Often pets have oral manifestations of various systemic disease, stomatitis, and autoimmune disorders. At Animal Dental Care & Oral Surgery we are experts in diagnosing and treating a wide range of disease.
Feline patients are subject to most of the same dental problems that plague dogs, but they do have a few dental conditions that are somewhat unique. When we examine cats for dental problems, these “cat specific” diseases are always at the top of our list of things to look for.
Feline Stomatitis
Stomatitis, also known as Lymphocytic Plasmacytic Stomatitis/Faucitis or Ulcerative Stomatitis is a very debilitating disease of cats that can lead to loss of all the teeth at a very early age. Although the causes are not known, the disease is possibly caused by an inappropriate overreaction of the immune system to plaque that is normally present on the teeth. This heightened immune response leads to severe oral inflammation, oral ulcers, foul breath, resorption of hard dental tissues, and difficulty in eating, sometimes at a very early age.
Viral infection may play some role in this disease, but nothing has been proven at the time of this writing (08/2010). Some patients have large areas of their oral cavity affected with painful, raw areas. This can be a very debilitating condition for the cat.
A large amount of anecdotal information exists on the internet regarding miracle cures for this condition. If proven effective medical treatments are developed in the future, veterinary dental specialists like Dr. Woodward will be at the forefront in utilizing and publicizing this information. A few cats respond to medical treatment, which revolves around meticulous plaque control and anti-inflammatory medication. Other treatment strategies include drugs that modify the immune response of the patient such as cyclosporine. In Europe, some success has been seen using Feline Omega Interferon, but results in the U.S. have been less encouraging.
For most cats, extraction of all the teeth provides the best solution, usually resulting in a much happier patient shortly after surgery. Interestingly, after treatment these cats will frequently prefer dry food, even though they have no teeth! Although this treatment might seem overly aggressive, owners are uniformly pleased with the results a few weeks down the road.
Feline Tooth Resorption
Feline Tooth Resorption has many names, including Feline Odontoclastic Tooth Resorption, Feline Cavities, Neck Lesions, Cervical Erosions, Cervical Cavities, and others. Most cats over the age of five have one or more of these painful cavities at or under the gum line. If your cat has “missing teeth”, they quite likely have been lost from this process. They start as small defects in the tooth structure just under the gum line, and progress to painful invasion of the tooth by cells that gradually remove tooth structure and replace it with bone.
The areas of tooth resorption commonly become visible above the gum line as fleshy pink areas of gum tissue. The nerve is frequently involved in the process, causing discomfort. Many times the weakened tooth breaks off, leaving painful retained roots in the jaw. The lesions can appear to be very small, yet can be associated with a large loss of tooth structure. Treatment usually involves extraction, as these teeth are not amenable to restoration.
When extracting these teeth, every effort should be made to remove all of the root structure. Some practitioners incorrectly treat these teeth by simply cutting off the visible part of the tooth, leaving the root structures in place under the gum line to be hopefully resorbed over time. This inferior form of treatment can leave painful roots in place for the rest of the cat’s life. Although this technique is occasionally appropriate, dental X-rays are needed to guide correct treatment. Can you imagine how you would feel if you had a tooth “extracted” and all they did was drill the visible part of the tooth away, leaving the roots in place? In the majority of cases, the roots of feline teeth can and should be extracted in their entirety.
Feline Fractured Canine Teeth
Cats do not have as many fractured teeth as dogs, but one particular fracture type occurs frequently. The canine teeth (fangs) of cats commonly have very small fractures of the tips of these teeth, which are easily overlooked.
These fractures commonly expose the pulp chamber (nerve chamber) leading to the infection and death of the tooth. Because the exposure of the pulp chamber is so small, it can be hard to visualize. We see many cats with almost total destruction of the tooth occurring under the gum line, yet the tooth appears normal on visual inspection. Any fractured canine tooth in a cat, regardless of fracture size, should be inspected closely under anesthesia and have dental radiographs taken of the tooth to make sure that no painful problems exist. If diagnosed early in the process, these teeth can usually be saved, avoiding the pain of long-term infection and trauma of extraction of these long-rooted teeth.
Juvenile-Onset Gingivitis/Periodontitis
We occasionally see the development of bright red gums (gingivitis) in young cats around 6 to 9 months of age. Oftentimes, these cats have little or no calculus accumulation. The exact cause is unknown, however, some theories include: viruses, breed disposition (more common in certain purebred cats such as Persians, Siamese and Abyssinians), genetic and environmental influences, immune suppression, and of course, plaque and calculus build up.
Initially, the gingivitis is mild and localized, but it may progress in some kittens to very severe inflammation with bleeding of the tissues around the teeth. If left untreated, these areas frequently develop areas of tooth resorption (feline cavities) and bone loss around the teeth.
Treatment of juvenile gingivitis includes eliminating and preventing plaque and calculus formation by performing a thorough teeth cleaning and polishing. Many of these patients require a brief dental cleaning every 3-6 months to remove accumulated plaque. This is followed by aggressive home care that may include sprays, rinses, water additives and, if tolerated, brushing the teeth. Fortunately, some cats seem to outgrow the disease by two years of age.
