Symptoms Your Cat has a Toothache

Symptoms Your Cat has a Toothache

The oral cavity is very important to the overall health of cats. It is the first part of the digestive tract, and arguably the most important. Domestic cats are designed to have 30 permanent teeth which erupt by the time they are 7-8 months of age. 

Cats use their mouths for hunting, eating, and grooming. They may spend up to 25% of their day grooming as they are very clean creatures. 


When Our Cats Hide Their Pain

It can be challenging to know when our pets, especially cats, are unwell. Although cats are typically thought of as a predator, they are also predated upon in the wild. When an animal displays signs of being unwell in the wild, it is seen as a weakness and can lead to the demise of the animal. 

Despite cats being the second most common pet in the US—fish are #1—they still are not truly domesticated and have an intrinsic nature to hide weakness. This makes it challenging for us to be their best advocate in health. 


What Causes a Toothache in Cats?

Cats can experience tooth pain as can dogs, humans and other creatures with teeth. The most common cause of toothache in a cat is an infected tooth. Teeth experiencing tooth resorption can cause a toothache. Cavities, also known as caries, are also a cause of tooth sensitivity. Fortunately, cavities are not much of a concern in cats as they are in humans, and to a lesser extent dogs and primates. 


What Are The Signs a Cat has Tooth Pain? 

When a cat has a healthy mouth, they tend to eat well without discomfort, groom themselves readily, and are lacking in halitosis (bad breath). Cats may also seemingly act normal despite having significant periodontal disease. There are common clinical signs and symptoms that may clue the astute pet owner that their furry feline friend is experiencing oral discomfort. 

Signs of painful teeth in cats include bad breath, decreased appetite, and a reluctance to groom. A cat with a painful mouth may be reluctant to eat or have a decreased appetite. Weight loss is often associated with a decreased appetite. Vomiting may occur if they are swallowing their food whole instead of chewing to bypass painful teeth. This may give the impression of stomach sensitivity rather than a primary dental concern. Some felines may growl at the food bowl as if they are angry because they are unable to eat without pain. A matted coat may also be observed due to decreased grooming behavior. 


Periodontal Disease in Cats

Periodontal disease is the most common cause of a painful tooth or teeth. The crowns or cusps of the teeth should be clean and free of tartar accumulation. The teeth should not be fractured. The gingiva (gum tissue) should be pink in color. If gingivitis is present, the gums will appear bright red and may bleed. To evaluate the entire tooth, including the root structure, dental radiographs are needed. 

The development of periodontal disease is as follows, plaque will accumulate within minutes of a dental cleaning. Calculus, which is an alternative term for tartar, will form 72 hours after plaque is present. The cycle will continue, leading to gingivitis, and subsequent attachment loss of the surrounding periodontal tissues. 

A common question we hear once dental disease is diagnosed is, “is my pet’s mouth painful if they are still eating?” 

Dental disease is painful. Anyone who has had a cavity, broken, or infected tooth can attest to the discomfort felt, which can vary from mild to extreme. Teeth are alive and contain living tissues including nerve fibers and a blood supply.  

Dog and cat teeth, similar to our teeth, are susceptible to disease, including, the gingival tissue and bone surrounding them.


Tooth Resorption in Cats

Tooth resorption is a painful and often undiagnosed oral condition in cats. It is the most common oral pathology seen in cats. In tooth resorption, the tooth structure begins to break down, resorbing to the surrounding bone. As the tooth begins to break down, dentin tubules are exposed which leads to pain and infection of the dental tissue. 

Resorptive lesions can occur at any age and in any breed of cat. There is not a specific identifiable cause for tooth resorption in cats but contributing factors such as periodontal disease, Feline Immunodeficiency Virus (FIV), and genetics may be present.

There are two predominant types of tooth resorption that are seen. These include Type I and Type II tooth resorption. In Type I tooth resorption, most of the tooth structure is intact with tooth defects within the crown and/or root. Treatment involves the complete removal of all remaining tooth structure.  

In Type II tooth resorption, the tooth is replaced with bone. Treatment for Type II tooth resorption involves surgical extraction of the crown of the tooth, also known as crown amputation. 

Unfortunately, due to the aggressive and progressive nature of tooth resorption in cats, extraction is the treatment of choice rather than restorative therapy. Once tooth resorption is detected in a patient, frequent professional cleanings every 6-9 months is recommended in addition to daily oral home care to minimize the development of future lesions and avoid unnecessary pain and discomfort.


Dental Disease is Hard to Detect Without Regular Exams

Animals in the wild are either predators or predated upon. It is not in the animal’s best interest to show signs of weakness to avoid being predated upon. Although our dogs and cats are domesticated, many will act seemingly normal and continue to eat with diseased teeth. After all, if dental disease is not recognized, they have no choice but to adapt to their discomfort. In many animals, the need to eat overrides the discomfort that they may feel. It oftentimes takes significant dental disease for a pet to stop eating. 

The significance of a pet’s discomfort is often not realized until after dental disease is addressed. Owners may have noticed a slightly decreased or picky appetite, bad breath, or tartar buildup within the mouth. Chronic periodontal disease can contribute to systemic illnesses such as heart disease, diabetes, and kidney disease, among others. 

Many owners report their pet acts with increased energy and vitality after dental care. Chronic diseases, such as diabetes, are more effectively managed once inflammation and infection in the oral cavity is addressed.

Maintaining a healthy oral cavity is a contributing factor to a good quality of life in our companion animals. Dogs and cats will continue to eat despite having oral pain and disease due to a nature of adaptability.


Treatment Options for a Toothache

The first stage of treatment is identifying a clinical concern with a specific tooth or teeth. The best way to do this is by scheduling a COHAT procedure. COHAT is an acronym for Comprehensive Oral Assessment and Treatment. Using the term COHAT in lieu of ‘dental’ for oral care is more encompassing and thorough for its intent. 

A COHAT is completed under anesthesia. This is necessary as 60% of the tooth is under the gumline. That means only 40% or less than ½ of the tooth, is seen during the awake oral exam. 

Imaging is imperative for identifying pathology that lies beneath the surface. During a COHAT, a full mouth exam is completed evaluating all 30 teeth in the feline patient (dogs have 42 teeth), followed by a dental cleaning, and imaging. Imaging has historically been completed with full-mouth intraoral dental radiographs. 

At Animal Dental Care and Oral Surgery, we utilize cone-beam CT imaging for examining all the teeth and the surrounding maxillofacial structures. It allows us a detailed evaluation of the full mouth and surrounding maxillofacial structures.  


Board-Certified Veterinary Dentist in Colorado

If you are concerned that your cat may have a toothache, call us at Animal Dental Care & Oral Surgery to schedule a consult exam. 


Photo by Marko Blazevic