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  • Dental Disease in Cats

    What it is, the serious health problems it can cause, and how you can help your cat

    Overview
    Causes of Dental Disease
    Signs of Dental Disease
    The Stages of Periodontal Disease
    Diagnosing Dental Disease
    The Cleaning Process
    Prognosis
    Preventive Dental Home Care For Your Cat

    Overview
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    Dental disease is a common and often overlooked problem in cats. Unlike humans, whose most common dental issue is cavities, cats more frequently suffer from gum disease (gingivitis) and plaque buildup on the teeth. Plaque, if not removed, eventually leads to tartar or calculus formation on the teeth. Left untreated, gingivitis, plaque and tartar and its byproducts inevitably lead to serious periodontal disease. With periodontal disease, the structures supporting the tooth below the gumline are diseased. Most Cat Hospital of Chicago dental surgery patients suffer from periodontal disease.

    Another dental problem affecting many cats is “tooth resorption,” previously known as “neck lesions.” In cats, affected teeth will erode and finally disappear when they are absorbed back into the cat’s body. The root structure breaks down, the enamel and most of the tooth becomes ruined, and bone replaces the tooth. This can be quite painful for a cat until the absorption is complete, although many cats will not show obvious signs of pain. At the current time, the cause(s) of tooth resorption in cats is unknown.

    Delaying dental care and letting tartar accumulate can cause serious health problems. Here’s how:

    1. Tartar pushes the gums away from the roots of the teeth. This loosens the teeth from their sockets and makes it easier for infection to enter the root socket. Left untreated, teeth will fall out or have to be extracted.
    2. When infection sets in, the results can include gingivitis, tonsillitis, a sore throat (pharyngitis) or a tooth root abscess. Infections can be treated temporarily with antibiotics, but if the tartar is not removed, infection will return quickly.
    3. Bacteria in a cat’s mouth can be picked up by the blood stream and carried to other parts of the body, including the kidneys, liver and heart, where it can cause potentially serious infections that can lead to organ damage. Geriatric, immune-deficient, cats with renal insufficiency, and diabetic cats can be especially susceptible to health problems from chronic bacterial shedding.

    Causes of Dental Disease
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    Many different factors and causes can lead to dental disease in cats. Veterinarians usually try to determine whether the problem is limited to the mouth (primary dental disease) or has developed because of another disease (secondary dental disease).

    The chemistry of each cat’s mouth is one factor that determines the amount of tartar buildup. Some cats need yearly cleanings to remove the tartar that has built up; other cats need a cleaning only once every few years. The frequency of needed prophylactic (preventive) professional dentistry varies among individual cats.

    The breed of your cat also can be a factor in dental disease. Some breeds, including Abyssinians, Oriental breeds and Persians, are more susceptible to dental disease than other breeds.

    Genetics can play a role, as well. If one littermate is affected by dental disease, often the others are, too.

    A bacterial organism called Bartonella has been implicated, though not definitively proven, as a possible cause of feline gingivitis.

    Feline dental disease also can be associated with feline leukemia virus, feline immunodeficiency virus, diabetes and other diseases. Severe disease of the teeth and gums can alert the veterinarian to test for these diseases.

    Diet plays a smaller role in tartar accumulation in cats than most people think. Studies have shown that there is no major difference in tartar buildup between cats that eat regular dry food and those that eat canned food. However, dental diets that use specially arranged plant fibers can help delay tartar buildup. The fibers split when the cat bites into the kibble, essentially scraping off the plaque before it can become tartar. Once tartar forms, however, a professional cleaning is necessary.

    Signs of Dental Disease
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    In some cases, dental disease can be easy for owners to detect. All cats with dental disease will have bad breath, which can be severe if the disease is widespread. Other obvious signs of dental disease include drooling, pawing at the mouth, food falling out when the cat eats, nasal discharge and facial swelling. More often than not, however, the signs of dental disease in cats are subtle and vague, such as an increase in sleep, a decrease in activity, diminished appetite or irritability.

