Caries Treatment in Cats

Feline caries is the technical term for feline odontoclastic resorptive lesions (FORLs). In layman’s terms, this means gingival lesions form near the gum line and the tooth begins to dissolve in places. Caries may also be called cavities, though feline cavities are not the same as cavities in humans. This condition is one of the most common dental diseases in cats, affecting approximately 75% of cats older than five years. Feline caries is usually treated by tooth extraction. In some cases of caries in which the root has fused to the bone, the surgeon may perform a procedure known as subgingival crown coronectomy. 

Tooth Extraction

1. The cat will first be given general anesthesia.
2. The surgeon will take dental x-rays to evaluate the extent of tooth and gum damage before performing surgery.
3. The surgeon will then place a tube down the cat’s windpipe. The throat is then packed to ensure fluid does not enter the throat.
4. The surgeon will first remove any tartar from the teeth and scale them.
5. The affected tooth or teeth will then be sectioned, or cut, according to its roots.
6. The surgeon will extract the tooth and root using forceps.
7. Following tooth extraction, the wound will be flushed with a saline solution and then closed with absorbable sutures.
8. If several teeth are extracted or if the cat is elderly, the cat will be hospitalized overnight.

Subgingival Crown Coronectomy

1. The cat will be anesthetized.
2. Based on dental x-rays, the surgeon will decide whether it is possible to perform subgingival crown coronectomy.
3. The surgeon will create a “flap”, which helps the surgeon see the alveolar bone better and assists with root sectioning.
4. Using a dental drill, the surgeon will remove the tooth crown.
5. The surgeon will then evaluate the roots. If more root damage is present, another flap is made for better access.
6. The surgeon may extract as much of the root as possible.
7. The surgeon will then take additional dental x-rays.

The efficacy of tooth extraction will depend on the severity of the caries and the number of teeth affected. FORLs are divided into two main types based on severity: type 1 and type 2. With type 1 lesions, teeth are not fused to the bone as a result of caries. Tooth extraction is often very effective in these cases. Type 2 lesions usually require subgingival coronectomy, because the tooth fuses to the bone. Subgingival crown coronectomy is less invasive than an extraction, and is often very effective in cats that show no signs of concurrent disease. There is also a type 3 stage FORL – in which type 1 and type 2 FORLs are evident in the same tooth – but these cases are extremely rare.

Following surgery, the cat will be prescribed analgesics and antibiotics. The cat will also be placed on a special, soft-food diet until pain has diminished and the wound has healed. The surgeon will be able to advise owners on the duration of the modified diet based on their cat’s specific needs. Cats recovering from tooth extraction surgery should not engage in activity for up to three days following surgery. A follow-up appointment is usually required one week after surgery to ensure the wound has healed and the condition has not recurred.

The cost of tooth extraction will vary based on the cost of living as well as additional costs incurred, including medications, hospitalization, and supportive care. Tooth extraction can be an expensive surgical procedure and generally ranges from $500 to $1,200. The average cost of tooth extraction to treat caries is $750.

Tooth extraction is a fairly straightforward treatment for feline caries that presents few postoperative complications. If teeth with caries are not extracted, the chance of recurrence is high. Teeth weakened by caries will cause pain for the cat and are prone to further damage and fracture.

Practicing daily dental hygiene is key to preventing feline caries. Owners should brush their cat’s teeth each day. Dental treats, water additives, gels, and sprays may also help prevent periodontal disease and feline caries.