Pet Dentistry Part One – Feline

It’s February again and that means its Pet Dental Month! Did you know that your pet’s Veterinarian is also their Dentist. If you haven’t considered dental care for your pet, here are a few things to consider. Regular dental care reduces the shed of bacteria into the bloodstream which can affect the heart valves and kidneys. Additionally, dental cleaning has been proven to lengthen a pet’s lifespan and make them happier, reduce or prevent mouth pain, and improve their breath. Here are a few symptoms to watch for that suggest that your four-legged friend needs a trip to their dentist – Broken or discolored teeth, excessive drooling, Reluctance to eat especially dry food or dropping kibble, Bleeding from the mouth or gums, Sudden change in behavior (aggressive or withdrawn), Abnormal discharge from the nose, A mass/growth in the mouth, and Bad breath. If you see any of these clinical signs, it is recommended taking your pet to your veterinarian for an oral examination to plan for a prophylactic cleaning.

Feline dental care is perhaps the most overlooked and under-treated area in companion animal medicine. Cats are affected by many of the same dental problems that affect dogs, such as periodontal diseases, fractured teeth, and oral masses. In addition to these oral health concerns, cats are also plagued with tooth resorption and oropharyngeal inflammation. More than half of cats over three years old will be affected by tooth resorption which is extremely painful and can change a cat’s behavior. Affected teeth often erode and disappear as they are replaced by bone. The root structure breaks down, then the enamel and most of the tooth is resorbed and replaced by bone. The molars are most commonly affected however, tooth resorption can be found on any tooth. The reason for this type of tooth resorption is unknown. Cats affected with tooth resorption may show excessive salivation, pain, bleeding in the mouth, or have difficulty eating. The incidence of clinical feline tooth resorptive lesions is reported to be 50 to 75%! Evaluation under anesthesia certainly finds more lesions than a clinical exam. While the signs of resorption are essentially those of pain, this often goes unnoticed because of cat’s ability to hide or mask the disease and pain.

Significant veterinary research has been conducted to better understand oral health issues in cats. The incidence of tooth resorption varies according to one study that documented an increased prevalence of tooth resorption in pure-breed cats (70.0%) compared with mixed-breed cats (38.0%). Another study indicated that cats with oral lesions were more likely to be older, female, taking medications, drinking city (vs. well) water, and playing less often with toys. In addition, cats without oral lesions were more likely to have owners who cleaned their teeth daily or twice a week and were fed diets with higher magnesium, calcium, phosphorus, and potassium content. Regardless of these studies, it is important to remember that tooth resorption has been detected in all types of cats.

Feline chronic gingival stomatitis is often associated with tooth resorption and periodontal disease. Feline chronic gingival stomatitis is a frustrating condition that afflicts many cats and may include Mucositis, an inflammation of the mucosa or tissue lining the mouth; Mucosal Ulceration, lesions or sores in the mucosal tissues; and Stomatitis, a widespread oral inflammation that is more severe than simple gingivitis and periodontitis. Diagnosis begins with a history and a complete physical examination of the mouth which usually requires general anesthesia for some cats. Gingival bleeding is one of the earliest signs that may be seen. Inflamed gingiva and/or mucosa is often found with stomatitis and may appear swollen, cobblestone, bright red, or raspberry-like. Most cats with “classical” stomatitis have a hyperproteinemia or excessive protein in the blood therefore routine bloodwork should be performed to aid in diagnosis. Stomatitis is one of the most difficult oral conditions to successfully treat. Treatment is extensive but necessary. Extraction of all the teeth may be necessary to improve quality of life. In one study, it was reported that in cats that had all teeth removed for therapeutic reasons, 50% of these cats did not require further treatment, 37% of the cats required less medications for mouth ailments after treatment, and only 13% of the cats required the same amount of medication after the therapeutic removal of teeth.

Cats can also be affected by oral cancers in their mouths. Squamous cell carcinoma is the most common type of oral cancer. Less common feline oral malignancies include melanoma, fibrosarcoma, lymphosarcoma, and undifferentiated carcinomas. Not all feline oral swellings are malignant. Cats are frequently affected by reactions to foreign bodies, inflammatory conditions from dental disease, tumor-like masses, infections, and growths in the nose or throat. Biopsies are commonly recommended for diagnosis of these conditions and further treatment.

The first step for prevention and treatment of dental disease is excellent oral hygiene. A professional dental cleaning will likely be necessary. Dental radiographs (X-rays) may be necessary to evaluate teeth for tooth resorption or to look for roots that remain subgingivally after crowns have resorbed or have been fractured. The radiographs evaluate loss of bone around the tooth. When teeth are cleaned, your veterinarian will also evaluate the teeth and mouth and grade periodontal disease and chart the teeth. Patients with oral infection will often need a coarse of antibiotics to keep these oral infections in check. It is important to remember that oral health plays an important role in your pet’s overall health. Remember, your family Veterinarian can help guide you through your pet’s health care!