A cat's mouth is one of the most interesting parts of its anatomy and most important to its health. The lips are the portal of the mouth. Cats have two sets of teeth. The first, or milk teeth, fall out after their roots are partially reserved by the body at about halfway through the growing period. The eruption of new teeth takes place rapidly. Domestic and wild cats have fewer teeth than any other carnivores. Kittens have twenty- six deciduous or temporary teeth. These are softer and thinner than the permanent teeth and start erupting through the gums at around two to three weeks of age. The permanent teeth begin to replace the baby teeth between fourteen to sixteen weeks of age. Unlike puppies, which usually suffer from swollen and sensitive gums during this period, kittens have few teething problems, although they have been known to chew at that time. While your kitten is teething, check its mouth frequently to see that the permanent teeth are pushing trough the gums properly.

The cat's 30 permanent teeth are in place by 6 months of age. Each side of the upper jaw has three incisors, one canine tooth, three premolars and one molar. Each side of the lower jaw has three incisors, one canine tooth , two premolars and one molar. The cat's lower jaw is narrower than its upper jaw. This, along with a rough tongue and pointed canine teeth, helps the cat grasp meat. The cat's incisors cut and rip, its molars have cutting edges that work like scissors, providing the shearing bite necessary to eat meat.

Enamel is the outer protective coating of teeth. It is the hardest body substance. If damaged or lost, it is not replaced. All other tooth substances undergo change. Dentin, the bulk of the tooth , first forms in the crown, then at the root. With age, it increases in thickness as the pulp decreases, leaving little pulp in the geriatric cat. The pulp is build up from soft tissue, blood vessels and nerves. Teeth are held in place by the periodontal ligament, from the bone to the cementum that covers the root surface.

WHY IS DENTAL CARE NECESSARY FOR CATS?

Our cats suffer from similar diseases of the oral cavity as we do:

Cats seldom develop cavities, probably because they eat foods lower in carbohydrates than foods people eat.

The most common problem is the buildup of plaque between the teeth hand around the gumline. As cats are predators in nature, their teeth and mouth is designed to grab prey, kill it and shear off pieces small enough to swallow. Our pampered pussycats are not forced to hunt their food anymore. Their food is always available and almost no chewing is necessary. This level of domestication has a detrimental impact on health of cat's teeth. Chronic viral infections of the gums are another reason why we see so many cats with dental diseases. Feline rhinotracheitis and calicivirus infection is quite common in unvaccinated cats.

WHAT IS CALCULUS, PLAQUE OR TARTAR?

Food debris in the mouth combines with bacteria to form plaque, which adheres to the surface of the teeth. Bacteria continue to grow and multiply in the plaque and, as calcium salts are deposited, the soft plaque becomes a very hard calculus- also called tartar. If this tartar buildup is allowed to accumulate, pockets of pus will eventually build up along the gum lines. This will further separate the gum from the tooth and thus allow more food debris to accumulate. The ultimate result is total erosion of the sockets which hold the teeth. Without a firm hold, the teeth fall out.

WHAT IS GINGIVITIS?

Gingivitis is the inflammation and infection of the gums due to both plaque and tartar buildup on the teeth. It will be evident by the gums being red and puffy, and they may be bleeding. The cat may show signs of having a sore mouth, drool more than normal and have bad breath. If left untreated gingivitis will lead to periodontitis. Gingivitis can also cause cavities along the gum line called neck lesion. These are very painful and should have fillings put in them or the teeth will be lost to decay.

WHAT IS PERIODONTITIS?

The bacteria that get under the gum line and cause gingivitis, if not treated, will cause deeper infection and breakdown of the structures and tissues that hold the teeth in the root socket. This is called periodontitis or periodontal disease. At this point the gums will be receding and there will likely be some bleeding and a foul odour from the mouth. There will often be pus present under the gum. If left untreated the infection will cause the bone of the tooth socket to resorb and recede. This results in the root of the tooth becoming exposed. There is a pocket where food and bacteria collect. Soon the tooth will become loose and cause severe pain and will have to be extracted. The bacteria causing the infection can get into bloodstream causing a bacteremia or blood poisoning. This can lead to serious problems such as heart and kidney disease.

