Liza Cahn, DVM
When you think about all the work we put into keeping our teeth clean and healthy (flossing, brushing twice a day, trips to the dentist every six months, etc.) compared to our furry family members, it’s no wonder that dental disease is such a common occurrence in our pets. Studies show that 50 to 90% of cats older than four years of age have some degree of dental disease. But luckily, there is a lot you can do to help keep your cat’s teeth clean and healthy. Let’s examine some of the most common types of dental disease affecting cats, what a dental cleaning under anesthesia with your vet involves (and why it’s important), and what you can do at home to help keep those fangs shiny and say goodbye to fishy breath.
Your Cat’s Teeth
Before diving into the details of how a cat’s teeth can become diseased or damaged, it’s important to understand some basics about their structure and function.
- Adult cats have 30 teeth while kittens have 26, including incisors, canines, premolars, and molars. Each type has a specific purpose and a different number of tooth roots.
- Your cat’s teeth can help reveal their age. Baby (deciduous) teeth start to appear around 2-6 weeks of age and are replaced by permanent adult teeth by approximately six months of age.
- The crown is the part of the tooth visible above the gumline, while the root is below and extends into the jawbone.
- Cat teeth are composed of several layers. The pulp canal is the soft inner part of the tooth, containing blood vessels and nerves. Dentin surrounds the pulp cavity and makes up the bulk of the tooth. It is harder than the pulp but still sensitive. Cementum is the hard mineralized tissue that covers the dentin layer on the tooth root, while enamel is the hard, white, outer layer visible on the crown.
- Alveolar bone forms sockets for the teeth, while connective tissue fibers, known as the periodontal ligament, support and hold them in place.
Symptoms of Dental Disease in Cats
Some cats with significant dental disease may show symptoms such as bad breath, discolored teeth, drooling, bleeding gums, pawing at the mouth, difficulty eating or chewing, and jaw chattering. However, cats are experts at hiding disease and discomfort, so even if your cat seems fine, dental disease could be lurking beneath the surface. In fact, most cats with dental disease do not show obvious clinical signs. For this reason, it’s especially important to keep up with routine veterinary care and follow your vet’s recommendations regarding your cat’s oral health.
Common Types of Feline Dental Disease
There are several types of dental disease that are seen in cats, the most common of which are:
Gingivitis
Feline gingivitis involves inflammation of the gums, causing them to appear red, swollen, and bleed easily. It is often the first stage of periodontal disease, a more serious condition that can lead to tooth loss and other health complications.
Gingivitis begins with plaque buildup, a sticky film of bacteria that accumulates on teeth. Within days, plaque hardens into tartar (also known as calculus), a rough mineralized substance that irritates the gums and leads to inflammation. Other factors, such as viral or bacterial infections, systemic disease, nutritional deficiencies, and misaligned teeth, can also contribute to plaque buildup and gingivitis in cats.
The good news is that gingivitis can be reversed if you catch it early enough. Treatment typically involves a professional dental cleaning with your veterinarian under anesthesia to remove plaque and tartar, followed by at-home care such as regular brushing.
Periodontal Disease
If left untreated, gingivitis will progress to periodontal disease, a condition in which the structures supporting the teeth (including the bone and ligaments) are damaged, eventually resulting in infection, loose teeth, and tooth loss. There are several stages of this disease:
- Early Periodontitis: Inflammation increases and the gums start to recede (pull away from the teeth) slightly. There is minor bone loss, but it might not be easily visible.
- Moderate Periodontitis: The bone loss becomes more evident, leading to gum pockets (deep spaces developing between the tooth and gums). This can make teeth loose and lead to bad breath.
- Advanced Periodontitis: There is significant bone loss (over 50%), gingival pockets deepen further, and infections and loose teeth are common. This stage often results in tooth loss, and the spread of bacteria can even affect a cat’s heart and other organs.
In order to diagnose and treat periodontal disease, your vet will need to perform a dental exam and cleaning under anesthesia, including dental X-rays to determine if disease is present below the gum line. They will then remove any diseased or damaged teeth.
Feline Odontoclastic Resorptive Lesions
Feline odontoclastic resorptive lesions (also known as FORLs) are characterized by the gradual destruction of tooth structure (dentin). While the cause is largely unknown, FORLs are extremely common, affecting 75% of cats over five years of age.
The clinical signs of FORL lesions can vary depending on the severity and location. Cats may show behavioral changes such as reluctance to eat or difficulty chewing. They may also show signs of oral pain, including pawing at the mouth, teeth chattering, or excessive drooling. In some cases, the lesions may be visible as fleshy, red areas along the gums or on the exposed tooth surface, although lesions can also occur under the gumline.
Diagnosis of FORL lesions typically involves a thorough oral examination under anesthesia. Dental radiographs (X-rays) are essential for assessing the extent of the damage and identifying lesions that may not be visible on the surface. Treatment involves removing the affected tooth or teeth, although the technique used may depend on the type and severity of resorption.
Other
Just like people, cats can also suffer from other types of dental issues, including retained baby teeth, stomatitis, fractured teeth, misaligned teeth, and growths or tumors in the mouth.
