What's Eating My Cat's Teeth?
Like all carnivores, cats rely on their teeth to properly process their diet. In addition, cats use their mouths for grooming, carrying objects such as prey, and for play, so pain-free oral health significantly contributes to their quality of life. February is National Pet Dental Health Month so it's appropriate to focus on oral conditions that can afflict our feline friends.
Like humans, cats have a set of baby teeth which are typically all shed by the time they are six months old. In normal adult cats, these are replaced by a total of 30 teeth, 16 upper and 14 lower, that they rely on for the rest of their lifetime. The teeth are held in the jaw bone by long, strong roots and supported by a fibrous attachment called a periodontal ligament.
In most species, including humans, bacteria grow in the oral cavity and tend to adhere to tooth structure. If not regularly cleaned away these bacteria form organized colonies, called plaque, that are responsible for dental cavities and gum inflammation. If the gum inflammation is allowed to progress, the deeper structures that support the teeth become affected and the teeth can become loose due to erosion of the bone and periodontal ligament. This process is known as periodontal disease and the majority of adult cats are affected by this chronic infection.
Not only can the infection cause painful, inflamed oral tissues and tooth loss, it can also impact an individual's overall health. Studies in humans show direct links between long-term periodontal infection and heart, liver and kidney diseases. No corresponding studies have been performed in felines but we have no reason to think their physiologies respond any differently than ours.
Professional dental cleanings to remove the plaque and tartar before they cause advanced disease are extremely helpful and are an appropriate part of any cat's health care regimen. Prevention of dental tartar may be accomplished by providing some kibble along with a kitty's canned diet. Special "dental diets" have been formulated by several pet food companies and are endorsed by the American Veterinary Dental Society. The best way to preserve dental health and monitor the condition of your cat's teeth is daily tooth brushing; if introduced gradually, many cats will learn to accept the toothbrush well. Feel free to ask the veterinarians at Muddy Creek Animal Care Center about the best regimen for your pet.
Tooth resorption is very rarely seen in human and canine patients, but these cavity-like lesions are a very common feline condition; by some estimates, 60% of cats are affected. Unlike cavities, which are caused by acids eating into tooth structure, resorptive lesions (also called RLs or FORLs – Feline Odontoclastic Resorptive Lesions) result from an aberrant cell which normally is part of healthy bone metabolism. For reasons that are not understood, these cells, called odontoclasts, turn against normal dental tissue and eat away at it. The results are painful defects in the tooth structure.
The defects typically start at the gum line and will sometimes also cause inflammation of the gum tissue. In severe cases, the crown of the tooth may become so undermined that it snaps off, leaving a root stump in the gum. Unlike human cavities, these lesions cannot be treated by filling the defect because the process continues around the restoration and the filling eventually falls out. Currently, the only way to resolve these painful defects is via tooth extraction. Daily brushing is thought to be helpful in preventing resorption, but some cats are afflicted in spite of regular oral hygiene care.
Felines are prone to a chronic inflammatory condition of the oral cavity known as stomatitis. Like resorptive lesions, this condition has been reported in other species but occurs at a much higher frequency in cats. Also known as Lymphocytic, Plasmacytic Stomatitis, or as Mucositis, this disease results in severe, painful inflammation of the gums and the soft tissues at the back of the mouth.
Affected cats are typically young to middle-aged. They may have halitosis, be reluctant to eat or groom, may drool excessively or may paw at their mouths. The condition is extremely painful and cats have been known to cry out while trying to eat or if an attempt is made to pull their lips back to examine their mouths. Frequently, sedation may be required for an oral evaluation and the tissues may be so swollen that they resemble masses, requiring biopsy to confirm the diagnosis.
It is currently unknown why some cats are afflicted with stomatitis. Treatment can be frustrating since the inflammation appears to be an exaggerated reaction to the bacterial plaque that all cats form in their mouths on a daily basis. Steroids and other anti-inflammatory medications may offer short term relief but these drugs carry potential health consequences of their own and many cats stop responding to this treatment after a few doses.
Sadly, the only predictable long-term treatment is extraction of the teeth, eliminating the surface that the bacterial plaque grows on. Often, all the teeth must be removed, necessitating more than one anesthetic event. The earlier in the disease process that the teeth are removed, the better the prognosis.
For all oral disease, early intervention yields the best results. Being aware of your cat's play, eating and grooming habits allows you to be aware when these behaviors change. In addition, having your new cat become accustomed to having its mouth gently handled and opened by you when it's young and healthy makes these exams less stressful when they become necessary later on.
Dr. Sylvia Reiser is an associate veterinarian at Muddy Creek Animal Care Center in Rowley, MA. Dr. Reiser is also a member of the American Association of Feline Practitioners.