Veterinary Dentistry

21st Century Solutions for Modern Cats

Doctor Zap Plaque, Frontier Veterinary Dentist wont be on the television schedules this fall. There was no need for that profession in the 19th century, when cats with naturally cleaner teeth roamed the range, says one veterinarian who specializes in dentistry at the Cornell University Hospital for Animals (CUHA).

Back in pioneer days when cats had to hunt to survive, their teeth were used both for catching prey and for gnawing on hide, bone and cartilage, says Eric Davis, DVM, of the dental referral service at the CUHA. Of course, back then cats survived only a few years before parasites and disease caused weakness and death, so they didnt incur some of the dental problems we see in todays long-lived cats. But their teeth were probably in good shape.

While Davis does not advocate the outdoor, lunch-on-the-run life of feral cats, or even feeding indoor cats on bunny bones and hunks of mouse meat, he says the veterinary profession is developing new solutions to help modern cats teeth last as long as the rest of them. Almost any dental procedure available to humans may be helpful to cats, he notes, and today new-product developers are doing their part.

Braces for kids, and now cats?
I often get more than a raised eyebrow when specific treatments, such as root canal therapy or orthodontic procedures, are suggested, Davis says. My response is: Why should cats have to suffer with pain and infection from dental disease? If we can adapt dental therapies useful in humans to felines, why shouldnt we?

However, practitioners draw the line at what might be called cat cosmetic dentistry and will not work on teeth just so that Tigger can have as pretty a smile as her owner, Davis emphasizes. Nevertheless, many justifiable veterinary procedures – orthodontic correction, for example, when improperly positioned lower canine teeth produce a painful malocclusion and threaten to puncture the roof of the cats mouth – may help enhance a cats appearance as an added benefit.

Advanced training, improved skills
If this sounds as though the venerable profession of animal doctors is becoming more specialized, it certainly is, Davis says, and veterinarians with advanced skills and training can be certified by one or more professional organizations.

The largest is the American Veterinary Dental Society. Another, the Academy of Veterinary Dentistry, requires applicants to log their dental cases, write five papers for publication in different disciplines of dentistry (periodontics, endodontics, orthodontics, oral surgery, or restorative dentistry), and pass an extensive examination before they are named as fellows to join Davis and 70 others in the academy. Even less common are diplomates of the American Veterinary Dental College (AVDC), which requires three to six years of advanced dental training with a mentor. So far, there are only 59 diplomates of the AVDC worldwide.

To sleep, perchance to clean
Even a routine teeth cleaning for a cat, which most veterinarians can perform, is more complicated (and more costly) than our visits to the dental hygienist. The main difference is general anesthesia – usually a mixture of anesthetic gas and oxygen flowing through a soft tube, called an endotracheal tube, that passes into the cats trachea (windpipe). Assuming the cat passes preliminary tests to make sure internal organs can safely tolerate anesthesia, Tigger will sleep peacefully through X-rays, cleaning, and polishing.

Awake cats do not appreciate the vibration and noise from the polishing procedure, even though it actually tickles, Davis says from experience. And while awake humans will obediently sit for X-rays in the dentists chair, can you imagine how your cat would respond if I tried to place dental film in her mouth and told her to hold still while I left the room?

The endotracheal tube serves a second function by preventing the cat from inhaling harmful bacteria and bits of plaque and calculus that are loosened while cleaning tooth crowns and under the gum line, Davis notes. And polishing is necessary after cleaning, he says, to smooth roughened surfaces where bacteria could re-attach themselves to the teeth.

Even as new dietary dental-health aids reach the marketplace, the veterinary dentist says, We still believe that the best way to maintain oral health is to keep the dentition clean. It is the fine bristles of a toothbrush (but not the fat, rubber prongs of finger brushes) that do the best job in disrupting the slime layer of plaque that is responsible for gingivitis and periodontitis.

While not a substitute for regular brushing, specially prepared dental diets are one product-based strategy designed to clean the tooth surfaces mechanically. Davis explains: Stratified abrasive layers within the nuggets of cat food scrape the surfaces of the teeth as the food is chewed. In another development, one pet-food maker  has introduced foods that contain hexametaphosphate, which chemically binds to calcium and is said to prevent plaque from mineralizing into calculus, although independent assessment of the efficacy of this product is still pending, Davis says.

But does this stuff really work?
Independent assessment of pet products can now be made by the recently established Veterinary Oral Health Council (VOHC), which, like human dentistrys Council on Dental Therapeutics, will confer the VOHC seal on products and treatments that prove to do what the manufactures claim they do. Although there are many treats and chews being marketed as being beneficial for the teeth of cats, these claims are unsubstantiated until they are independently reviewed, Davis advises.

Some of the newer dental diets can be useful adjuncts to brushing the cats teeth daily, Davis says. But merely using sprays in the mouth or applying a dentifrice on the finger and rubbing into the gums does nothing to disrupt plaque.

Materials science to the rescue
One new development veterinary dental specialists have available is a synthetic bone graft material for treatment of periodontal disease. According to Davis, The treatment employs tiny ceramic particles coated with hydroxyapatite, which has a chemical composition similar to that of natural bone. The material is placed – after thorough cleaning and tissue preparation – into deep periodontal pockets that have formed between tooth and bone. This synthetic bone graft material helps to re-form a bony attachment to teeth that otherwise would either be lost or require extraction.

If that doesnt work, the veterinary dentist offers some advice that surprises many cat owners: Household pet cats can survive just fine without a single tooth in their mouths. If they dont have to catch their dinner and we provide a nutritionally complete ration of softened food, teeth are not actually necessary for survival.

But even that toothless state – with cats gumming their way into the 21st century – cant be achieved, the veterinarian says, without some dental care to prepare Tiggers smile for the future.