Dental Disease in Cats

Many studies have shown that dental disease is the most common disease in cats. Over 80% of cats have gum infections and about 60% have Feline Oral Resorptive Lesions (feline cavities).

Dental disease is often overlooked in cats because veterinarians do not receive any substantial training in dentistry. Dental-specific training requires post-graduate classes and seminars. This is one area of veterinary medicine that has been sadly overlooked.

close examination of a patient
(under anesthesia).

Gum disease or painful lesion?
Only a thorough dental exam
and x-ray can tell for sure.

Bottom: tooth being resorbed
into the jaw, which is very
painful for cats.

Why we use x-rays for routine dental exams:

The third premolar at left could appear to have gum disease and might be treated as such.

However, the x-ray (bottom photo) shows that the tooth is actually being resorbed into the jaw. Notice that the roots of the teeth at left are easily identifiable, while this tooth is barely recognizable.

This is called a Feline Osteoclastic Resorptive Lesion. Routine x-rays can spot this and similar diseases before they cause this degree of damage. Using x-rays, we can find and extract them, and prevent potential discomfort and bacterial infections. Oral examination of FORLs produce a chattering motion of the jaw when touched by a probe, even under general anesthesia. Please monitor if your cat has pain upon chewing or if one side of the jaw is favored over the other.

Preventive dental care is essential to ensuring a long, healthy life for your cat.

While cavities represent the most common dental disease in humans, cats are more frequently bothered by tartar buildup on the teeth. Tartar accumulation leads to irritation of the gums around the base of the teeth, ultimately leading to exposure of the roots. This tooth root exposure can lead to gum infections and tooth loss. Gum infection can possibly lead to premature kidney failure and generally poor health and weight loss.

The most distressing part of the disease is the number of undiagnosed dental cavities. These teeth are actually being resorbed by the body (as seen in the x-ray, above) and can be very painful.

Contributing Factors

One of the main factors in determining the amount of tartar buildup is the individual chemistry in the mouth. Without a daily program of dental prevention, most cats need annual cleanings; other cats need a cleaning only once every few years.

Diet plays more of a role in tartar accumulation than most people think. Because dry food is not as sticky as canned food, it does not adhere to the teeth as much and, thus, does not cause tartar buildup as rapidly. However, eating dry food does not remove tartar from the teeth. Once tartar forms, a professional cleaning is necessary.

Certain cat breeds, such as the Abyssinian and Somali, are more likely to develop periodontal disease. Age is a factor as well - peridontal disease is more common as pets get older.

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Clinical Signs

In almost all cases, owners are unaware that their cat has dental disease. The problem is usually identified on an initial or routine annual physical exam or during investigation of another problem. In other situations, the probability of dental disease is apparent to the owner. Signs include:

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Causes

Many different disorders can lead to dental disease in the cat. In general, we will try to determine whether the problem is limited to the oral cavity (primary dental disease) or has developed as a consequence of another disease (secondary dental disease). We believe that the current diets offered to cats are not the best from a dental standpoint. Recent research is showing that a more coarsely textured diet would be better at allowing a natural cleaning action of the cat's teeth as the food is consumed. As in the wild, by chewing and tearing the prey/food, the cat could theoretically self clean the teeth. What we are really saying is that whole mice are better than prepared soft mushy foods or small dry pellets that can be swallowed whole! Currently, the only available diets close to the natural diet are Prescription Diet T/D and Friskies Dental Diet. City Cats recommends that you feed these diets to your cat following a dental cleaning.

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Diagnosis

Diagnosis of dental disease is usually very straightforward. In most cases, the true extent of the disease cannot be determined unless the cat is under anesthesia. This permits a more complete examination of the mouth. Unfortunately, this leads to a major problem in determining the expected cost; an initial assessment of cost can double after an examination, since a thorough exam and dental x-rays can only be done once the cat is anesthetized.

Actual diagnosis of the dental problems can occur in one of two ways: First, we can perform an initial exam and cleaning to diagnose and determine if there are any cavities or periodontal infections, followed by a later anesthetic to perform any needed care such as root planing or dental extractions. Second, we can try to get the cleaning, the diagnosing, and the actual treatment all done under a single anesthetic. The second option can create a larger initial bill, but is actually cheaper in the long run and is safer since only one general anesthetic is involved.

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The Cleaning Process

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Prognosis

In the early stages of dental disease, the problems may be reversible. At some point, however, even cleaning cannot restore the mouth to normal. This is not a reason to avoid cleaning! At the least, we want to remove the oral infection and any painful, broken teeth. The prognosis is worsened if tartar is left on the teeth indefinitely. Some of the consequences of delayed dental care are:

1. Accumulation of tartar, which pushes the gums away from the roots of the teeth. This allows the teeth to loosen because infection has entered the root socket. The infection leads to loss of bone around the tooth and can cause the teeth to loosen and fall out or have to be extracted.
2. Infection will accumulate in the mouth, resulting in gingivitis (gums), tonsillitis, and pharyngitis (sore throat). Antibiotics may temporarily suppress the infection, but if the tartar is not removed from the teeth, inflammation will return quickly.
3. Infection within the mouth will be picked up by the bloodstream and carried to other parts of the body. Kidney and heart infections frequently begin in the mouth. We believe that most older cats with kidney failure may in part have this due to long-standing dental and oral infections.

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Prevention

Several preventive measures are recommended to aid in oral hygiene for your cat. You can refer to our Home Dental Care page for more in-depth information.

1. Have a dental and physical examination at least yearly. Have the teeth cleaned when advised (often yearly).
2. Try to maintain home dental care by brushing your cat's teeth. Special toothbrushes and flavored toothpastes such as C.E.T. and Enzadent are available. We will be happy to show you how to do this and to recommend a schedule.
3. Brushing alternatives include Maxi-Guard oral cleansing gel and C.E.T./Enzadent chews. These provide a solution for cats who simply will not tolerate having their teeth brushed.
4. A tartar control diet, available through our clinic, can be used as a maintenance diet or as a treat. It will prolong the interval between professional cleanings, but it will neither cure nor completely prevent dental disease.

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back to care directory

contributing factors

clinical signs

causes

diagnosis

the cleaning process

prognosis

prevention

recommendations for scheduled cleanings

how to brush
your cat's teeth