Bay Hill Cat Hospital
Client Education Series #5
Feline Oral Education
Introduction:
A cat grows two sets of teeth during its lifetime. The first set comprises 26
deciduous teeth, otherwise known as baby teeth. They start to appear
when a kitten is about four weeks old, and by six weeks of age or so, the
full complement is present. By the time the kitten is about six months old,
the deciduous teeth will have fallen out and been replaced by 30 adult
teeth - tailor-made by Mother Nature for catching prey, ripping it to
pieces and chewing it up. They're also useful for self-defense.
Common terms:
Gingival = tissue over the bone and is the first line of defense
Periodontal = tooth supporting structures made up of Bone, Ligaments
and Associated structures
Tooth made up of Enamel, Dentin, Root, Root canal with vessels
Plaque is bacteria mixed with glycoprotein's that form a film on the teeth
Calculus is when the plaque mineralizes to a hard shell.
Diseases of the mouth:
Feline gingivitis: The gingival tissue overlies the bony alveolar processes of
the maxilla and mandible and surrounds the tooth. It is the first line of
defense against periodontal disease protecting the bone and supporting
tooth structures. Any inflammation of these tissues is termed gingivitis. Both
gingivitis stages one and two are reversible with professional care and a
daily client periodontal maintenance homecare program.
Feline periodontitis: A disease of the tooth-supporting apparatus that
occurs in 85% of cats over 4 years of age. Inflammation of these tissues
leads to progressively destructive changes and loss of bone and
periodontal ligament. Attachment loss can be minimal to very extensive,
with greater than 50% bone loss defined as stage three and four.
Radiographic changes of horizontal, vertical, furcation and oblique bone
loss are common. Oral radiology diagnostics are essential in proper
diagnosis and treatment of feline periodontitis. Inflammation from plaque
bacteria leads to many pathologic changes of soft tissue, bony tissue.
Periodontitis is an irreversible form of periodontal disease that can be
controlled with professional care and exceptional individualized client
periodontal maintenance homecare programs.
Resorptive Lesions: Many names have been assigned over the years to this
pathology, including feline resorptive lesions, feline dental resorptive
lesions, feline odontoclastic-osteoclastic resorptive lesions, subgingival
resorptive pathology and feline cervical resorptive lesions. Since we now
find these lesions in multiple species, this lesion is currently referred to as
Tooth Resorption.
The etiology of these lesions is unknown and they are commonly found at
the cementoenamel junction of the tooth just under the gingival margin
covered with hyperplastic gingival. Minor lesions can progress leading to
pulp involvement, root resorption and the crown being dissolved.
Radiography is essential for diagnosis and treatment. Many times, lesions
can be identified below the gum line only with radiology. We never try to
touch these teeth in an awake patient to search for these lesions instead
we use general inhalation anesthesia with preemptive pain control to
prevent further wind up in your cat. If exploration without anesthesia is
attempted it will precipitate a severe pain reaction if the lesion is in into
the pulp tissue.
All cats should undergo full-mouth oral radiology for periodontal
assessment and to examine for resorptive pathology; resorptive lesions are
non-restorable lesions with extraction being the course of treatment as the
lesions approach pulp tissue.
Feline gingivostomatitis (FGS) also known as Lymphocytic-plasmacytic
gingivitis/stomatitis (LPGS) syndrome or Feline oral inflammatory disease is
a severe oral disease that affects some cats where the body becomes
allergic to plaque around the teeth. The allergic response appears as
marked inflammation at the area where the tooth meets the gum line.
While the specific cause of FGS is unknown, it is not believed to be related
to feline leukemia virus, feline immunodeficiency virus, sex, spaying or
neutering, or diet. Some bacteria may play a role in the severity of the
disease. Severe inflammation around the teeth exists with FGS. In many
cases there are also inflammatory lesions in the back of the throat
(stomatitis). Affected cats may have difficulty chewing hard food. Oral
pain may cause a decrease in self grooming, resulting in a scruffy hair
coat. An examination usually reveals inflammation completely
surrounding the teeth. The maxillary and mandibular cheek teeth are most
commonly affected. In severe cases, the canines and incisors are also
involved. In 20% of affected cats, the pharynx appears cobblestone red.
There are many options that may give short-term response including
antibiotics, steroids, laser therapy, as well as interferon and other immune
modulators. Extraction of the teeth behind the canines will resolve
approximately 60% to 80% of the stomatitis cases leading to a prognosis
that is good to excellent.
By having your cat’s mouth checked twice a year, at regularly
scheduled exams, early problems in the mouth can be identified and
treated before more severe health issues arise.