brush some cats' teeth.
In addition, or as an alternative to brushing, a range of antibacterial mouthwashes and gels can be applied to the teeth and mouth to reduce the number of bacteria present. Please ask your veterinarian for further details regarding the recommended dental products for your cat.
Dr. Joe Barbosa and Staff