Does Your Cat Feel Down in the Mouth?

Dental disease is likely to strike most cats at some point during their lives.

If your normally playful cat is moping around the house – quiet, reclusive, seemingly depressed – you naturally want to figure out what in the world is going on in the poor animals head. But youd be better off instead to try, with your veterinarians help, to determine what in the world is going on inside its mouth, since disease is more common there than anywhere else in a cats body. 


Signs of Trouble
According to Daniel T. Carmichael, DVM, a dental specialist at the Center for Specialized Veterinary Care in Westbury, New York, approximately 90 percent of all cats will experience some type of dental disease at one time or another.

Depression and lethargy are common indications that such a problem may be present, that your cat may indeed be experiencing pain and that the animal is doing its best to conceal its discomfort. In fact, the most common sign of pain is no sign at all. If noticeable, signs include red and swollen gums, bad breath (halitosis), weight loss, declining appetite (especially for hard food), dehydration and vomiting.

Feline Dentition 
Cats are born toothless. Like dogs as well as humans, they grow two sets of teeth during their lifetimes. The first set comprises 26 deciduous teeth, otherwise known as milk teeth. They start to appear when a kitten is about four weeks old, and the full complement is present about two weeks later. By the time the kitten is around six months old, the deciduous teeth have fallen out and been replaced by 30 permanent teeth – 16 upper and 14 lower. Collectively, the permanent teeth are shaped and arranged in the mouth to accommodate a cats carnivorous needs and desires, like catching prey, ripping it to pieces and chewing it up. Theyre also useful for self-defense.

There are four types of teeth: incisors, canines, premolars and molars. Each type differs in shape and size according to its principal predatory function. The incisors, located at the front of the mouth – six upper and six lower – perform a nipping function; next in line are the canines (or fangs) – two upper and two lower – that are good for grasping and puncturing; behind the canines are the premolars – six upper and four lower – that are built for gripping; and, at the back of the mouth, the molars – two upper and two lower-that are used for grinding.

Inside each tooth, explains Dr. Carmichael, is a chamber (the root canal) that contains a tissue – made up of blood vessels, lymphatic vessels and nerves – that communicates with the rest of a cats body. The pulp tissue in this chamber is surrounded by a bony tissue called dentin, which accounts for the bulk of a tooths structure. And covering the crown of the tooth (its outer surface above the gumline) is a layer of enamel, which protects the dentin. All of the tissues that constitute a cats tooth are vulnerable to disease or injury.

Serious Conditions
Four types of feline dental disease make up the vast majority of serious conditions affecting the teeth or the areas around the teeth. The following conditions frequently require treatment by a veterinarian and often require extraction of one or more teeth:

Periodontal disease is very common, affecting an estimated 85 percent of cats over the age of six. In this disease, layers of plaque accumulate and harden on the tooths surface. Bacterial toxins and enzymes from the plaque eventually prompt an inflammatory response in the gums (gingiva) that, if left untreated, leads to severe gum inflammation (gingivitis). In cats, advanced periodontal disease can quickly progress to an end-stage condition for which extraction is the only reasonable treatment option.

Feline odontoclastic resorptive lesions (FORL) is another comparatively common dental affliction, affecting an estimated 50 percent of cats. The lesions can progress rapidly and damage the tooth and its root irreparably. In Dr. Carmichaels opinion, any tooth with a FORL must be extracted.

Feline gingivitis/stomatitis syndrome (FGS) is relatively uncommon, occurring in about one in 100 cats. Cats with this condition frequently have marked pain and swelling of tissues within the mouth, especially near the back of the throat. The cause is unknown in most cases, and, although antibiotics and steroid therapy may be helpful in some cases, extraction of most or all teeth may be the only treatment option.

Fractured teeth may occur as the result of trauma or, less commonly, through chewing.  Doing nothing, Dr. Carmichael points out, leaves a broken tooth that is painful and a possible avenue for infection. Two treatment options exist for a severely damaged tooth: either extract it or perform an endodontic procedure, in which diseased root canal tissue is removed and the resulting cavity filled with an inert material.

Addressing the Problem
The only way to really find out whats going on in a cats mouth, says Dr. Carmichael, is to examine the animals teeth under general anesthesia and, if necessary, take X-rays. The cat will usually be anesthetized for as long as it takes to clean its teeth, do the examination and perform treatment as needed. If extraction is called for, the procedure should take from 45 minutes to an hour.

Unless a tooth is so deteriorated that it is ready to fall out, Dr. Carmichael extracts a tooth through surgical removal. We never just pull a tooth, he explains. Rather, we lift the gum tissue on the outside of the tooth and use a high-powered water-cooled drill to remove some of the bone tissue that is holding the tooth in the mouth. Then, with special instruments, we remove the tooth and sew the gums back together with dissolvable suture material. Any licensed veterinarian is qualified to clean, examine and extract teeth. According to Dr. Carmichael, the cost of an extraction, depending on the difficulty of the procedure, will typically range from $25 to $100.

In a root canal procedure, which is significantly more complicated and expensive, the goal is to preserve tooth function. The procedure involves surgically accessing the canal, filing and shaping its interior, and filling it. 

Shortly after either procedure, says Dr. Carmichael, the cat wakes up and goes home with a few days supply of pain medicine and possibly some antibiotics. Full recovery is swift, with the patient behaving normally again within a day or two.

Increased Risk
To an extent, says Dr. Carmichael, genetics plays a role in determining which cats are more susceptible than others to dental disease. He points out, for example, that purebreds – such as Abyssinians, Siamese, Maine Coons, Persians and Somalis – tend to be at greatest risk. But the overriding cause of dental problems, he says, can be traced to the modern cats diet, which tends to produce a dangerous superabundance of plaque and tartar.

The cat is a carnivore, says Dr. Carmichael, and his teeth were meant to be kept strong and clean by chewing up the flesh and bones of birds, rodents and other prey. Today, the cat subsists basically on a diet of the mush that we supply. We, as owners, are setting our cats up for serious dental problems.

These problems are compounded, Dr. Carmichael and other veterinarians agree, by a failure among owners to provide their cats with proper preventive dental care. Noting that plaque bacteria can colonize on a cats teeth within 24 hours, he recommends daily tooth brushing as the best thing you can do at home to promote good oral hygiene. He also points out that several commercial diets have been shown to significantly reduce plaque.

Owners can receive instruction from a veterinarian on how to approach the intimidating task of brushing a cats teeth as well as on the type of brush and toothpaste that should be used.  A veterinarian can also recommend brands of cat food that may be beneficial to dental health.

Perhaps most importantly, owners should see to it that their cats undergo a thorough dental examination at least once a year.