Cats Need Unique Dental Care- Feline Tooth Resorption
Both cats and dogs develop calculus and gingivitis as a result of bacterial infection under the gum line. This process results in bad breath, discomfort, loss of the bone that holds the tooth in the mouth, and eventual loss of the tooth. Most of our dental care efforts (at- home daily care and periodic assessments under general anesthesia) are aimed at preventing or slowing down this disease process.
Unfortunately for our feline patients, there is a form of dental disease that cannot be helped with brushing or other forms of dental care. This disease is called Feline Tooth resorption or Feline Odontoclastic Resorptive Lesions (FORL), but it has had many names over the years (cervical lesions, neck lesions, feline caries). This disease is unique in that it is not due to tooth decay secondary bacteria and that it cannot be resolved with dental care or fillings/restoratives. A specific cell type called the Odontoclast (literally tooth-eating cell) attacks the tooth at the junction where the crown of the tooth meets the gum line. As the destruction of the tooth becomes more extensive and deeper, sensitive parts of the tooth become exposed and inflamed and significant pain ensues. The process is progressive and irreversible and will usually lead to loss of the crown (visible part of the tooth) and retention of the root remnants. The entire process of losing the crown is painful and can take years. Once the crown is lost there is often still significant discomfort associated with the retained roots.
An important part of what Veterinarians do during yearly feline wellness visits is a close examination of the teeth to look for evidence of tooth resorption. Once identified, affected teeth have to be extracted to restore comfort. It is common for early areas of tooth resorption to be missed during a physical exam, exam—so it is recommended that all teeth be evaluated with radiographs (x-ray) during dental cleanings and assessments. It is also common to find hidden painful dental conditions that are easily missed during a visual exam because a lot of disease processes happen at the root.
Severe dental pain in cats usually manifests with chattering, drooling and pawing, or rubbing the face, but mild to moderate pain usually goes unnoticed. This is why anesthetized dental assessments are recommended even when only mild dental disease is evident in our feline patients during their physical exams.