    Many cats with dental disease show no obvious signs of illness or discomfort. Cats tend to hide pain and discomfort until they are no longer able to do so, but by then, the disease may be quite advanced. Veterinarians often detect dental disease during routine physical examinations or while checking for another problem.

    The Stages of Periodontal Disease
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    Stage 1 Stage 1, Gingivitis. This is the ONLY REVERSIBLE STAGE of periodontal disease. The gum (gingiva) tissue around the tooth is inflamed and swollen, and plaque and tartar on the tooth surface is present. Treatment can reverse these conditions.
    Stage 2 Stage 2, Early Periodontitis. Entire attached gum is inflamed and swollen. Parts of the tissue and bone supporting the tooth are starting to become destroyed. Radiographic changes in tooth roots start to become evident. The mouth is painful and bad breath becomes noticeable.
    Stage 3 Stage 3, Moderate Periodontitis. Cherry red and bleeding, the attached gum is being destroyed by infection and tartar (calculus). Advancing inflammation and infection also continue to destroy the tooth root structure. Painful mouth affects eating and behavior. Bad breath intensifies.
    Stage 4 Stage 4, Advanced Periodontitis. Chronic bacterial infection is destroying the gum, tooth and bone. The mouth is extremely painful, affecting eating and behavior. The risk for systemic disease becomes very real as bacteria enter the bloodstream and  possibly affect other organs, including the heart, kidneys, liver and GI tract.
    Photos courtesy of Cats Exclusive Veterinary Center

    Diagnosing Dental Disease
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    Diagnosing dental disease is usually very straightforward. In most cases, a veterinarian can only determine the true extent of the disease by placing the cat under general anesthesia, which allows a more complete examination of the mouth.

    The Cleaning Process
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    Merely scraping the tartar off the teeth in an exam room while the cat is awake is not adequate treatment. It makes the cat more prone to future tartar development and does not remove all the tartar, especially under the gums. In addition, it does not allow the veterinarian to see below the cat’s gumline to thoroughly evaluate the extent of the dental disease.

    Proper cleaning of the teeth, including tartar and plaque removal, requires the patient’s complete cooperation, so general anesthesia is necessary. Owners often are very concerned about having their cats under general anesthesia. The use of any anesthetic carries some degree of risk, but the risks to cats’ health from poor dental care are more serious.

    Cat Hospital of Chicago minimizes the risk of complications from anesthesia by using modern techniques that are considered safe even for older cats. We also draw blood before a cat is anesthetized to evaluate his or major organ systems and blood cell counts. And, while cats are under anesthesia, they are monitored closely by veterinarians, veterinary nurses and electronic monitoring equipment.

    There are four main steps in the dental cleaning process:

    • Scaling, with hand instruments and ultrasonic cleaning equipment, removes tartar and plaque above and below the gumline.
    • Polishing smoothes the surface of the teeth, removes any remaining plaque and helps prevent additional plaque from forming.
    • Flushing removes dislodged tartar from the teeth and helps eliminate the bacteria that accompany tartar.
    • Gumline probing locates pockets and rough areas that may be associated with tooth resorption. Sometimes lesions are readily visible. Other times, the veterinarian may need to take an X-ray for a closer look.

    Beyond the basic cleaning process, the majority of cats also need to have at least some type of periodontal treatment performed. Periodontal therapy involves treatments that address loss of tooth root structure, and these treatments may be surgical, non-surgical, or a combination of both.

    In some cases, non-surgical periodontal therapy involves removing tartar from under the gumline and/or deep debris from pockets around the root of the tooth. This procedure is called “subgingival curettage.” We use an instrument called a “curette” to do this.

