Dental Disease (Gingivitis and Periodontal Disease) in Cats

There are multiple forms of dental disease in cats. Gingivitis (gum inflammation) and periodontitis (inflammation of the structures holding the tooth in place), are the most common forms. Tooth resorption (FORLs) is also common, especially in older cats.

In cats with gingivitis and periodontitis, the presence of plaque and tartar on the teeth and under the gumline trigger the body’s immune response causing swollen, red and bleeding gums. In the case of gingivitis, this damage is reversible with the aid of a veterinarian. If left untreated, gingivitis develops into periodontitis, causing the erosion of the support structures holding the teeth in place. Eventually the condition becomes irreversible.

Other forms of dental disease in cats include:

• Dental tartar and decay
• Dental abscesses
• Broken teeth
• Supernumerary teeth (too many teeth)
• Discolored teeth

A form of dental disease called stomatitis occurs most frequently in cats with significant health conditions including FeLV and FIV. Inflammation becomes chronic and spreads to other tissues in the mouth. Treatment for stomatitis requires extraction of most or all of the teeth.

Cats with the symptoms of dental disease require veterinary care, particularly since many cats only show symptoms once dental disease is severe. Early detection and treatment are crucial for good outcomes.

Dental disease is extremely common in cats. Some forms of dental disease are progressive and benefit from early detection and treatment. Some forms are genetic. Dental disease occurs in all types of cats at all ages. Risk factors that lead to greater susceptibility include:

• Misaligned, crowded, or broken teeth
• Underlying infectious diseases such as feline immunodeficiency virus (FIV), feline leukemia (FeLV), or feline calicivirus (FCV)
• Infection of the gums
• Poor dental hygiene
• Genetic predisposition
• Poor diet
• Unique oral biochemistry
• Population imbalance of bacterial flora in the mouth

Severity depends on which form of dental disease is present and how far the disease has progressed. Many cats only show noticeable symptoms once disease has progressed significantly.

Left untreated, dental disease affects other systems. In some cases, dental disease leads to bone infection, kidney disease or heart disease. These conditions are sometimes fatal.

The cause of dental disease depends on the specific form present.

Gingivitis and periodontitis are caused by the body’s immune response to a buildup of plaque and tartar. In cats with good oral health, the mouth is naturally full of bacteria that aid digestion. These bacteria create plaque. If they are left in the mouth too long, the bacteria migrate deeper toward the root of the tooth, causing a shift towards disease-producing bacteria.

Without regular oral hygiene, mineral deposits in plaque solidify into tartar. Tartar attracts further bacterial growth and production of substances that damage the teeth, gums, and underlying structures.

In the case of tooth resorption, the tooth structure breaks down for unknown reasons. The process starts from within the tooth and progresses to the outer layer.

Many cats show few to no symptoms of dental disease, even when dental disease is severe.

Diagnosis aims to distinguish the specific underlying cause and plan appropriate treatment. Diagnostic tools include:

• Physical examination
• X-rays

Diagnosis often requires anesthesia to facilitate the process, especially when diagnostic imaging is indicated.

Treatment depends on the form of dental disease identified. Treatments include:

• Deep cleaning to remove plaque
• Scaling to remove tartar
• Polishing of teeth
• Tooth extraction
• Antibiotics, in the case of infection
• Crown amputation (removal of part of the tooth)
• Steroid therapy (in cases of stomatitis)

Aftercare for cats who have had a tooth extracted include:

• Pain medications
• Antibiotics to prevent infection
• Adjustment of diet to encourage eating

A missing tooth is much easier for a cat to cope with than a painful, broken or inflamed tooth.

With most forms of dental disease, prognosis with early detection and treatment is excellent. Routine cleaning, scaling, and polishing the teeth is often successful in reducing the symptoms and pain associated with gingivitis. In cases of advanced dental disease, extraction of one or more teeth is often sufficient for full recovery. Left untreated, dental disease can affect other bodily systems, in some cases becoming life-threatening.

Most dental diseases are preventable. Preventative measures include:

• Daily tooth brushing at home using a cat-safe toothpaste
• Routine veterinary dental cleaning including oral x-rays (yearly in healthy cats)
• Early and frequent assessment by a veterinarian to detect and correct risk factors such as overcrowding, broken teeth, discoloration, and plaque and tartar build up

There is no evidence that crunchy or specifically shaped foods remove plaque or tartar.

Human toothpaste is unsafe for cats and should never be used. Always consult a veterinarian before selecting oral hygiene products for pets.

Dental disease is one of the most common health problems in cats.

• Cleaning, scaling and polishing of teeth
• Extraction of teeth
• Crown amputation
• Pain medication
• Antibiotics
• Steroid therapy