“Hans” was a beautiful, eight-year-old, Seal Point, Siamese cat. “Hans” was brought into the clinic as he had not been eating well recently. His owner relayed that he was drooling excessively and chewing his food awkwardly, and he was becoming quite grumpy and difficult to handle, which was not like him.
On his examination I noted that he had a painful, bleeding lesion on the side of one of his upper back molar teeth. He was booked in for a full Dental examination under a safely monitored anaesthetic.
Dental disease can cause pain and discomfort and is an extremely common problem in cats. A staggering 85% of cats over the age of just three years old can have some form of Dental disease which can impact on their quality of life.
Pain is often very difficult to detect in cats, as they do tend to hide the symptoms of pain very well. Dental pain can however be extremely debilitating, so prompt action should be taken. Signs of Dental pain in cats can include withdrawn behaviour, hiding away, a lowered head, salivating excessively, a decrease in appetite, chattering jaws, chewing awkwardly while turning their head, absence of their normal grooming behaviours and temperament changes.
Fortunately, most common forms of dental disease are largely preventable and often treatable.
The three most common dental diseases in cats are gingivitis, periodontitis, and tooth resorption.
Gingivitis is a condition in which the gums around the teeth become inflamed, red, swollen, and painful. This inflammation is the result of a process that begins with the build-up of plaque, a film that harbours bacteria, on the teeth. As the plaque builds up it migrates deeper toward the base of the tooth. When plaque becomes hardened by absorbing minerals from both the saliva and from the gingiva itself, it is referred to as calculus or tartar. Calculus provides a rougher surface that the disease-causing bacteria can also attach to. The cat’s immune system mounts a response to these bacteria, resulting in the gum inflammation that we refer to as gingivitis.
Gingivitis can also be brought on by several infectious or systemic diseases, including feline leukaemia virus, feline immunodeficiency virus, feline calicivirus, severe kidney disease, diabetes mellitus, and autoimmune diseases. These causes should also be considered.
Gingivitis is characterized by swelling, redness, discomfort, and, in severe cases, bleeding gums where the gums and the teeth meet. Cats with gingivitis may be reluctant to eat or show a preference for soft foods and develop bad breath.
The recommended treatment for gingivitis will depend upon how severe your cat’s case is and on the underlying cause. This usually involves scaling the plaque and calculus from the teeth, which does require a safe general anaesthetic, and in some cases, the removal of any diseased teeth.
If gingivitis is not controlled, it can progress to periodontitis, a condition that eventually cannot be reversed. In periodontitis, the tissues that attach the tooth to the underlying gums and bone are affected, leading to loosened teeth and so to tooth loss. Periodontitis is almost always the result of untreated gingivitis, so controlling the initial gingivitis caused by plaque build-up is crucial and key.
Cats with periodontitis show recession of the gum tissues, exposure of tooth root surfaces, and an excess mobility of the teeth. Complete evaluation of cats with periodontitis requires a safely monitored general anaesthetic allowing a full examination and probing of the teeth, dental X-rays, dental scaling, and extractions as required.
Tooth resorption is a process in which the tooth structure breaks down, beginning inside the tooth, often at the tooth root, progressing to other parts of the tooth. Tooth resorption is the most common cause of tooth loss in cats, with up to 70% of cats showing some sign of this destructive dental process. Tooth resorption is usually first identified as a pinkish bleeding defect in the tooth at the gum line. Unfortunately, by the time this defect is visible, the tooth is already significantly damaged. Tooth resorptive lesions are called “FORL” lesions: (Feline Odontoclastic Resorptive Lesions), these lesions can be extremely painful and can develop very quickly. FORL lesions start beneath the gum line, often gradually dissolving the root of the affected tooth, which is subsequently replaced by the surrounding bone. The disease then continues inside the tooth to the crown, leaving the pulp cavity exposed, thereby causing pain and sensitivity. Resorptive lesions do need full dental examination and X-rays with extractions under general anaesthesia. Teeth with FORL lesions do require to be removed, often the “crown” of the tooth the part visible above the gum line is amputated and then burred and smoothed down, as the affected tooth root has already been resorbed. Careful monitoring of these cases is important, as further resorptive lesions can appear quickly.
“Hans” did have a painful FORL lesion, and he had this tooth crown amputated and burred down. He ate well and was so much happier and amiable after his procedure, and he was monitored closely for any further lesions.
If you are at all concerned about your cat's Dental health, then do contact your Vet’s surgery, and arrange an appointment initially for a dental examination, and you will be advised appropriately from there.