HOW DO I KNOW MY CAT HAS DENTAL DISEASE?

It is very easy to inspect your cat's mouth. Lift your cat's lips and examine its teeth and gums.

Signs of healthy mouth are:

* White, clean and shiny teeth
* Teeth are not covered with plaque or tartar
* Gums are pink and not swollen
* Gums adhere to teeth
* No repugnant breath

Signs of poor oral health or dental disease are:

* Bad breath
* Sensitivity to touch around mouth, gums, teeth
* Pawing at mouth
* Decreased appetite or refusal to eat dry food
* Weight loss
* Plaque, tartar (brown buildup on teeth)
* Swollen, red, inflamed or receded gums
* Easily bleeding gums
* Drooling, salivation
* Sneezing or coughing

 

IS IT TRUE THAT GUM DISEASE CAN CAUSE HEART/LIVER OR KIDNEY DISEASE?

Yes. A massive mouth infection can also be responsible for other serious conditions such as heart or kidney disease in the following way.

The bacteria in the infected gums are picked up by the blood stream and literally showered around the body forming tiny microabscesses in multiple organ systems, primarily the heart valves, the kidneys and even the spine. This then leads to heart failure, kidney failure and arthritis.

A TRIP TO THE DENTIST

HOW OFTEN DO CATS NEED TO HAVE THEIR TEETH CLEANED

WHAT SAFETY PRECAUTIONS CAN BE TAKEN TO DECREASE ANAESTHETIC RISKS?

A TRIP TO THE DENTIST

Dental cleaning or dental prophylaxis is the means by which you and your veterinarian can prevent periodontal disease and all its ramifications. Prophylactic dental cleaning is part of our Dental Wellness Programmes and it involves a number of highly skilled procedures, which can only be done at a veterinary facility. If any of these procedures are necessary for the patient, there is no substitute treatment.

HOW OFTEN DO CATS NEED TO HAVE THEIR TEETH CLEANED?

The need for, and frequency of, dental cleaning varies from cat to cat. For most routine cases, we recommend dental cleaning once a year along with brushing the cat's teeth at home 2-3 times weekly (more often if possible). For severe cases we recommend dental cleaning more often, along with brushing. A very small minority of adult cats do not develop significant plaque or tartar and do not need dental cleaning. The only way to know your cat's category, is for your veterinarian to examine your cat's teeth.

WHY DOES MY CAT NEED PROPHYLACTIC DENTAL CLEANING?

1. To remove plaque and dental tartar from the teeth.
2. To prevent or control painful periodontal disease.
3. To prevent deterioration of the gums.>
4. To prevent the absorption of toxins and bacteria present in the mouth which can damage internal organs.

WHAT WILL I NOTICE AFTER THE PROPHYLACTIC DENTAL CLEANING?

1. My cat's breath will improve.
2. My pet's teeth will be clean and white and have no tartar.
3. Although these are desirable improvements, the most important improvements will be those not noticeable to the owner. These include:
4. Prevention or elimination of PAIN.
5. Improved health by preventing the absorption of toxins and bacteria as mentioned above.
6. Personality change if not in pain anymore.

Before and After

WHAT IS INVOLVED IN HAVING PROPHYLACTIC DENTAL CLEANING?

	1. Ultrasonic scaling (cleaning) of teeth. Once your cat is anaesthetized, the first step in our dental procedure is a thorough cleaning. All of the plaque buildup is removed with an ultrasonic scaler. The scaler breaks up the deposits of plaque and tartar without injury to the enamel or gums.
	2. Comprehensive oral exam under general anesthesia. When the plaque and tartar are removed, we perform a detailed examination of the teeth, gums and mouth. Any lesion or tooth that is a source of pain or infection is evaluated, treated and notes are made on the dental chart in the medical record.
	3. Taking dental X-rays if necessary. In some cases, to take dental x-rays is crucial in order to plan the best possible treatment procedure. Intraoral x-rays supply important information when deciding which tooth will benefit from treatment. X-rays help to evaluate supportive bone around the teeth.
	4. Correction of gum and teeth problems by proper dental techniques (filings, extractions). Filling of small cavities can be done to prolong the life of the tooth. Teeth with cervical neck lesions can also be filled. Severely infected or exposed roots are reason to extract teeth. Remember, it is better to have no teeth with healthy gums than chronic infection and pain. We have many cats with no teeth that still love their dry food.
	5. Polishing all teeth. After a thorough cleaning treatment, teeth are polished to smooth away any tiny rough spots on the tooth surface that would allow tartar to reoccur.
	6. Application of an antiseptic agent, fluoride and antibiotic therapy if necessary. All pockets under gums that are cleaned are disinfected with an antiseptic solution. Fluoride gel is then applied to prevent future problems. Cats who have lot of inflammation or have had extractions will be administered injectable and oral antibiotics for several days after the procedure.

