Tooth and gum care is perhaps one of the most overlooked and under-treated problems plaguing cats and it is estimated that 75% of cats over the age of 5 are in need of some kind of dental care.Because cats have been known to “hide” discomfort , it can sometimes be difficult to tell if your feline friend has any oral pain, but there are a few subtle hints that you can look for:
Cats are subject to many of the same dental problems as dogs, but there are also a few conditions that are unique to cats and require specific care.
Feline Odontoclastic Resorptive Lesions (FORL)
Exactly what causes FORL is currently unknown, yet these are the most frequently seen dental lesions in cats, and it is estimated that if your cat is over the age of 5, there’s a 72% chance he/she may have one. Also known as “cervical” or “neck” lesions, these are painful “cavities” that most often affect the premolars, but they can be found on any tooth. FORL can present itself in 4 different stages:
Stage 1 – the initial stage of FORL, in which an enamel defect is detected. The lesion may appear like a chipped tooth, but because it has not yet entered the dentin, sensitivity is minimal. Treatment for this is usually a thorough cleaning, polishing, and smoothing. Daily tooth brushing may be recommended.
Stage 2 – the lesion has penetrated the tooth enamel and dentin. Glass ionomer restoratives may be used in treatment – this releases fluoride ions that will desensitize any exposed dentin, strengthen the tooth enamel, and chemically bind to the tooth surface. Unfortunately, the long term effectiveness of Stage 2 restoration has yet to be proven and some consideration should be given to full tooth extraction.
Stage 3 – X-Rays are required to determine how far gone the lesion has become. At this point, the lesion has entered the pulp chamber of the tooth and is extremely painful. An abscess is likely and bacteria now has an easy access route to the bloodstream – it is well documented that tooth root abscesses can be the source of infections in the heart valves, liver, kidneys, spleen, joints, bones, and central nervous system. Treatment may involve either a root canal, or tooth extraction.
Stage 4 – the crown of the tooth has become eroded or fractured. Gum tissue has grown over the root fragments, leaving behind a lesion that may sometimes be painful or bleed when probed. Treatment for Stage 4 is usually flap surgery, crown amputation, or extraction of the root fragments if the tissue surrounding the lesion appears to be inflamed or causing pain.
Feline Lymphocytic Plasmacytic Stomatitis (LPS)
LPS is a severe, often painful periodontal disease that affects the entire feline oral cavity with inflammation. Rapidly progressive, it often eventually stops responding to conventional treatments such as maintaining good oral hygiene and the use of antibiotics, anti-inflammatories, and immunoregulators. Symptoms include:
Exactly what causes this disease is unknown, but it has been documented that about half the the patients that have presented with LPS may also have had one or more of the following: FELV (feline leukemia), FIV (feline aids), FIP (feline infectious peritonitis), Calici virus, thyroid conditions, FORL (feline osteoclastic resorptive lesions), periodontal disease or plaque. Several pure breeds (Abyssinian, Persian, Himalayan, Burmese, Siamese, and Somali) are predisposed.
While there are many treatments available that have been used to try to control LPS, no one treatment has proven to be 100% successful. Initial treatment usually consists of teeth cleaning and a strict home tooth brushing regimen for the affected teeth. Currently, the most effective treatment with a 70% success rate is the extraction of the molars and premolars. Follow-up home care and drug therapy may also be used.