We recently had the pleasure of meeting the handsome “Leo”, a 13 year old British Shorthair. When Leo first came to see us for a check-up, it was noted that he had evidence of dental disease. He had severe tartar to his upper pre-molars (teeth 108 and 208 in particular) and part of tooth 208 (an upper left premolar) was missing. As cats are masters at hiding pain, Leo had not shown obvious symptoms at home, despite the fact he must have certainly been experiencing some discomfort.
If left untreated, dental disease can be a hidden source of pain and discomfort, lowers the appetite, can cause weight loss and prevents your cat from being able to adequately groom themselves. Infection in the gums and surrounding bone can lead to other serious health problems including heart and kidney disease.
In order to perform thorough dental treatment for cats, they require administration of a general anaesthetic. This allows the vet to perform gum probing to assess for any pathology and also enables them to obtain a complete set of dental x-rays.
Prior to admitting Leo to hospital for his dental procedure he had a thorough physical exam and pre-anaesthetic blood test to screen for any underlying disease. Leo’s Mum and Dad were relieved to hear that his complete blood count and biochemistry were all normal!
Once under general anaesthetic in our dedicated dental theatre we were able to extensively examine all of Leo’s teeth. This was achieved via gentle gum probing with feline specific IM3 dentistry hand pieces and taking a full series of digital dental x-rays to evaluate the tooth roots. Up to 50% of dental pathology in cats will be hidden below the gum line which means many lesions will not be detected without taking x-rays. This was certainly the case with Leo as we found some nasty looking tooth resorption lesions.
Tooth resorption results in erosion and destruction of the enamel of the tooth causing pain, inflammation and infection. Once feline tooth resorptive lesions (TR’s) have developed, the changes in the tooth are irreversible. Unfortunately, the only form of treatment for TR’s is tooth extraction.
Poor little Leo required 6 tooth extractions due to the presence of TR’s.
Our Elite IM3 dental suite has an ultrasonic scaler, LED high speed drill, polisher, suction and a three way syringe to flush the mouth. After carefully probing every tooth and obtaining x-rays, we then proceeded with cleaning each tooth surface with an ultrasonic scaler. This removes all the tartar from the tooth surface. Polishing the tooth surface creates a smooth area making it more difficult for plaque to adhere to and thus delaying further tartar formation.
Extracting a cat’s tooth is no simple matter as their roots are often three times the depth or size of the crown, as opposed to our own teeth where the crown and root are of similar size. This means the extraction procedure can be far more time consuming and complicated than in humans, especially when removing a multi-rooted tooth. Prior to any extractions, we administer local nerve blocks to provide additional pain relief. Many tooth extractions require a surgical flap of gum tissue to be elevated to be able to access the root properly without damage to the surrounding bone and gums. Where possible, once the tooth is extracted we seal the sockets with a special dental fibre cement called Alvogyl and then suture the gum flap back in place using fine dissolvable sutures.
Little Leo was discharged home that evening with continued pain relief and antibiotics for the week. Whilst his extraction sites were healing he was allowed wet food only. We saw Leo back for a final post-surgery check and his mouth was looking beautiful. In order to help prevent further dental disease for Leo, as we do for all of our post-surgery patients, we developed a dental prevention plan.
Prevention is key and the home care that you provide for your cat’s oral health will form a vital part of their ongoing treatment plan. Recommendations may include special diets such as Royal Canin Dental, addition of supplements to the drinking water (Healthy Mouth), an algae to soften plaque such as Plaque Off and for some very compliant cats brushing their teeth.
In the last week we have also commenced using an exciting new product called SANOS®. SANOS® is a gingival dental sealant for cats that seals the subgingival gum line (gingival sulcus) against the formation of plaque. SANOS® can be applied after every dental clean to protect under the gumline and is clinically proven to last for 6 months without any take-home application required.
Dental disease affects nearly all adult cats at some point in their life, so Leo is not alone! Regular dental check-ups are the key to identifying disease early. Once a patient has had a dental procedure, we generally recommend a dental check-up once every 6 months. Your cats mouth will also be examined at your annual wellness check or vaccination. Lets try to help your kitty retain as many teeth as possible!