How Common is Dental Disease in Cats?
Dental disease is one of the most common medical conditions seen by veterinarians. More than half of all cats over the age of three have some form of dental disease.
What Are the Clinical Signs of Dental Disease?
Many cats do not display signs of dental disease that their owners can detect. To detect hidden disease, it is important that your cat has complete oral examinations under general anesthesia, with intraoral X-rays (radiographs), beginning early in the cat’s life.
If your cat does show signs, they may include pawing at the mouth, head shaking, or jaw chattering. The cat may chew with obvious discomfort, drop food from their mouth, swallow with difficulty, or drool excessively. The saliva may contain blood. Halitosis (bad breath) is also common.
Many cats refuse dry food or swallow it whole (no chewing) and demonstrate a preference for moist or canned foods. Some cats have a decreased interest in food or may hesitantly approach their food bowl with reluctance to eat, which may lead to noticeable weight loss.
What Are the Most Common Dental Diseases in Cats?
The most common dental diseases in cats are gingivitis (inflammation of the gums caused by the accumulation of plaque), periodontal disease (a progression from gingivitis), and tooth resorption (formerly called feline oral resorptive lesions or cervical neck lesions).
What is Periodontal Disease?
Periodontal disease describes infection and associated inflammation of the periodontium (the tissues surrounding the tooth). Four tissues comprise the periodontium: the gingiva (gums), the cementum (covering the root surface), the periodontal ligament (attaching the tooth root to the bone), and the bone surrounding the tooth.
Periodontal disease starts with gingivitis (inflammation of the gums). Gingivitis results from plaque (bacterial slime) that accumulates on tooth surfaces and contacts the gingiva. Plaque is a biofilm and home to many thousands of bacteria.
Without daily brushing, plaque quickly builds and eventually mineralizes (over 36-48 hours), forming hard tartar (also called calculus). Tartar has a rough surface that plaque can stick to more readily. Untreated gingivitis may lead to further inflammation of other tissues of the periodontium. Progression of periodontal disease leads to loss of tooth support and eventual loss of the tooth.
There may be other consequences of periodontal disease due to the loss of bone, including oronasal fistula (a hole from the mouth into the nose), jaw fracture, and abscessation with draining tracts that develop in the mouth, on the face, or under the chin. Some studies indicate that the bacteria from severe oral disease, which gets into the bloodstream, may also be associated with pathological changes in major organs, such as the heart, liver, and kidney.
What is Tooth Resorption?
Tooth resorption is the slow, progressive destruction of the tooth (crown and root), resulting in "holes" in the affected teeth. Once sensitive parts of the tooth are exposed (dentin and pulp), these lesions become intensely painful, and the only effective and humane treatment is to extract the tooth. While the cause of this disease is unknown, poor oral hygiene can play a role in the disease process (see the handout called “Tooth Resorption in Cats” for further details).
What is Stomatitis?
Stomatitis is a severe oral inflammation that affects some cats. It is a complex condition with no specific cause identified, though it is believed that affected cats have an extreme reaction to oral bacteria and plaque. The inflammation can cause significant distress for both the cat and the owner and often significantly impacts the cat’s quality of life.
Treatment typically involves a detailed oral examination under general anesthesia, with intraoral radiographs and the extraction of teeth affected by periodontitis. Following the extractions, a thorough cleaning is performed, and therapy is instituted, which may include anti-inflammatories, antibiotics, or immunomodulatory treatments.
Studies have shown that up to 60% of cats can have their condition significantly improved or even resolved. However, 40% of cats may continue to experience varying degrees of oral inflammation. Stomatitis cases are often best managed by referral to a board-certified veterinary dentist who can tailor therapy to the individual cat.
Can Kittens Get Gingivitis?
As kittens' teeth erupt, increased gum redness may occur, which is known as eruption gingivitis. This should resolve naturally as the teeth finish erupting. However, some kittens can develop juvenile gingivitis, a persistent inflammation of the gums, typically diagnosed between 6 to 12 months old. Treatment involves frequent dental assessments, thorough periodontal cleanings, and intense home care to prevent further complications.
What Should I Do if My Cat Shows Signs of Dental Problems?
If you notice signs of dental disease such as tartar accumulation or gingivitis, or if your cat exhibits signs of mouth pain, you should take the cat to your veterinarian for a full oral examination. Treatment may involve professional cleaning and extractions under general anesthesia. Your veterinarian will help you determine the appropriate course of action based on your cat's specific condition.
Do not try to remove tartar yourself with metallic instruments, as it can damage the tooth surface, creating scratches that encourage plaque buildup. Maintaining a smooth tooth surface is essential, which is why your veterinarian will polish the teeth after cleaning to slow down plaque accumulation.
What Can I Do to Help Prevent Dental Disease in My Cat?
The best way to prevent dental disease is to reduce plaque and tartar accumulation. This can be achieved by using veterinary-recommended products such as water additives, dental diets, and dental chews. The Veterinary Oral Health Council (VOHC) evaluates the effectiveness of dental products, and their seal of acceptance is only awarded to products proven to reduce plaque or tartar. Visit their website at vohc.org for a list of approved products.
The most effective way to prevent plaque buildup is daily tooth brushing (see the handout “Brushing Your Cat’s Teeth” for more information). Always use pet-safe toothpaste, as human toothpaste contains ingredients that should not be swallowed. Pet toothpaste is non-foaming and available in flavors appealing to cats.
You can help train your cat to accept toothbrushing by starting with a cotton swab dipped in tuna juice, rubbing it on your cat’s teeth to help create a positive association. Gradually progress to using a toothbrush. With patience, many cats will accept daily brushing, greatly reducing the risk of dental disease.
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