Many cats do not display signs of dental disease that their owners can detect. Complete oral examination under general anesthetic with intraoral radiographs (X-rays) to detect hidden disease is required beginning very early in your cat’s life. If your cat does show signs, they may include pawing at her mouth, head shaking, or jaw chattering. She may chew with obvious discomfort, drop food from her mouth, swallow with difficulty, or drool excessively. The saliva may contain blood. Halitosis (bad breath) is also common.
“Dental disease and oral pain may account for some cats’ finicky appetites.”
Dental disease and oral pain may account for some cats’ finicky appetites. Many cats will refuse dry food or swallow it whole (no chewing) and demonstrate a preference for moist or canned foods. Some cats will have a decreased interest in food or may hesitantly approach their food bowl with reluctance to eat. This may lead to noticeable weight loss.
Untreated dental disease may cause:
The most common dental diseases in cats are periodontal disease and tooth resorption.
Periodontal disease is a term used to describe infection and associated inflammation of the periodontium (the tissues surrounding the tooth). Four tissues comprise the periodontium: the gingiva, the cementum (covering the root surface), the periodontal ligament (attaching the tooth root to the bone), and the alveolar bone.
Periodontal disease starts with gingivitis (with early inflammation of the gums). Gingivitis results from plaque (bacterial slime) that accumulates on the tooth surfaces and contacts the gingiva. Plaque is a biofilm and home to many thousands of bacteria. Some of this plaque is naturally removed during eating or by the cat’s tongue. However, plaque quickly builds without daily brushing and eventually (over 36-48 hours) mineralizes, forming hard tartar (also called calculus). Tartar has a rough surface to which plaque can “stick” more readily. Untreated gingivitis may lead to further inflammation of the other tissues of the periodontium. Progression of the periodontal disease leads to loss of tooth support and loss of the tooth.
“Progression of the periodontal disease leads to loss of tooth support and loss of the tooth.”
There may be other consequences of periodontal disease due to the loss of bone, including oronasal fistula (a hole from the mouth into the nose), jaw fracture, abscessation with draining tracts that develop in the mouth, on the face, or under the chin. Some studies indicate that the bacteria from a severe oral disease, which gets into the bloodstream, may also be associated with pathological changes in major organs, such as the heart, liver, and kidney.
As teeth erupt, there is an increased redness in the gums, and this is known as eruption gingivitis. This should resolve as development progresses.
Some cats, however, develop severe oral inflammation called stomatitis. This is a complex condition for which no specific cause has been identified. It is believed that cats who develop this disease have an extreme reaction to oral bacteria and plaque. The degree and extent of the ensuing inflammation can be excruciating, significantly lower the cat’s quality of life, and cause intense distress for the cat and her owner.
Treatment involves a detailed oral evaluation under general anesthetic, with intraoral radiographs and the extraction of any teeth affected with periodontitis, along with a thorough periodontal cleaning of the remaining healthy teeth. Afterward, various forms of therapy that combine medications, such as anti-inflammatories, antibiotics, or immunomodulators, and oral home care are instituted. Each cat is different, and medication choices can vary depending on the individual cat’s response. Studies have shown that up to 60% of cats can have their disease significantly decreased or even resolved, while 40% continue to struggle with varying degrees of oral inflammation.
Stomatitis cases are best referred to a board-certified veterinary dentist who can tailor therapy to the individual cat.