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Published on August 15, 2016
Cats can suffer from the formation of painful cavities in their teeth. Unlike the cavities in our teeth, which are the result of bacterial invasion of the periodontal tissues and subsequent tooth decay, cats suffer from resorption of their teeth.
TOOTH RESORPTION – THE PROCESS
Tooth resorption is a poorly understood metabolic disease which begins in the tooth, not in the surrounding gum tissue. The microscopic structure of the tooth actually changes, causing the tooth to melt away. When this happens below the gumline in the root of the tooth, the defect may or may not be painful to the cat. In some cases, the resorbing root will become replaced with hard calcified tissue and become undistinguishable on X-ray from the surrounding bone.
If a resorptive lesion develops in the crown of the tooth, where it is exposed and quickly infected by bacteria, it will be painful. Cats with these lesions may eat with their heads tilted to one side to avoid chewing on their painful tooth, may begin to drop food outside of their dish, or begin to refuse dry food. In most cases, however, there are no obvious symptoms. Many cats will live for years with painful mouths. In some cases, after prolonged resorption of the crown, the visible part of the tooth will break off or be dissolved entirely. The gum tissue will then grow across the remaining tooth root and the tooth will appear missing on oral exam.
WHY DOES THIS HAPPEN AND WHAT CAN WE DO?
The cause of tooth resorption in cats is not known. The disease has been documented extensively only in the last few decades. Whether this is because it is a relatively new disease or whether it was just discovered because of the increased focus on dental care in both dogs and cats in the last 20 years is unclear. One study linked tooth resorption to high levels of Vitamin D in commercial pet foods. Another found no correlation between diet and disease. Research continues, but our understanding of the disease remains poor.
As the cause is unknown, tooth resorption is not a preventable disease. Once it is present in a patient, our entire goal is to eliminate pain for the cat. The only treatment for resorbing teeth is extraction, or at least removal of the crown of the tooth if the root is completely resorbed and indistinguishable from bone. Extractions can involve fairly complex oral surgery. Once the teeth are removed, the gum tissue is sutured over the extraction sites. Cats undergoing extractions will be sent home on pain medication, but antibiotics are rarely necessary. Your cat’s mouth should be rechecked several weeks after the extraction to make sure healing is complete.
ROUTINE ORAL EXAMS — UNDER ANESTHESIA — ARE ESSENTIAL
Tooth resorption is now a very common problem seen by veterinarians. Cavities can be visible on exam, usually distinguished by a flap of gum tissue growing up the side of the tooth, trying to wall off the defect below. A patient may have missing teeth without any history of previous dental care. In most cases, however, these painful lesions are found only when the cat is anesthesized for a routine comprehensive oral health assessment and treatment (COHAT). Deep probing of the teeth and whole mouth X-rays, which can only be done under general anesthesia, are necessary to fully diagnose the extent of the disease.
Concerns about anesthetic risk as well as expense make many owners reluctant to have a COHAT performed as frequently as is recommended. While these concerns are reasonable, remember that delaying full examination may mean more extended discomfort for your cat. Discuss your concerns with your veterinarian today as the first step towards a healthier mouth for your feline friend.