A Guide to Feline Dental Care

Feline dental care is perhaps the most overlooked and under-treated area in small animal medicine.

Cats are affected by many of the same dental problems that affect dogs, including periodontal disease, fractured teeth, and oral masses. In addition, they can develop unique conditions such as tooth resorption and oropharyngeal inflammation.

Understanding tooth resorption in cats

More than 50 percent of cats over three years old will be affected by tooth resorption (TR).

These tooth defects have also been referred to as:

• Cavities
• Neck lesions
• External or internal root resorptions
• Cervical line erosions

Teeth affected by these lesions gradually erode and eventually disappear as they are absorbed back into the cat's body.

The root structure breaks down, followed by damage to the enamel and most of the tooth structure. Bone then replaces the affected tooth.

This process most commonly occurs where the gum meets the tooth surface.

Although molars are most frequently affected, tooth resorptions can occur in any tooth.

The exact cause of tooth resorption remains unknown, although theories involving an autoimmune response have been proposed.

(Tooth resorption can be seen as indicated by the arrow. Photo courtesy of Dr. Jan Bellows.)

Signs of tooth resorption

Cats affected by tooth resorption may experience:

• Excessive salivation
• Bleeding from the mouth
• Difficulty eating

Tooth resorptions can be extremely painful.

However, many affected cats do not show obvious clinical signs. In many cases, the lesions are identified during a routine oral examination performed by a veterinarian.

How is tooth resorption diagnosed?

Diagnostic aids may include:

• A dental probe
• A cotton-tipped applicator applied to the suspected area

When the probe touches an active lesion, it may cause pain and jaw spasms.

Dental radiographs are also helpful in establishing a definitive diagnosis and creating an appropriate treatment plan.

Stages of tooth resorption

Tooth resorptions can be classified into several stages:

Stage 1 (TR 1)

Mild dental hard tissue loss.

Stage 2 (TR 2)

Moderate dental hard tissue loss.

Stage 3 (TR 3)

Deep dental hard tissue loss, although most of the tooth retains its integrity.

Stage 4 (TR 4)

Extensive dental hard tissue loss, and most of the tooth has lost its integrity.

Subcategories include:

• TR 4a: Crown and root are equally affected.
• TR 4b: Crown is more severely affected than the root.
• TR 4c: Root is more severely affected than the crown.

Stage 5 (TR 5)

Only remnants of dental hard tissue remain visible as irregular radiopacities, and the gum has completely covered the affected area.

The role of dental x-rays

Radiographic appearances of tooth resorption vary, but all stages can be identified through dental x-rays performed by your veterinarian.

If the periodontal ligament is visible, the affected tooth should be extracted using flap exposure techniques.

If the periodontal ligament is not visible, crown reduction and gingival closure may be performed.

(Tooth resorption can be seen in x-rays. Photo courtesy of Dr. Jan Bellows.)

Oropharyngeal inflammation in cats

Cats can also develop oropharyngeal inflammation, a serious inflammatory condition.

Although the exact cause remains unknown, an immune-related origin is suspected.

Signs of oropharyngeal inflammation may include:

• Difficulty swallowing
• Weight loss
• Excessive salivation

An oral examination often reveals multiple abnormalities, and dental x-rays frequently demonstrate moderate to severe periodontal disease with associated bone loss.

Treatment options for oropharyngeal inflammation

Managing this condition can be challenging.

Conservative treatment approaches and medical therapy are often ineffective.

Treatment outcomes generally include:

• Approximately 60% of cats: Improvement after extraction of selected teeth
• Approximately 20% of cats: Continued management with medications, typically prednisone
• Approximately 20% of cats: Poor response to treatment

A carbon dioxide laser has also been used with some success.

Oral cancer in cats

Cats may also develop cancers within the oral cavity.

The most common type of feline oral cancer is:

• Squamous cell carcinoma

Less common oral malignancies include:

• Melanoma
• Fibrosarcoma
• Lymphosarcoma
• Undifferentiated carcinomas

Not all oral masses are cancerous

It is important to remember that not every oral swelling is malignant.

Cats frequently develop oral abnormalities related to:

• Foreign body reactions
• Dental disease
• Tumor-like masses
• Infections
• Growths originating from the nose or throat

Biopsies are essential for obtaining an accurate diagnosis.

The importance of routine oral examinations

Cats can be affected by many painful oral and dental conditions, ranging from tooth resorptions and inflammatory diseases to oral cancer.

Working closely with your veterinarian and scheduling routine oral examinations can help identify problems early and ensure your cat receives the best possible care.

Copyright 2013–2014 by the Veterinary Information Network, Inc. All rights reserved.

Copyright 2002, Veterinary Information Network, Inc. & Jan Bellows, D.V.M., Dipl. AVDC.