Feline dental disease – Feline Dental Dilemmas
Cats with dental disease will still usually eat with very painful mouths !
The following two syndromes are unique to cats because of their unique immune systems
Feline Gingivitis – Stomatitis
Gingivitis and Stomatitis
Diagnosis – A veterinary dentist would consider the following:
- evaluation of the oral cavity and teeth,
- periodontal treatment – scaling and polishing , root planning and sub gingival curetting.
- extraction of teeth that have resorption or periodontal bone loss.
- If Cancer is is suspected, a biopsy is obtained for pathology.
Medical management of oral inflammatory disease by a cat dentist
As this is an immune mediated disease ! SO therapy is aimed at
- pain management and suppression of the inflammatory/immune response.
- treatments generally are required every 3–6 weeks.
- Occasionally Cyclosporine and feline omega interferon (Virbagen® Omega, Virbac) have been reported to be helpful
Also to note
This is a syndrome not a diagnosis. – Usually associated clinically with yellow grey film on teeth and marked periodontal disease and gingivostomatitis – Wide spread oral inflammation – extensive.
FLPGS is very different from Gingivitis or gum disease associated with periodontal disease.
Feline LPGS – the cause is mutlifactorial – we need a diagnosis usually by getting a histological diagnosis from a veterinary pathology lab from a small oral tissue sample. There is a chronic antigen specific immune response.
Which antigens ? – Plaque bacteria and their products , infectious antigens like FCV (Calici virus), FHV-1(feline herpes virus) FCoV (feline corona virus). NO infectious like food or additives and possibly autoimmune.
Why is the reaction so severe in feline lymphocytic plasmacytic oral disease. ?
Possibly associated with an immunodeficiency decrease neutrophils response and effectively.
Diagnosis – is usually based on appearance – often typical.
WE would do routine bloods to rule out renal disease, Diabetes, etc Consider Viral testing also .
Need a general anaesthetic for full assessment and treatments.
Dental radiographs are so helpful – to remove retained roots
Biopsy is recommended to rule out cancer like SCC – squamous cell carcinoma , or FEGC)
Treatments for FLPGS
This is a very very painful condition.
Firstly complete professional periodontal treatments – usually the same time as the assessment, remove all plaque and calculus, extract damaged teeth. Add pain relief.
Antibiotics like Doxy or Amoxycillin-clavulonic
Possibly immunomedulatory drugs.
Treatment : Often extraction of all affected teeth – once after 4 weeks of mendical therapy !
Once teeth are out – we often get good resolution 60%
20 % excellent resolution and 20 % will show a poor response and need medication occasionally .
Feline tooth resorption
–is poorly understood
– also called cervical lesions, neck lesions, or FORLS
– feline oseoclastic resorptive lesions – feline caries(cat do not get cavities like people). FORL are present at the tooth Neck or at the gum level.
FORLS is Intensely painful but really common in cats more than 50 % !!
Increases with age 74% of cats over 6 years old.
See lytic or eaten on xrays – we classify the lesions depending on the severity
Caused by odontoclastic activity = – cells that resorb bone and dentine, once they enter the tooth from the root. –completely abnormal and unusual! Cats are unique in that they get it in such high numbers.
Even wild cats get them!
Why ? Angry ondontoclasts on steroids?
Especially in the Asian short haired breeds –so is a genetic component.
New diets with little chewing possibly contribute to periodontal disease, viral disease, Vitamin Davidson levels – again Feline tooth resorption is poorly understood.
Treatments for feline tooth resorption
Extraction of the entire tooth
Or crown amputation of teeth ( if dental x-rays are done)
based on lecture notes from
Veterinary Dental Specialist Dr Chris Hawke
Dr Phil is an experienced animal dentist