Dental disease is one of the most common conditions seen by vets today and can be hugely painful for your cat, particularly if it progresses unnoticed and untreated. However unlike many other health problems, the good news is that for the most part it is fully preventable.
What is dental disease?
Otherwise known as periodontal disease, in it’s simplest form it is an inflammation of the gums around the teeth. Over time if left untreated, it can affect both the health of the tooth as well as its underlying structures and support systems.
What causes it?
When food particles gather between the teeth and along the gum line, they create a perfect environment for bacteria to grow. It is normal to have bacteria present within the mouth, but when they combine with sugars from food particles a soft, sticky, colourless film called plaque forms. This plaque attaches itself to the teeth and gums, where the bacteria feed off the sugars and produce acids as well as toxins that both attack the tooth enamel and irritate the gums. Saliva is the body’s only natural defence at this stage, as it acts to neutralise acid erosion. However, regular tooth brushing is the only way to actually remove the plaque.
When plaque isn’t removed, the normal minerals contained in saliva chemically combine with the plaque film and this causes it to harden. Tartar or calculus is the name given to this hardened and calcified plaque. Once this happens, the bacteria held at the tooth face are trapped and the acid and toxins they produce bore into the tooth enamel and start to form cavities.
Stages & Symptoms
There are multiple stages to the progression of dental disease, each with different symptoms and clinical signs.
The first stage is gingivitis and this is reversible if caught in time. It is often observed as swollen, reddened and possibly bleeding gums.
Stages 2 - 4
Periodontitis is a long-term advanced stage of dental disease, which worsens over time. Initially the inflamed gums progress to form pockets between the tooth and gum. The tooth roots may become exposed due to receding gums and as the inflammation progresses it can cause tooth root abscesses to occur, due to infection in these pockets. The deeper structures around the tooth then begin to get affected and the first sign of this occurs with loss of the tooth attachment, ultimately ending in tooth loss.
The clinical signs of advanced dental disease include halitosis (characteristic bad breath), a reluctance to eat, excessive drooling, eating to one side of the mouth, difficulty swallowing or an abnormal swelling around the face that may indicate an oral abscess.
Once tartar has formed it cannot be removed by manual brushing and requires specialist professional dentistry equipment e.g. ultrasonic scaling and a general anaesthetic.
The level of treatment will be dependent on the stage of dental disease. Treatment for Stage 1 gingivitis involves professional cleaning, scaling and polishing plus ensuring an on-going strict regime of regular and effective tooth brushing at home, with routine repeat check-ups at the vet. Appropriate nutrition is also critical to the long-term control and management of dental disease, as it helps to control plaque accumulation. The ultimate aim of all treatment is maintaining a healthy and pain-free mouth for your cat.
It is an area of on-going research to work out how best to help slow down the accumulation of tartar and progression of periodontal disease in our companion animals. Consequently there are a number of specialised diets on the market that work to tackle this issue through a combination of mechanical abrasion and chemical means. These methods include designing specific dry food kibble shapes, densities and textures that will help scrape off plaque as the tooth cuts through the kibble during the chewing process. Other methods generally work by including a specific ingredient in the food that binds to specific substances within the saliva to reduce the formation of plaque.
Regardless of which food you choose however, there is no substitute available for regular tooth brushing with a feline specific toothbrush and toothpaste. Oral enzymatic gels are also available, but routine veterinary dental checks are crucial to the long-term management of this disease to ensure early and appropriate intervention as necessary.