Veterinary Dental Treatments
Dental cleanings under anesthesia with your vet are an extremely important part of taking care of your pet’s oral health and managing cat dental disease. How often these cleanings are needed depends on your cat’s individual situation – their dental health, genetics, and how well you care for their teeth at home.
What Happens During a Cleaning?
While this may vary depending on your vet’s experience, comfort level, and individual preferences, most dental cleanings consist of the following components.
First, your cat will undergo a pre-anesthetic assessment. This involves a thorough physical examination to evaluate their overall health and identify any potential anesthesia risks. Blood tests are recommended to check organ function and ensure your cat is fit for the procedure.
Your cat will then be given medications to help them relax and fall asleep. Anesthesia is a critical part of a thorough dental cleaning, because it allows your vet to clean above and below the gumline and extract any diseased or damaged teeth, while your cat remains still and pain-free. Your cat’s vital signs, including heart rate, respiratory rate, blood pressure, and oxygen levels, are continuously monitored to ensure their safety. Intravenous fluids are administered to maintain hydration and blood pressure, and pain medications are given to keep your cat comfortable as needed.
Your vet will then conduct a thorough oral examination, inspecting every part of your cat’s mouth. Dental X-rays should be taken to get a detailed view of the tooth roots and jawbone, revealing any underlying issues that might not be visible on the surface. They will clean the teeth with an ultrasonic scaler to remove plaque and tartar buildup above and below the gum line, and polish them to remove any rough surfaces. In cases of severe damage or disease, tooth extractions may be needed to alleviate pain and prevent further complications.
After the procedure, your cat will be carefully monitored as they recover from anesthesia. They will be sent home later that day with detailed instructions for at-home care. If your cat had teeth extracted, they may need to eat a soft diet, take pain medications, and wear a cone during their recovery.
Preventing Dental Disease in Cats
Toothbrushing
While the idea of brushing your cat’s teeth may seem daunting or downright impossible to many pet parents, it’s the best thing that you can do at home to support the health of their teeth and gums. With some practice, patience, and positive reinforcement, many cats can even learn to enjoy it.
How To Teach Your Cat To Have Their Teeth Brushed
To introduce low-stress tooth brushing to your cat, start by wrapping a piece of gauze around your finger and applying a small amount of cat-specific toothpaste. Let your cat lick the toothpaste and get used to the flavor. Once they seem comfortable, gently slide your finger under their lip along the side of their mouth and rub the outer surface of the teeth and gums. Offer praise and treats throughout the process. Over several sessions, gradually increase the duration and extent of the rubbing.
When your cat accepts this, you can introduce a toothbrush. Let them sniff and explore it before applying a small amount of toothpaste to the brush. Mimic the same gentle rubbing motion you used with your finger, starting with just a few teeth and gradually increasing the area as your cat becomes more comfortable. Continue to offer positive reinforcement and be patient, keeping brushing sessions short and positive. Focus on making gentle circular motions on the outer surface of the teeth. There is no need to open your cat’s mouth fully to attempt to brush the inner surfaces.
How Often Should You Brush Your Cat’s Teeth?
Brushing daily is recommended to remove plaque from your cat’s teeth before it has the chance to harden into tartar or calculus. In order to be beneficial, brushing should be done a minimum of 3-4 times per week.
Dental Diets
Dental diets for cats are prescription diets specially formulated to help reduce plaque and tartar buildup. These diets often feature larger kibble sizes and a unique texture that encourages chewing, which helps to scrape away plaque from the tooth surfaces. They also contain ingredients that freshen breath and inhibit bacterial growth in the mouth.
Other Dental Products
There are several types of dental products that can help keep your cat’s teeth clean and healthy. These include water additives, treats and chews, dental powders, and dental wipes. The most important consideration when choosing a dental product for your cat is to look for the Veterinary Oral Health Council seal of approval. These products are proven to help reduce plaque and tarter buildup, are recommended by vets, and, most importantly, are safe for your cat when used appropriately.
Additional Tips For Cat Owners
We all know that cats are unique, special, and quirky. Therefore, when beginning an at-home dental care routine for your cat, there are some additional things that cat parents should consider.
- Consider your cat’s temperament and mood – While toothbrushing is considered the gold standard for at-home dental care, there are some cats who will just not tolerate it. Even the friendliest cat can bite or scratch under stress. If you don’t think you can safely brush your cat’s teeth without getting bitten, talk to your vet about other options instead.
- Start early – Your cat will be more accepting of dental care if it is something you have practiced with them since kittenhood. Most older cats can still be trained to tolerate toothbrushing, but it may take more time and patience.
- Make it a routine – Cats are creatures of habit, so try to choose a time of day and location that work best and then stick to it. Eventually, you will probably find them there waiting for you!
- Use cat-friendly products – Dental products intended for humans, or even dogs, can sometimes be toxic to cats. Therefore, it’s important to always read the label and choose a product that is made specifically for cats.
- Patience and positive reinforcement – Cats can be sensitive or wary of new things, including beginning an at-home dental care routine. Be sure to go slowly, don’t be afraid to take a step back if your cat is showing signs of anxiety, and always use positive reinforcement.