Affected Animals:
All animals can suffer from oral or dental disease, but only cats develop external root resorption with chronic gingivitis or periodontitis.

Overview: Dental disease is a common feline illness, but it often goes undetected. Few cats are willing to keep their mouths open long enough for their owners to search for evidence of a potential problem.  It is essential to take a cat to the veterinarian for regular check-ups so that any signs of dental disease will be identified while in their earliest stages.

As with humans and other animals, cats frequently get diseases of the gums and teeth. Build-ups of plaque and tartar cause  gingivitis and periodontitis. Also, feline diseases such as kidney failure, feline leukemia virus, and feline immunodeficiency virus can lead to dental disease. 

Unlike any other animal, however, cats can develop a potentially serious dental condition called external root resorption, sometimes called "neck" lesions, in which holes or cavitations form in the teeth at the gumline.  Chronic gingivitis and periodontal disease can cause external root resorption.  This condition, which can be intensely painful for the cat, sometimes will lead to the tooth breaking off, leaving the root behind.  A common dental disorder affecting up to 50 percent of domestic cats, external root resorption can be treated and possibly prevented through good dental care.

Most dental problems can be prevented through professional dental cleanings performed by a veterinarian. Certain cat foods also can aid in the prevention of tartar. Cat owners should consult a veterinarian about providing feline dental hygiene.

Clinical Signs:
Typically, the clinical signs of dental disease include ptyalism, dysphagia, halitosis, pawing at the mouth, and oral lesions.  There can be less specific clinical signs of dental disease such as anorexia, inappetence, fever, dehydration, vomiting, and lethargy.  Cats with dental disease also may stop grooming and develop an unkempt hair coat.  Because chewing can be painful, animals may begin to prefer soft cat food to harder varieties.

Symptoms:
Foul breath, drooling or salivating more than normal, difficulty eating, pawing at the face, and sores in the mouth are common symptoms of dental disease.  Some cats may have less specific clinical symptoms such as loss of appetite or decreased appetite, vomiting, laying around more than usual, and less interest in grooming resulting in unkempt fur.  Because chewing can be quite painful, cats with dental disease may begin to prefer soft cat foot to harder varieties.

Description:
Dental diseases effect all animals -- including humans -- but cats can develop certain dental problems that are unique and very painful. All animals develop bacterial plaque on their teeth, which hardens to form calculus or tartar. The calculus then leads to inflammation of the gum tissue called gingivitis. As the gingivitis worsens, the gums begin to become swollen, easily damaged, and can bleed.

Without treatment, the gingivitis progresses to periodontitis. This is a condition where the inflammation goes beyond the gumline and extends deep into the tooth pocket and jawbone in which the teeth rest. Bacteria often overgrow and can cause an infection called an abscess. Periodontitis is a very painful condition for cats and they will usually show signs of discomfort when the dental disease has reached this stage. Cats can develop a condition unique to them called external root resorption, commonly known as "neck" lesions. When this condition occurs, inflammatory substances begin to eat away at the tooth, forming cavitations or holes along the gumline and leaving the sensitive part of the tooth, the dentin, exposed and easily stimulated. At this point, the tooth may become weak and break off, leaving the roots behind in the bone. The roots can become attached to the jawbone by the continuing bony reaction, resulting in pain and discomfort. Some cats can develop another severe dental disease called stomatitis, which is the formation of painful ulcers in the mouth. This condition can accompany severe gingivitis and periodontitis, or it can occur because of other diseases such as calicivirus, feline leukemia virus, and feline immunodeficiency virus. Every cat with stomatitis should be tested for these viruses.

Diagnosis:
The veterinarian will obtain a thorough history of the cat's health and perform a complete physical examination.  The cat may need to be sedated so that the veterinarian can examine its entire mouth for abnormalities such as ulcers, cancerous masses, gum disease or gingivitis, broken bones or teeth, and foreign objects such as string found under the tongue.

Other tests that may be done include a complete blood count, or CBC; a blood chemistry profile, which will detect problems with the function of organs such as the kidneys, thyroid, and liver; a urinalysis; and tests for feline leukemia virus and feline immunodeficiency virus. Many diseases that affect the organs can cause problems with the mouth, such as ulcers.  The veterinarian may need to take x-rays of the head to see if there are any problems with the teeth and the bones surrounding the teeth.

Prognosis:
With good dental care and routine dental cleanings, most dental problems can be cured or controlled.  Cats with underlying diseases may have persistent or recurring bouts of dental disease.

Transmission or Cause:
The causes of dental diseases include poor dental hygiene, poor nutrition or a diet that does not aid in the mechanical break-up of tartar, and teeth that are not aligned properly.  Many underlying illnesses including kidney failure, feline leukemia virus, and feline immunodeficiency virus, also can cause dental problems.

Treatment: Treatment always begins with a professional dentistry performed by a veterinarian.  The cat is placed under general anesthesia to allow the teeth to be cleaned, polished, and checked for any abnormalities.  Sometimes the veterinarian will need to remove teeth to prevent future problems with pain or infections.  Antibiotics occasionally are given to cats with severe gingivitis or periodontitis.

Home dental care often is very helpful in decreasing dental plaque and tartar; it also stimulates the flow of blood to the gums.  Veterinary toothpaste must be used because human toothpaste foams and can cause vomiting when swallowed.  There are various fluoride gels that can be applied topically to the teeth to help prevent gum disease. A veterinarian can provide information about the different products that are available for home dental care and can set up a plan to maintain good dental care for the pet.

Prevention: To help prevent the common dental diseases -- gingivitis and periodontitis -- it is important to provide good oral hygiene, maintain good health, and provide a quality cat food that is well balanced and helps keep the teeth clean.  Generally, hard, dry cat food is better at breaking down tarter and plaque than soft varieties, but talk to a veterinarian about which of the different diets that are available might be best for the cat's dental health.

Home care of the teeth is very beneficial in reducing the amount of plaque and tarter buildup.  Owners can attempt to brush their cat's teeth with a small toothbrush and toothpaste made especially for animals; human toothpaste can make animals sick and should never be used on cats.  Unfortunately, most cats will resist having their teeth brushed or their mouth examined, so it is often necessary to have the teeth evaluated professionally every year and cleaned by the veterinarian as needed.