Feline Dental Disease

by
Pierre Tung, DVM
Bridgeton Animal Hospital & Dental Service

The current status of feline dental disease consists of several well recognized conditions. Proper and aggressive treatment of these conditions can greatly contribute to the well being and longevity of the patient.

Some conditions are similar to those experienced by humans, while others are unique to felines. The most common condition seen in cats is gingivitis and periodontal disease secondary to plaque and tartar accumulation on the teeth. As in humans, plaque and tartar contain high concentrations of bacteria which cause inflammation and eventual damage to the gums (gingivitis) and as this is allowed to progress the inflammation destroys the bony tissue which anchors the tooth in the socket (periodontitis). In addition to the local damage to the oral tissue, these high concentrations of bacteria enter the bloodstream through the gingiva resulting in cardiac, liver and kidney involvement. Frequent, regular dental cleaning is the key to preventing this conditions from becoming irreversible problems. Keep in mind, virtually any dental procedure must be performed while the patient is under general anesthesia. While there is no "perfect' anesthetic agent, the newer inhalant anesthetic agents truly increase the safety margin.

Feline lymphocytic, plasmacytic gingivitis (LPG) is a condition unique to cats that is seen fairly frequently. This condition is characterized by an exaggerated inflammation of the gum tissue in response to a relatively mild accumulation of plaque. The gingival tissue is also very thickened and painful. Sometimes the affected tissue may extend all the way back to the tonsillar area. These patients should be checked for Feline Leukemia, Feline Immunodefiency Virus, and other possible metabolic disease (kidney failure). Most cases of LPG are thought to be some form of immune reaction to relatively low concentrations of bacteria in the plaque. Early cases can sometimes be managed with frequent cleaning, steroids, and antibiotics. Eventually most cases become chronic and non-responsive to this form of treatment. Therefore, the best current long-term treatment for this is total extraction. Although this may sound extreme, by eliminating the surfaces on which plaque is allowed to accumulate, the gingival reaction ceases. Furthermore, by stopping the chronic inflammation, the potential systemic effects are also limited.

Feline odontoclastic resorptive lesions (FORLS) are a form of spontaneous tooth resorption seen in middle age and older cats. These lesions are cavity-like erosions which develop at the gum line and progress inward and toward the ends of the roots. These are very subtle in appearance yet quite painful. Unfortunately, because of their insidious onset, by the time these are found they can be fairly advanced and can only be treated by extracting the affected tooth. To date, there is no known cause.

Clearly, felines are susceptible to several different types of dental conditions. Symptoms of the above mentioned conditions can vary. Gingivitis and periodontitis often present as halitosis (bad breath) and occasionally excess salivation and difficulty eating. Lymphocytic gingivitis also presents as severe bad breath and is usually very painful. Odontoclastic resorptive lesions are very subtle and often painful. Occasionally these lesions may cause difficulty eating or if the lesions are advanced, can result in premature tooth fracture.

Preventive measures are most effective for gingivitis and periodontitis. Regular brushing with small brushes, finger brushes and sponge-type devices are often helpful, but must be done on a very regular basis. The only effective dietary management is with the use of Hills Feline T/D diet, but ONLY after the teeth have been professionally cleaned.

And please keep in mind that regular dental exams are helpful to prevent localized dental conditions as well as systemic problems which can arise from dental disease.

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