Welcome to a special edition of Treats & Tidbits

February, March and April of 2009 is Pet Dental Health Quarter at Cat Hospital of Chicago. Historically, February has been the month designated by the American Veterinary Medical Association, the Academy of Veterinary Dentistry and other national veterinary associations to call attention to the importance of proper oral health for dogs and cats. This year, we are offering our dental promotion to include an entire quarter to give even more of you, our valued clients, an opportunity to have dental disease in your cats addressed while making it economically manageable at the same time.

In recognition of Pet Dental Health Month, we are devoting this entire issue to explaining dental disease in cats and providing tips for how you can ensure year-round care for your cat’s teeth.

Cat with lesions

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 tartar buildup on the teeth, which results in plaque. Left untreated, gingivitis, tartar and plaque 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 many cats suffer from is “tooth resorption,” also known as “neck lesions,” which are similar to cavities in people. 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 become 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.

Delaying dental care and leaving tartar to 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.

Cat with gingivitis

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 and diabetic cats can be especially susceptible to health problems from chronic bacteria shedding.

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 of the main factors 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 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 also may contribute to gingivitis in cats.

In addition, feline dental disease also can be caused by 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 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.

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.

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 anesthesia, which allows a more complete examination of the mouth.

Periodontal therapy (cleaning of the crown and under the gum surface)

Merely scraping the tartar off 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.

Cat under general anesthesia

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 anesthetic protocols that are considered safe even for older cats. We also draw blood before a cat is anesthetized to evaluate his or her major organ systems and blood cell counts. And, while cats are under anesthesia, they are watched closely by veterinarians, veterinary nurses and electronic monitoring equipment. The Cat Hospital team carefully monitors your cat’s breathing, gum color, heart sounds and depth of anesthesia throughout the procedure.

A dental in progress

There are four main steps in the dental cleaning process, more accurately referred to as “periodontal treatment:”

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

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. If there is a lesion, the tooth may need to be surgically extracted (removed).

If necessary, diseased, non-salvageable teeth are extracted by the veterinarian. Some of the more common reasons for teeth extractions are resorptive areas, root abscesses, looseness or mobility, severe surrounding bone loss (visible on dental X-rays) or exposure of the pulp canal (often seen with fractured teeth).

Following oral surgery, each cat receives pain medications tailored for him or her and based on the procedures conducted. When the procedure is complete, the cat is placed in a cage with heated flooring, and careful monitoring continues to ensure safe recovery from anesthesia. Cats that have had extractions are treated aggressively with pain medication. Cats that have had several teeth extracted will receive a pain-relief patch that slowly releases pain medication over the next three to five days.

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.

Cats that allow more aggressive home care tend to need fewer professional dental cleanings and less periodontal surgery throughout their lives. There are several things you can do to maintain your cat’s oral hygiene:

1. Seek regular veterinary care and have your cat’s teeth cleaned when your veterinarian recommends it.

2. Brush your cat’s teeth at home. For cats that allow it—and for owners willing to do it—regularly brushing your cat’s teeth three times a week is an ideal way to help prevent further tartar buildup. Special toothbrushes with flavored toothpastes and oral rinses are available, and Cat Hospital veterinarians can recommend a schedule and show you how to clean your cat’s teeth. An important note: Do not use human toothpaste, which can make cats nauseous and may cause vomiting.

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. These products are available at Cat Hospital of Chicago and pet supply stores. They can be used alone as maintenance diets or as part of a dry-food diet.

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

In honor of Pet Dental Health Quarter, Cat Hospital of Chicago is offering special pricing on dental cleanings. To qualify for the reduced price, you must call and schedule the procedure to take place during the months of February, March or April of 2009. To schedule an appointment, or for more information, please call (773) 539-9080.

Visit the Pets Need Dental Care, Too Web site at www.petdental.com.