Tooth Removal in Cats

Tooth removal in the cat is commonly undertaken in first opinion practice as a means of managing dental pain from damaged teeth. It requires a full general anesthetic and careful postoperative pain management. In addition, because of the complex way feline teeth are firmly attached and the invasive techniques necessary to remove them, tooth removal in the cat is considered an act of veterinary surgery, 

The vast majority of dental extractions are undertaken as a result of advanced dental disease. The latter is preventable with regular tooth brushing, in the same way brushing is beneficial for our dental health.

Once dental disease is identified, the cat is assessed for fitness for a general anesthetic. This includes screening blood tests, and in older patients intravenous fluids may be necessary to protect kidney function. If a dental abscess or gingivitis is present, the clinician may prescribe antibiotics prior to the extractions. 

Once anesthetized, dental radiographs are taken to check for complications such as lesions below the gum line or disease of the jaw bone. The clinician systematically probes all the teeth and gingival pockets, to check for issues not evident in the conscious cat. 

Depending on which teeth need removing, different techniques are used. For difficult removals this involves creating a flap of gum over the tooth root and lifting the flap to expose the jawbone. A high-speed bur then grinds away the bone overlying the root. In multi-rooted teeth the tooth is sectioned using a high-speed cutting bit. Then a sharp dental elevator is inserted between the tooth root and the socket in order to break down the ligaments holding the tooth in place. Only once the tooth is loose will the clinician use extractors to twist and pull the tooth out. 

Where a flap of gum was created, this is replaced and sutured so to seal off the socket. 

Tooth removal is permanent and non-reversible. It is however extremely effective at removing a constant source of discomfort and pain from a diseased tooth. 

Alternatives to tooth removal include orthodontic treatments including root canal therapy or fillings. However, these are not widely used in first opinion practice and mainly the domain of veterinary dental specialists. Those cases going forward for orthodontic therapy need careful selection, since it is not appropriate to use such advanced techniques unless the owner then commits to daily tooth brushing. 

Gum healing takes approximately 10 to 14 days, and the judicious use of gum flaps can greatly increase the cat's comfort during this time. Good pain relief during the procedure reduces postoperative discomfort, but for extensive removals pain relief is advisable for several days. 

After having teeth removed most cats find it easier to lap liquid recovery diets or eat soft food. However, some cats are adept at scooping up biscuits and swallowing them whole, so don't discount kibble as an option.

Most patients are recalled for a postoperative check 2 to 3 days after their surgery. At this stage, the vet checks the gums are healing, there is no infection, and the cat is comfortable. Appropriate action can be taken if complications have arisen. The cat is then checked a week later and, if all has gone well, signed off.

Dental surgery in the cat takes expertise and time. In part, the cost of tooth removal reflects the time needed, with a single canine tooth taking 40 to 60 minutes to remove successfully. Add in the cost of intravenous fluids and general anesthetic, and the invoice starts to climb. 

Whilst basic dental descales under anesthesia can cost as little as $120, this rises considerably depending if a number of extractions are required. It is not unusual for complex or multiple extractions to cost $600 - $750, including dental radiographs. 

Referral to a veterinary dentist incurs a specialist consultation fee, around $110 - $220, with screening test and a descale costing around $630. The fee for complex orthodontics is proportionately higher and liable to reach four figures. 

Dental extractions are not without the risk of complications. Feline teeth have long deep roots, and unfortunately a fistula (a hole or tract) may develop between the mouth and the nasal cavity. This may then need corrective surgery further down the line, in order move a flap of gum to fill the hole. 

Teeth sockets are well supplied with blood, and hemorrhage can be another complication. Part of the preoperative assessment is to look for factors that could predispose to clotting problems. In rare situations, when the sockets bleed once the cat is awake, a repeat anesthetic to control the hemorrhage may be necessary. 

However, the good news is that once the mouth has healed, most cats do very well indeed and are much better able to eat than with diseased teeth. 

Good dental hygiene is key to preventing the need for extractions. This is achievable through a combination of strategies: 

• Tooth Brushing: Daily tooth brushing with a pet toothpaste is strongly recommended. This removes the food debris which leads to plaque deposition on the surface enamel, which in time hardens to tartar
• Dental Foods: Special dental kibble biscuits mimic a tooth brushing action and slow up the deposition of plaque on the surface of the teeth
• Dental Treats and Chews: Again, these are designed to scrub the surface of the tooth as the cat chews on them. 
• Food or Water Additives: Certain seaweed-based additives appear to be beneficial at reducing plaque formation on the teeth. 

In addition six-monthly dental checks by a vet are advisable. This facilitates the early detection of problems, so that they can be treated early and reduce the risk of deterioration leading to dental extractions. 

As well as reducing unnecessary pain and discomfort, good dental hygiene also promotes fresh breath: a bonus for any cat owner! It should also be noted that whilst tooth removal solves the problem with that particular tooth, unless measures are taken to improve dental health, the repeat situation could arise in the future with a different tooth.