Dental disease is the most common problem we diagnose
in cats of all ages. In fact, by the age of three years 70% of cats
show some sign of a dental problem.
Although controversial, some studies have shown that the consequences of
periodontal disease can be very serious. Besides the obvious discomfort and
bad breath that gum and tooth disease can cause, there is evidence linking
poor oral health with weight loss, kidney and even heart disease. Because
of this, good preventative dental care is one of the most important steps
you can take to ensure a long, happy, healthy life for your cat.
Causes of
Dental Disease
Dental disease follows a specific sequence that,
left untreated, can result in tooth loss or more serious disease.
The
first step is the formation of plaque. Plaque is a colorless film
on the teeth that contains large numbers of bacteria. This
is what people routinely
brush their teeth to remove. Because cats do not generally have their teeth
brushed, this plaque often hardens into tartar. Tartar usually starts at
the gumline,
and causes inflammation that is known as gingivitis. Gingivitis is easily
seen as redness where the gums meet the teeth. As the inflammation
of gingivitis
progresses, the gums and tissues that support the teeth are destroyed.
This leads to painful
feline odontoclastic resorptive lesions (FORLs) and eventually, tooth loss.
FORLs will be discussed later.
Contributing Factors
- Poor oral hygiene. Imagine what our teeth
would look like if they were never brushed and we never visited
the dentist. Cats
need regular veterinary
dental
checkups and cleanings, just like you.
- Breed. Overcrowded or misaligned
teeth can contribute to the buildup of periodontal disease.
Certain cat breeds, such as Abyssinian and
Somali, are
more likely
to develop periodontal disease.
- Age. Periodontal disease is more
common as cats get older.
Signs of Periodontal Disease
- Bad breath
- Dribbling saliva
- Bleeding gums
- Subdued behavior
- Tooth loss
- Pawing at the mouth
- Buildup of yellow-brown tartar
- Change of chewing or eating habits
- Pain when eating
- Refusing to eat
- Most cats have no noticeable signs of a problem
until they are probed under anesthesia
Feline Odontoclastic Resorptive
Lesions (FORLs)
Feline odontoclastic
resorptive lesions are a type of cavity that only cats develop.
These cavities
occur right
at the
gumline, and are almost
impossible to detect
in the un-anesthetized cat until they are
very advanced. These lesions are extremely painful,
with some degree
of discomfort present even
at
the very early stages.
FORLs are a very serious form
of periodontal disease. These cavities generally cause the teeth
to become
very brittle,
and
left untreated, most of these
teeth will end up breaking, leaving the
roots behind. This can lead to severe pain,
and occasionally to a disease called lymphocytic
plasmacytic stomatitis. This condition is generally
believed to be one of
the most painful
diseases recognized
in feline medicine, with the discomfort
sometimes becoming so excruciating that a feeding tube must be
placed to allow for
nutritional support.
FORLs can appear as early as
two years of age. It is our goal, with regular dental care, to
prevent these
lesions
from occurring. However,
most cats
will develop
some of these lesions as they age, regardless
of the level of care. When they do develop, treatment
options are very
limited.
In the
case of very
early lesions,
a dental prophylaxis may slow the progression,
but cannot reverse the damage that is already done.
Most of the
time these
lesions will eventually
become
deeper and cause discomfort. For lesions
that are
already causing
pain, the only treatment
option we can offer is extraction. Although
extraction seems extreme, in most cases cats return
to a much more
comfortable state within
days of
surgery, causing many owners to remark
that they had no idea
how uncomfortable their
pets were
before until they got to see the difference.
Other
treatments, such as restorations with glass ionomers or composites,
have
been attempted
and
are being applied
with some
success by
veterinary dentists.
We cannot offer these services at Albuquerque
Cat Clinic as they require advanced
training in veterinary
dentistry.
If
you are
interested in
restoration for
your cat’s FORLs, please let
us know and we would be happy to refer
you.
Your Cat’s Dental Prophylaxis
We do not believe that what
happens while your cat is here should be
a mystery
to you. For
that reason,
following
is a complete
list of
the procedures
that
will be performed when your cat
comes to us for a dental prophylaxis.
- We perform a pre-anesthesia
physical exam. This involves listening to
your cat’s heart and lungs,
doing an oral exam if we have
not already done so, and obtaining
your cat’s vital statistics
to establish a baseline for
during and after the procedure.
