Dental disease affects all cats at some point in their lives. For at least half of cats, this includes painful resorptive lesions in one or more teeth. With these lesions, the enamel of the tooth is eroded away exposing the pulp of the tooth. The pulp contains the nerve and blood supply. Depending on the size of the lesion, this can mean mild to severe pain for your cat. Unfortunately, many cat owners are not aware that this is happening with their cat.
Few cats with these lesions stop eating or cry in pain. But there can be some subtle signs. Some owners do notice their cat eating more on one side of their mouth or preferring a different type of food. Some cats will prefer canned because it is easier to chew. Other cats prefer dry food because they can swallow it easily without chewing. Cats may exhibit behavioral changes such as not grooming well or exhibit a change in the interaction between cats in the house.
At some point many of the lesions can lead to the breaking of the crown of the tooth. Cats may show pain at this point because of the increase in severity of the pain. The pain may subside a little with time and the cat learns to deal with it and hide it again. But the cat is still most likely in considerable discomfort.
Unlike with human teeth, there is no way to fill these lesions like our dentists do with cavities. The best treatment for these lesions is extraction of the tooth to remove the source of pain. After removing the damaged tooth, the gum tissue is closed with sutures and heals well in a short period of time. After the extractions, most cats become more active due to the relief of their pain. They eat well even if many or all the teeth must be extracted. Our clinic cat, Kristina, has had all of her teeth removed and most of our clients can attest to how well she loves her hard treats.
Below are some photos and radiographs showing how teeth that appear healthy and normal can have problems discovered on closer examination.
In the first photo below we see, on first inspection, what looks like normal, healthy teeth (Photo 1). However, this cat has severe resorptive lesions not easily visible in a reluctant cat. Cats, as you might imagine, are usually not completely cooperative when their owner or veterinarian tries to look inside their mouth. Yet with a closer examination when the cat is anesthetized, we can see a lesion on an upper tooth (note the red discoloration in Photo 2). A complete oral examination under anesthesia following a dental cleaning enables your veterinarian to find these painful lesions and treat them.
Photo 1. The lip side of the premolar appears normal. (Click for close-up view)
Photo 2. Resorptive lesion on the tongue side of the upper third premolar is obvious during exam under anesthesia. (Click for close-up view)
Yet simple visual inspection will not show all problems in your cat’s teeth. To gain a complete understanding of your cat’s oral health, dental radiographs (x-rays) need to be taken on all cats undergoing a dental procedure to look for resorption of the roots of the teeth. Because the roots of the teeth are below the gum line, radiographs are the only way we can see the health of this part of the tooth. In this second cat, the entire root of the canine tooth (fang) was resorbing even though the crown of the tooth appeared normal to the eye (Photo 3). Under x-rays, however, we can see clearly that the root is almost completely resorbed (Photo 4). In Photo 4, the compromised fang is shadowy and barely visible. Compare this to a radiograph of a healthy fang (Photo 5), where the tooth is distinct and a solid white, showing us a solid root. The diseased tooth in Photos 3 and 4 would have eventually broken, resulting in severe pain for this cat. By performing oral surgery and removing the tooth during the dental procedure, he was saved from this outcome.
Photo 3. This canine tooth (fang) appears normal. (Click for close-up view)
Photo 4. Severe resorption of the root is obvious on radiographs. Note the barely visible outline of the tooth. (Click for close-up view)
Photo 5. Radiograph of normal canine tooth (fang) showing a solid white outline of the root.
Dental health represents a significant element in your cat’s overall health. Unhealthy, compromised teeth are not only painful (as any of us who have had a sore tooth can attest), but dental disease can also result in other, more widespread problems. Pain and discomfort can lead to poor nutrition and behavior problems, while bacteria from dental disease can lead to organ problems. These can be serious problems and not to be treated lightly. It is important to take care of your cat’s teeth to keep them happy and active.