Does your cat have stinky breath? Red gums? Tartar? Discomfort when eating? Your cat may suffer from periodontal (gum) disease. Over 70% of cats have periodontal disease with a majority of cats over three years developing resorptive lesions that lead to painful and prolonged tooth loss. Oral diseases that are less common but still important include stomatitis, which is generalized inflammation of the entire mouth, and oral cancer, which usually affects senior-age cats.

Unless you are brushing your cat’s teeth every day, your cat most likely will suffer from dental disease at some point in life. Regular dental cleanings, evaluations, and home care are necessary for a long and happy life for your cat. The doctors at Cat Hospital of Metairie have extra training and experience with feline dental techniques. You may find less expensive treatment elsewhere, but when it comes to safety, pain control, and skill, we do not take any shortcuts for your cat and believe our dental services offer state-of-the-art and compassionate care.

What is periodontal disease?

Periodontal disease is bacterial infection of the teeth, gums, and surrounding bone. It causes pain and inflammation in the mouth. Left untreated, it can lead to tooth loss and systemic disease.

What are resorptive lesions?

Resorptive lesions are a result of the cat’s body destroying its own teeth. Osteoclasts (cells that “eat” bone) begin to work on the tooth roots and then work up to the crowns (the part of the teeth that we see in the mouth). It’s almost like an autoimmune disease, but truly, we do not know what causes this process.. It is probably an age-related change, but can also occur secondary to periodontal disease. Most cats start to develop these lesions when they are only a few years old. Resorptive lesions usually only affect one or two teeth at a time, but this can be a lifelong disease that may eventually claim all the teeth. This disease is painful, and although each tooth will eventually be reabsorbed and disappear, it will take years. This means prolonged pain with extraction usually the only treatment for resorptive lesions.

My cat is still eating fine. Why should I worry about dental disease?

It’s true that most cats manage to eat sufficiently in spite of dental disease (except for stomatitis and cancer). However, it is still painful. A cat’s appetite is strong enough to force the cat to tolerate the pain, but it doesn’t mean the cat doesn’t still feel the constant soreness and inflammation of periodontal disease. It just makes it easier to ignore, which is not in the best interest of the cat.

If you took the entire area of infection covering the teeth and gums and placed it on your cat’s back as a skin infection, it would be the size of the palm of your hand. Would you treat the skin infection? Yes, of course! Therefore, even though dental infection is hidden in the mouth, we still need to address it.

Dental disease affects much more than the mouth of your cat. Bacteria spread to the bloodstream and can affect your cat’s other organ systems such as the heart, kidneys, and liver. Cats with underlying disease, such as diabetes or inflammatory bowel disease, will often benefit from dental work and should not be excluded because of chronic disease.

If this is a bacterial infection, can’t we just give antibiotics?

Antibiotics may help temporarily, but we must remove the source of the infection: plaque underneath the gum line and on the teeth. Otherwise, dental disease will never truly go away and will progress.

What happens when my cat has a dental procedure?

Cats won’t listen if we tell them, “Open up and say ahhh!” For any dental procedure, your cat must be under general anesthesia with an endotracheal tube to protect the airway and an intravenous catheter to give fluids to maintain blood pressure and access to give injections if needed. A nurse dedicated to monitoring will use advanced anesthesia equipment, along with sight and sound, to help assure the well-being and safety of your cat. Keeping your kitty warm with a circulating water blanket and other specialized equipment helps minimize the amount of gas anesthesia needed, further ensuring your cat’s safety and comfort.

Each patient is examined before surgery. We assess temperature and the heart and lungs, in particular. We recommend pre-anesthetic blood work to check the kidneys, liver, blood glucose, protein levels, and red blood cell count before anesthesia.

We need dental X-rays to evaluate the roots of the teeth to find hidden disease and also to know how to approach the teeth surgically. 60% of dental disease is hidden under the gumline. Full mouth radiographs, using digital technology, take only a few minutes to obtain yet provides us with a wealth of information on how to best treat your cat.

A full oral exam assesses facial symmetry, “bite,” all surfaces inside the mouth, and finally, every surface of every tooth using a dental probe.

A dental cleaning is similar to what you experience at your dentist. We use a combination of ultrasonic scaling and hand scaling, focusing particularly underneath the gumline.

For teeth that cannot be saved by cleaning alone, extractions are frequently necessary. Pain medication and a local block to numb the mouth are standard to control pain and minimize anesthesia required when we extract any teeth. There is no such thing as simply "pulling teeth" when it comes to proper dental extractions, especially in cats. We need to cut the gum tissue, bur a small amount of bone, and patiently use special instruments to maneuver the tooth out of socket. A cat's tooth root is more than half the tooth, and it is stubbornly attached to the bone, even if it is already loosened by disease. We also need to suture over the extraction site when possible to speed healing and reduce pain from exposed nerves.

Will my cat be okay without its teeth?

While we strive to save every tooth, often we have to decide that no tooth is better than an infected or painful tooth. Cats’ teeth are designed for hunting and eating prey, not really for chewing food. In fact, most cats with all their teeth intact swallow their dry food whole! Your cat can still eat its regular diet, wet or dry, if extractions are required.

Is my cat is too old for anesthesia?

Most of our dental patients are older cats with concurrent chronic diseases, many of which may actually improve after a dental procedure. We require any cats over ten years of age to have pre-anesthetic blood work, and we may recommend chest X-rays to screen for heart or lung disease. Anesthetic protocols are tailored for each patient, and we take special care with our older kitties.