- We
draw blood for pre-anesthesia
lab work, if requested. We
have in-house testing equipment,
so your cat’s blood
tests will be run prior to
the administration
of any anesthetic drugs.
This allows us the maximum
flexibility
in our anesthetic
protocols. In some rare instances,
we may not be able to obtain
a blood sample prior to administering
pre-anesthetic medications.
In these cases, we give a
mild sedative so that your
cat will allow a blood draw
to occur,
and then run the tests before
complete anesthetic induction.
- A pre-anesthetic injection
is given. This injection sedates
the
cat, thus
reducing stress, and starts
the pain management
process.
- An intravenous catheter
will be placed and IV fluids started.
This
requires
that we clip
a small
spot
of hair on one of
your cat’s front
legs. IV catheters allow
the administration
of further IV injections
without causing
pain and distress in your
pet. It also gives us a
venous port
to administer emergency
drugs if necessary. IV
fluids containing
pain medication are administered
to help maintain blood
pressure to support internal
organ health,
as well as to prevent dehydration
and continue the pain management
process.
- General anesthesia
will be induced. This is
accomplished by an injection
of drugs
intravenously. The cat
is then intubated, which
allows the
delivery of
a gas anesthetic to keep
your cat asleep for the duration
of the
procedure and
prevents aspiration
of the water
and bacteria
that
will be in your
cat’s
mouth during the cleaning.
We use safe and modern
anesthetic protocols that
provide for
pain control. Most pets
wake up minutes after procedures
are completed.
- Monitors will
be hooked up. Immediately
upon induction,
your cat will be
hooked up to monitors
that tell
us the heart rate,
respiration
and
blood oxygen saturation
so that we will know immediately
if there is any change
in your cat’s condition.
- The
teeth are brushed with
an antiseptic solution to reduce
bacterial
spray
during the procedure.
- The
tartar is scaled off the teeth. Most of this is
done with
an ultra-sonic
scaler
similar
to the
units used in
human dental
offices.
Some of it
is done with hand instruments.
After the crown, or
part of the tooth you can
seem,
is cleaned, we clean
above the gums with very specialized
instrumentation.
- The teeth
are polished with a pumice-containing
paste that
makes
them smooth, and
thus more difficult
for bacteria to
cling to.
- We rinse
the mouth thoroughly with an antibacterial
oral
hygiene rinse.
- A
fluoride treatment is applied to decrease
tooth sensitivity
following treatment.
- The teeth and gumline are probed to detect
any evidence
of FORLs,
fractures,
periodontal disease,
or other
problems. A
diagnostic
and treatment plan is formed specifically
for
your cat.
- Radiographs
are taken as needed
to determine
if there
are further
problems
below the
gums. Attempting
to perform
dental treatment
without appropriate
x-rays would
be similar to your
doctor trying
to set
a broken
leg without
x-rays.
- Diseased
and painful teeth
are extracted.
At this
point, we try
to contact
you if you have
requested
that we do so prior
to extractions.
If you
are not available,
or
have
not requested
that
we call,
we will proceed
according
to our best judgment.
We place
blocks with local
anesthetics
to numb
the mouth
and prevent pain
upon waking.
Extracting
teeth requires additional
time and
skill. It is a surgical
procedure
which involves very
specialized
equipment and knowledge.
Only the
doctor will extract
teeth.
The gums are stitched
together
after the
teeth are
extracted with a very
fine, absorbable
suture
material that will
dissolve
within 2-4 weeks.
- Additional
pain
medication is administered
if
necessary.
- An antibiotic is prescribed
if
there have been
any
extractions to prevent
extraction
sites
from
becoming infected.
- Your kitty goes
home
the
same day
in
the afternoon.
Sometimes
we
will send
home
medication for continued
pain
relief, and if
any
teeth have
been
extracted we will
recommend
feeding
a
soft food
diet
for the next
3-5
days while
the gums heal.
- You
will receive
a follow-up visit
at no additional
charge in
2 weeks to
evaluate healing
and discuss
home care
to help prevent
future problems.
If
you
have
questions
about
any
step
in
this
process,
please
feel
free
to
ask
Kathy
or
Dr.
Walker.
We
want
you
to
feel
comfortable
with
the
process
of
good
dental
health.
Please
do
not
hesitate
to
express
any
concerns
that
you
might
have,
and
we
will
do
our
very
best
to
set
your
mind
at
ease.
Thank
you for
trusting Albuquerque
Cat Clinic
with the
care of
your feline
companion.
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