Teeth and Oral Health Problems in Cats

Posted by Nurse Whiskers. January 15th 2014.

A cat goes out daily into the outside world where it may suffer traumas involving the mouth. These can be caused by simple things such as cat fights, a sliced tongue when exploring an empty tuna fish tin in the rubbish, to a caustic burn when licking something in the environment off their coat, to the more life-threatening things.

Due to their lifestyle cats will often be involved in RTAs and oral trauma is often results in both soft tissue damage to lips, gums or even brain and bone damage and fractured jaws that will require surgery.

Cat with open mouth

How to spot if your cat has an oral health issue

Whatever the cause, cats are easily put off eating by a painful mouth and may require help and encouragement to eat.

In extreme cases, a feeding tube will be used until recovery starts.

When a cat seems unhappy with its mouth, if possible open their mouth and have a look.  If you are concerned or the cause is not obvious, you should contact your vet.  Your vet will also check the cat’s mouth as part of its routine health check.

Cats have 30 teeth in total and dental disease is a very common problem in both young and old cats; 85% of cats over 3 years old are thought to have some sort of dental disease.

Cat’s teeth are divided into canines, incisors, pre-molars and molars.  Each tooth plays its part in hunting and eating.

The incisors are the little tiny teeth at the front of the mouth and are useful in helping to hold prey in the mouth. They are quite wobbly unstable teeth when they are diseased and may fall out. Cats start off with 12 of them – 6 at top and 6 at bottom- but often will have some missing and some may fail to develop in the first place.

The canines are the big long teeth that look a little like fangs. The cat is a true carnivore, evolved for hunting and killing prey such as rodents and birds, with the canine teeth being the ones responsible for killing and shredding. They are long teeth and only have a single long root, supported by strong ligaments and deeply embedded in the bone. A cat should have four canines, one on each side at both the top and the bottom.

The pre-molars are used for chewing prey and will cut through meat and bone; they have 2, 3 or more roots and are very well anchored. There should be 3 on each side in the top jaw and 2 on each side in the lower jaw.

Molars are also used for cutting through meat and bone when the cat is crunching and chewing up their prey. There should be one on each side in the top jaw and one on each side in the lower jaw. They too have many roots to anchor them in place.

Teeth sit in a socket in the bone of the jaw and are held in place by strong ligaments.  The structure of the tooth is divided into the crown, which is the bit visible above the gum line, and the root, which is the bit below the gum line.

The structure of the actual tooth itself consists of 3 things – pulp, dentine and enamel.

Pulp – this lies within the pulp cavity or centre of the tooth. Pulp fills this cavity and contains cells nerves and blood vessels which enter at the tip of the root. As a result of this, damage or inflammation of the tooth affecting the pulp is extremely painful.

Dentine – this covers the pulp and is the main bulk of the root as well as providing a middle layer between the pulp and the enamel on the crown of the tooth. Dentine is hard and mineralised, but is very sensitive so making root exposure or enamel damage very painful.

Enamel this is a very hard, mineralised substance, which contains no nerves and is insensitive. Enamel covers the crown of the tooth protecting the tooth and the underlying dentine which prevents sensitivity when the animal is eating. Damage to the enamel exposes the underlying dentine and will result in a very sensitive tooth, which is also susceptible to infection.

Health problems in cats’ mouths are varied. They can be as a direct result of poor dental hygiene, but may also indicate an underlying problem. Whatever the cause, they should be treated, as dental issues can lead to further health problems.

cat eating

Oral health issues in cats

Gingivitis – inflammation of the gums.  This is common where there is tartar accumulation and can lead to irritation or bacterial infection; however, if a cat has an underlying health problem, it can occur in the absence of tartar build up. The gums may become very raw, red and eating may be painful. Treatment can vary depending on the cause; this may be simple dental treatment, to lifelong medical treatment if an underlying recurring cause is present. Dental hygiene and sometimes tooth extraction can improve a large number of cases.

Tartar Build-Up – when tartar build-up is excessive or causing secondary problems e.g. bacterial infection, your vet will recommend a dental scale and clean up, under general anaesthetic.
There may be some teeth that require extraction because they are insecure or very infected and may be a health hazard if left in place. It is difficult for your vet to say how many teeth will need to be extracted until the tartar has been removed with scaling and the teeth and extent of any problems can be clearly seen. The cat is likely to be given a course of antibiotics, as the dental procedure can drive any bacteria present on the teeth into the cat’s bloodstream.  After the dental treatment, the cat will be much happier and eat better.

Prevention can be difficult – feeding a dried food helps, as can tooth brushing, if tolerated by the cat.  Your vet can advise you on products available for your cat to chew or gels to help prevent bacteria building up.

Ulcers – ulcers can appear on the tongue, lips, gums or roof of the mouth as a result of a cat flu viral infection. They can appear quite quickly and cause a great deal of pain, salivation and a loss of appetite. In an otherwise healthy cat, it will often recover without treatment but may need support and encouragement to eat during the healing process.
Cats can also develop oral ulcers as a result of underlying problems e.g. kidney failure or immune disorders and are likely to require veterinary care.

Oral Tumours – These usually affect older cats. Often difficulty with eating is the first sign, or blood coming from the mouth and the cat having smelly breath. Any area of the mouth can be affected and a biopsy would be required to confirm the diagnosis.

Trauma – Mouth injuries are common, especially after road traffic accidents. Broken jaws are much more likely in cats than in dogs. Multiple jaw fractures require surgery by a vet to put the bones back in place, often using surgical wire.  In such instances, assisted feeding might be necessary for a couple of weeks until the cat can feed itself.  There may well be associated head trauma and brain damage, so recovery may be over an extended period.

Unable to close mouth – Commonly small bones can become stuck on the back teeth and wedge the mouth open. The cat can be quite distressed, pawing at its mouth, salivating and trying to be sick. A loose tooth that has moved out of place can have the same effect, as can a fractured or dislocated jaw.

Feline Oral Resorptive Lesions (FORLs) or Cervical neck lesions – this is a common and very painful problem where the enamel at the neck of the tooth erodes leaving the underlying sensitive structures below exposed. The cause is unknown, it may be hygiene related, with the only treatment being extraction as ultimately the tooth will snap off.

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