Jul 30
2012

Dental Disease – bad breath, not eating, drooling

How common is dental disease in cats?

Approximately two-thirds (68%) of cats over three years of age have some degree of dental disease. The most common problems are due to periodontal disease, gingivitis and Feline Odontoclastic Resorptive Lesions (FORLs.)

What signs am I likely to see?

There are some signs that should alert you to dental disease or other mouth problems presenting your cat. Many times, few or no symptoms are seen with feline dental disease. 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 caution and discomfort, or may swallow with difficulty. Drooling may be seen, possibly with blood, and there may be a marked unpleasant odor to the breath. In some cases the cat may be seen pawing at their mouth or shaking its head. Dental disease and oral pain may account for the "finicky appetites" that many cats display. Dental pain may also manifest in other less obvious ways. Painful cats, just like people, may act in ways we would refer to as cranky, easily agitated, or aggressive towards people, especially children, and/or other animals. Pain or discomfort from any source/cause, not just dental/oral pain, often cause cats to act out of their ordinary routine. They may hide; be less social; have different eating habits as described above; and/or have different elimination habits, which often means not using their litterbox to urinate and/or defecate. Sick or painful cats are not being spiteful or acting out of anger, just out of distress. It is their natural instinct to behave this way. In the wild, a sick cat is a weak cat and a weak cat is a potential victim.

What causes dental disease?

The most common cause of dental disease in cats is due to tartar and calculus accumulation. As in humans, cats accumulate bacterial plaque on the surface of their teeth. If the plaque is not removed quickly, it becomes mineralized to form 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 (premolars & molars). In severe cases it may cover the entire tooth. The accumulation of tartar and bacteria on the surfaces of the teeth lead to infection and gingivitis (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, periodontal disease may occur. During this process the bone and ligaments that support the tooth are destroyed leading to excessive tooth mobility and eventual tooth loss. Infection around the socket causes the formation of pus and a foul odor and may spread deep into the tooth socket creating an abscess, or even more severe problems. Once periodontal disease starts, the degenerative changes 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 just below the edge of the gum may be considered 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 not fully understood, but it is likely to be multi-factorial and may differ between individual cases. This condition is called Stomatitis/Faucitis.

What are Feline Odontoclastic Resportive Lesions (FORLs)?

FORLs lesions result from a progressive destruction of the enamel resulting in slowly deepening "holes" in the affected teeth. Odontoclastic resportive lesions are classified into two types. Type 2 FORLs are different, in that the destructive root is replaced by bone. Type 1 FORLs, on the other hand, will undergo the destruction process similarly to Type 2, but the dissolving roots will need to be removed surgically, otherwise they will be a source of continued pain. The cause of this disease is unknown: however, poor oral hygiene is suspected to play a role in the disease-process.

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 cleaned under short-acting general anesthesia. If your cat needs teeth extracted, they will receive an injection for pain, and localized nerve blocks. All cats get an antibiotic injection with a dental cleaning. Some cats may go home on antibiotics at the discretion of the veterinarian. The rate of tartar accumulation is very variable between individual cats, and in some cases this may necessitate professional cleaning on a regular basis (every 6-12 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 are likely to damage the tooth surface by creating microscopic scratches, which will encourage more rapid plaque formation and cause further disease.

What can I do to prevent dental disease in my cat?

The prime aim to help 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 nutrition have resulted in diets that reduce tartar accumulation. Your veterinarian can give you specific dietary recommendations, such as Hill’s Oral Care and T/D that will benefit your pet’s dental health. The most effective way of reducing plaque and tartar is to brush the teeth. A number of toothpastes and brushes are available from your veterinarian that are specially designed for a cat’s mouth. With gentleness, patience and perseverance it is possible to regularly clean some cats’ teeth in this way. Never use human toothpaste on cats, as these are not designed to be regularly swallowed and could cause be toxic to your cat.