Cavities in Cats

Cavities in cats, defined as periodontal disease, is the shearing off and degradation of the tooth at or below the gum line resulting in painful, bloody lesions as well as destruction of the entire tooth structure. The most common type of periodontal disease is tooth resorption (absorption back into the body), although there are several other kinds of periodontal disease in cats.

Cavities in cats are not the same as cavities in humans. While it is an extremely common condition and is believed to be found in 85% of all cats aged three years and older, it is identified more as periodontal disease rather than simple cavities or decay. If left untreated, periodontal disease can become more severe as the cat ages. Bacteria in the mouth creates a buildup of plaque and tartar on the teeth which, over time, can affect the health of the tooth, the entire dental structure, and possibly even the rest of the body.

Symptoms of cavities in cats often include:

• Bad breath that gets more severe over time
• Drooling
• Bleeding from the mouth
• Vomiting of unchewed food
• Pawing at the mouth
• Eating on one side of the mouth only
• Food falling frequently from the mouth 
• Nasal discharge
• Bloody spots on the tooth where it meets the gum line
• Weight loss

Less apparent symptoms:

• Increased sleep
• Decreased daily activity
• Diminished appetite
• Irritability

Symptoms of periodontal disease in cats can be difficult to detect. Cats do not often exhibit signs of pain until they cannot handle it any longer. Close observation by the pet owner is needed to assess the presence of any pain.

Types

• Feline odontoclastic resorptive lesions (FORLs), mainly known as tooth resorption, is the most common type of periodontal disease, affecting three out of five cats over five years old. Painful lesions are found most commonly on the molar and premolar teeth of the lower jaw but can be found on other teeth as well. The lesions occur as the tooth erodes down to the root structure and eventually disappears as the body absorbs the tooth and replaces it with bone. The lesions are located where the gum is swollen up over the tooth in order to fill the depressions that are developing within the tooth.
• Gingivitis is inflammation of the gingiva, which is the gum surrounding the tooth, beginning with plaque and tartar build-up on the tooth surface. This is the only periodontal disease that can be completely reversed as long as it is diagnosed early. Advanced stages of gingivitis can result in periodontitis (see below) and a surgical procedure to extract the tooth. Gingivitis can be found alone or in combination with stomatitis. 
• Stomatitis is a chronic, very painful condition that affects the entire oral cavity beginning at the gingiva. Inflammation can first be seen at the back of the mouth although inflammation can occur anywhere. The condition is primarily known as lymphocytic plasmacytic gingivostomatitis complex (LPGC) or chronic gingivo-stomatitis.
• Periodontitis is an advanced form of periodontal disease where the ligaments holding the tooth are diseased causing the tooth root to be exposed and the tooth to become unstable. Plaque and tartar build-up, gum recession, inflammation, and infection are clearly evident as the gum, tooth, and bone are being destroyed. It is an extremely painful condition. Periodontitis is more common in older cats. 

It is very important to note that each type of periodontal disease, if left untreated, can develop into a chronic infection that enters the bloodstream and travels to the internal organs, causing a wider spread of the disease. 

There are currently no precise causes of periodontal disease in cats, although tartar and plaque build-up is involved in every case. Other suspicions include:

• Lack of routine cleaning
• Diet
• Genetics (some breeds are more prone to the disease than others)
• Chemistry in the mouth
• Tooth alignment trapping tartar and plaque
• Tooth injury
• Environmental influences
• An association with feline leukemia, feline immunodeficiency virus, diabetes, and other diseases

Diagnosis of periodontal disease in cats is based on probing the teeth for inflammation and tartar build-up, and by the taking of x-rays under general anesthesia to provide a positive identification of lesions, root fragments within the gums, and bone loss. 

Feline odontoclastic resorptive lesions (FORLs)

Extraction of the affected tooth or teeth and its entire structure is the only way to ensure that the disease does not spread. A continued use of x-rays to visualize fractured tooth fragments hidden under the gumline is crucial in order to ensure complete removal and to prevent the spreading of further infection. X-rays will likely be taken several times before the procedure is complete. 

Depending on the case, the canine teeth may be saved. However, it is common that they will degrade again and need removing in the future. 

Gingivitis

Mild to moderate cases of gingivitis do not affect the root of the tooth and may be handled with a thorough, non-surgical cleaning called subgingival curettage followed by at-home care. More severe cases where the cat is in a large amount of pain will require a deeper cleaning under general anesthesia. If gum recession is too severe then the tooth may be extracted. 

Stomatitis

An initial cleaning of the teeth followed by at-home care and the use of antibiotics and anti-inflammatories is possible in most cases. Immunosuppressive drugs may also be utilized. Severe cases will involve the extraction of the affected tooth under general anesthesia in order to remove the focal site of bacterial growth.

Periodontitis

Extraction of the tooth is the only treatment for periodontitis due to the severity of the disease. 

Pet owners should make sure that their veterinarian is adequately equipped and staffed to handle these kinds of surgical procedures. If not, they should ask their veterinarian for a recommendation or referral to a feline dental specialist. 

Continued use of oral antibiotics and anti-inflammatories at home is standard post-operative practice. Immunosuppressive drugs may continue to be recommended. Follow-up appointments will be required to ensure proper healing and to gauge any recurrence of infection. Full recovery should occur within 1-2 weeks.

In periodontal disease, prevention is worth a pound of cure. Good oral hygiene is a must. Routine examinations by a veterinarian along with regular care at home are the best way to keep a cat’s mouth healthy. Examinations by a veterinarian should be scheduled at least every 12 months. If your cat has been treated for the disease already, then more frequent visits are needed. Daily brushing along with a proper diet will help to keep the disease from occurring. The veterinarian may also recommend specially formulated dental foods and treats that will slow the buildup of tartar and reduce the severity of the disease. A food that is low in acid and in Vitamin D is suspected to be a good choice for proper dental health.