    In many other cases, however, surgical periodontal therapy is necessary. This means that diseased, non-salvageable teeth are surgically extracted by the veterinarian. Some of the more common reasons for teeth extractions include resorptive areas, root abscesses, tooth mobility, severe surrounding bone loss (visible on dental X-rays) or exposure of the pulp canal (often seen with fractured teeth). Surgical extraction involves creation of a “gingival flap,” allowing the surgeon better exposure to the tooth root.

    For a detailed description of the dental cleaning process, please see our handout, “Prophylactic (Preventive) Dentistry And Periodontal Therapy For Your Cat.”

    Prognosis
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    In the early stages of dental disease, the problems may be reversible. As dental disease progresses, however, even a thorough cleaning cannot restore the mouth to normal. But that’s not a reason to avoid cleaning! Good oral hygiene is in the best interest of your cat’s overall health and comfort, so it is up to you to ensure that dental disease in your cat is addressed appropriately and in a timely manner.

    Preventive Dental Home Care For Your Cat
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    Preventive dental home care is the least expensive and most rewarding form of home care. The goal of any cat dental home care program is to decrease plaque (bacterial film) and prevent calculus (tartar) formation on your cat’s teeth. Prevention of periodontal disease involves a multifaceted approach combining the use of daily brushing, diets, chews, and treats. Home care can make a significant difference in your cat’s overall health and comfort. Remember, the more that you can do at home, the less will need to be done by your Cat Hospital of Chicago veterinarian. Cats that allow more aggressive home care tend to need fewer professional dental cleanings and less periodontal surgery throughout their lives. We have listed here some of the things you can do at home to maintain your cat’s oral hygiene:

    1. Seek regular veterinary care and have your cat’s teeth professionally cleaned when your veterinarian recommends it.
    2. Brush your cat’s teeth at home. Daily brushing remains the single most effective way to decrease plaque and tartar. Brushing mechanically eliminates the plaque or sticky film that forms on your cat’s teeth thus preventing the development of tartar.We recommend the CET Oral Hygiene Kit. Made specifically for cats, the small brush or fingerbrush can be used in conjunction with the seafood or poultry flavored enzymatic gel to remove plaque before it turns into tartar. An important note: Do not use human toothpaste, which can make cats nauseous and may cause vomiting.Brush ONLY the outside of all of your cat’s teeth with the same circular motion that you use on your own teeth. Pay special attention to the gumline where plaque and tartar tend to accumulate. Remember to make it a pleasant experience for everyone. Praise! Praise! Praise! It may take time and effort to help your cat become accustomed to having his or her teeth brushed, but many cats are actually very tolerant of this procedure. If you are unable to do it daily, aim for at least two to three times weekly. One of our technicians would be happy to give you a tooth brushing demonstration if you would like.
    3. Consider feeding your cat one of the specially formulated dental diets with the Veterinary Oral Health Council Seal of Acceptance. Products with this seal, including Hill’s Prescription Diet t/d Feline, Purina Veterinary Diets DH Dental Health, and Science Diet Oral Care,are recommended help to retard new tartar buildup and gingivitis for reducing the severity of periodontal disease. The prescription products are available through Cat Hospital of Chicago; non-prescription diets are available both at Cat Hospital of Chicago and at pet supply stores. They can be used alone as maintenance diets or as part of a dry-food diet.

    We also recommend a couple of treats that can also aid in the prevention of periodontal disease. These include CET dental chews and Greenies for Cats.

    Cat Hospital of Chicago can help you maintain your cat’s dental health. Don’t forget that your cats have teeth, too, and that regular teeth cleaning and good oral health care are keys to your cat’s overall care and comfort.


    Cat Hospital of Chicago is your source for the best cat veterinarians and veterinary equipment in Chicago. Our cat doctors bring years of experience and a lifetime of compassion to our cats-only facility. We use state-of-the-art equipment, and our cat veterinarians receive continued training and education, making Cat Hospital of Chicago the best cat veterinary facility in Chicago. For more information about Cat Hospital’s cat doctors, click here.