Dental and other oral diseases are very common in cats. Specific diseases include gingivitis-periodontitis, tooth fractures, resorptive lesions, stomatitis, and alveolar bone expansion.
When we talk about "dentals" in cats, it's never just a "dental cleaning". Since most dental disease involves pain and suffering, our goal is always to treat disease.
We should note that we still call dental procedures "dentals" - this is our web-page on what a "dental" includes. Some veterinarians prefer to use the less idiomatic acronym "COHAT" to describe the procedure.
Severe Dental Disease in a Cat
This photo illustrates several types of dental disease that cats can develop.
Although this cat had a very painful mouth, she didn't show any signs.
Yellow Arrow: Tartar
Green Arrow: Gingivitis
White Arrows: Tooth Resorption
Blue Arrow: Missing Tooth (area of previous tooth resorption)
Red Arrow: Broken Tooth
Orange Arrow: Alveolar Bone Expansion
Black Arrow: Gum Recession
Gingivitis-periodontitis is inflammation of the gums and other support structures of the teeth. It is due in part to accumulation of plaque and tartar. Gingivitis can be partially prevented by removing plaque. This can be done most effectively by brushing a cat's teeth.
It is easier to start when they are kittens. If you start when cats are older, it is best to have an examination done first to make sure that there aren't any painful teeth in the mouth.
A cat's teeth with tartar and secondary gingivitis / periodontitis.
Dental Foods and Treats
There are cat foods and treats that are intended to help decrease plaque formation.
We don't usually recommend any of these because when they are tested scientifically, they are compared to other dry foods.
Also, no long term studies have been done on the traumatic effect these hard foods have on the relatively delicate teeth of cats.
Until the dental treats and foods are compared to canned foods without any carbohydrates, and shown to be beneficial long term, I am going to withhold judgment on their value.
Brushing Your Cat's Teeth
Cornell University has a series of videos on brushing a cat's teeth. This fourth and final video is the actual description.
Fractured or broken teeth are commonly found in cats - usually due to trauma or disease of the tooth. If left untreated, these fractures commonly lead to infection and pain. As with most conditions in a cat's mouth, the cat is usually fairly good at hiding the resulting pain. As a general rule, if a tooth is broken, it should be radiographed (x-rayed) and treated appropriately.
Tooth resorption in cats results in FORLs (Feline Odontoclastic Resorptive Lesions - AKA Feline Oral Resorptive Lesions).
These are very common and easily missed on physical examination.
These resorptive lesions are very painful holes that form in teeth. The only effective treatment is to remove the affected teeth.
The word stomatitis means inflammation of the mouth and when we talk about it in cats, we are referring to a syndrome that causes extensive chronic inflammatory disease. We don't know what causes stomatitis it but it is usually only effectively treated by extracting most or all of the teeth. There are other things that can help but they usually just serve to delay treatment and delaying treatment can worsen the prognosis.
Stomatitis is one of the "secret diseases" that we see in cats.
Stomatitis in a cat.
The most effective treatment for feline stomatitis is to remove all of the teeth.
When we discuss removing all of a cat's teeth, people worry about pain, the ability of the cat to function and eat, the expense, and the cat's appearance.
Affected cats appear to be in significantly less pain immediately after the surgery. We feed our patients as soon as they wake from the anesthesia and most eat more aggressively than they did before surgery.
When the mouth is no longer painful, cats are able to eat, groom, and play more easily. We have some stubborn patients who still eat dry food, even though they have no teeth.
I don't have a good answer for this. To properly remove all of a cat's teeth is an involved, time consuming process that requires a number of people and expensive equipment. It's expensive.
Here are pictures of four different cats. It is difficult to impossible to tell who has teeth and who doesn't until the mouth is open. (By the way, the photos of Savannah were taken 9 days after her teeth were removed for severe dental disease. In the open mouth photo, you can see a dissolving strand of suture.)
Alveolar Bone Expansion
Also called alveolar osteitis, this is a commonly seen condition in cats. It usually manifests as a swelling of the gums around the upper canine teeth (fangs) and is a reaction of the bone, usually to diseased teeth. When seen, it is an indication that there is an underlying problem that should be addressed. A lot of times the affected teeth are best treated by extraction, either because of resorption or infection.
Alveolar bone expansion of the upper left canine tooth in a cat.