Feline Dental Disease
Cats, like dogs, commonly have oral disease. Often, feline dental disease has symptoms that can be confused with other diseases which affect their health. If your pet is not eating or is inappetent, this becomes a serious problem even if it is only for a short amount of time. Unlike a dog which can go for days without eating, cats that do not eat, quickly develop changes of their liver which become life threatening.
Although a lack of appetite can be a sign of systemic disease affecting other body systems, not eating due to oral pain has a very specific behavioral pattern. The cat will frequently approach their bowls acting hungry but do not consummate their meal. If they do eventually take a bite, they will often either flip their heads side-to-side when chewing or drop their food and walk away. This painful pattern of chewing or attempting to gulp their food to minimize chewing often triggers them to vomit. The inability to eat because of oral pain subsequently causes chronic weight loss, or worse, liver failure.
Stomatitis is an inappropriate, abnormal, hyperimmune response to bacterial plaque; we suspect it may also be an aberrant response to some common cat viruses. It is characterized by moderate to severe inflammation of the mouth. Stomatitis is typically identified as severe inflammation extending above the gum tissue involving the mucosa of the cheeks and in some cats involves the tissue of the back of the mouth and throat. Typical signs of stomatitis are foul breath, not eating, staring at the food bowl, vocalizing when eating, will only eat soft food, or will only lick the gravy off soft food. Initial treatment of stomatitis is extraction of all of the cat’s teeth, as there is no way to prevent plaque formation, even with the most judicious daily tooth brushing and frequent professional dental cleanings. The good news is the majority of cats with feline dental disease such as stomatitis, that have full mouth extraction, do very well and frequently do not require long-term medications to have a comfortable mouth. Cats without teeth can even eat hard food after their mouth is healed from surgery! Some cats with stomatitis do continue to have inflammation despite surgery, thus it is very important to have surgery as soon as possible to reduce the inflammatory immune response.
Feline Tooth Resorption
Tooth resorption is a process where dental structures are resorbed or removed and degraded by the body. Tooth resorption causes the tooth to breakdown and exposes dental nerves, causing oral pain. Two-thirds of cats that present to their veterinarian for signs of oral pain are affected by tooth resorption. If you notice your cat eating on one side of the mouth, turning the head when eating, dropping food, staring at the food bowl, running away in the middle of a meal, vocalizing when eating, and making a mess when eating, these are all signs of oral pain. Any cat can develop tooth resorption at they age, and some may not have obvious signs of oral pain. Some cats are exceptionally good at hiding their discomfort. A thorough oral exam will help identify tooth resorption, but in most cases an anesthetic examination with diagnostic imaging (radiographs or xrays) is the only way to confirm teeth with tooth resorption.
Feline Periodontal Disease
Periodontal disease, or gum disease that can progress to bone loss and tooth loss, is an infection from bacterial plaque of the supporting structures that hold the teeth in the mouth. These structures are the gum tissue (gingival), the periodontal ligament, the tooth root (cementum), and the jawbone. There are 4 stages of periodontal disease. Stage 1 is identified as gingivitis, or the swelling and inflammation of the gum tissue with bleeding when touched with a toothbrush. Stage 2 is identified as up to 25% percent loss of bone and gingiva. Stage 3 is identified by 25-50% bone loss. Stage 4 is identified by greater that 50% bone loss. Feline dental disease is typically characterized by tartar build up, gum recession, exposed roots, and foul breath. Teeth with stage 4 periodontal disease may be loose and may fall out! The best prevention for periodontal disease is daily tooth brushing with routine professional dental cleanings performed by a veterinarian.