DENTAL EQUIPMENT AND INSTRUMENTS USED FOR PROPHYLACIC CLEANING

WHY DOES MY CAT NEED GENERAL ANESTHESIA?

The results achieved when a dental procedure is performed under anesthesia are far superior to those achieved when anesthesia is not used. In fact we believe that acceptable gum and teeth cleaning can only be achieved under a light general anesthesia, no matter how cooperative the patient is. The ultrasonic scaler is water-cooled and leaves a fine mist in the air when used. This mist combines with the bacteria from your cat's mouth and we must be careful that the cat does not breathe this mixture because it could cause a respiratory infection. To prevent this, we place an endotracheal tube in the trachea. This tube will also guard against aspirating any fluids into the lungs when the mouth is rinsed or treated. Patients anaesthetized for dental procedures are kept on a very light plane of anesthesia. The vast majority of these patients are up and moving around within minutes after the dental is completed. If you require more information on General Anesthesia, please ask for our pamphlet called GUIDE TO GENERAL ANESTHESIA which is available from our office.

WHAT SAFETY PRECAUTIONS CAN BE TAKEN TO DECREASE ANAESTHETIC RISKS?

Although there are some risks associated with general anesthesia, newer agents and high levels of caution minimize the risk. We recommend screening each patient beforehand for any potential complications such as heart, lung, liver and kidney problems, diabetes, etc., using a pre-anesthetic physical examination and appropriate laboratory blood tests and x-rays, when required. We also place the patient on antibiotics before the procedure, if necessary. Also, we monitor the patient closely (heart rate, rhythm, respiration, circulation, etc.) both during and after dental procedure.

WHAT CAN I DO TO PREVENT DENTAL DISEASE?

Begin when your cat is a baby! Kittens are much easier to train than adults. Toothbrushing is considered the most effective method of removing plaque.

HOW IS MY CAT GOING TO BENEFIT FROM BRUSHING?

The benefits of brushing your pet's teeth are basically the same as for brushing your own. The main benefits are improved oral hygiene, less gum disease, and less halitosis (bad breath). Also, since gum disease has now been conclusively shown to be linked with heart, kidney and liver disease (transmitted through the bloodstream), brushing your pet's teeth can be very beneficial to overall health.

WHAT ARE THE CHANCES THAT MY PET WILL ACCEPT BRUSHING?

It depends on many factors but we estimate that with patience and persistence 50-60% of cats will let us brush their teeth.

HOW EARLY CAN I START BRUSHING MY KITTEN'S TEETH?

As soon as possible. Eight to twelve weeks of age is the best.

CAN I TRAIN MY ADULT CAT?

It is never too late. However, to train an adult cat can be quite challenging. You will need more patience and time.

HOW OFTEN SHOULD I BRUSH MY PET'S TEETH?

Just like people, pets also would benefit from more frequent brushing. The minimum frequency for brushing your pet's teeth seems to be about once a week, however, 3 to 4 times weekly usually gives good results and is the maximum that most people's schedules can handle.

HOW DO I START BRUSHING MY CAT'S TEETH?

Step One: Get your cat used to having its mouth handled. This may take some time and patience on your part. MAKE IT FUN! Use a lot of love and praise to gain your cat's confidence. Late in the evening works well, as everyone involved is generally in a quiet mood. Start to open and close the mouth and gently move your fingers around inside the mouth. Wash your hands well after because, contrary to popular belief, your cat's mouth is not clean but packed with bacteria. For this reason we do recommend to start training adult cats after the prophylactic dental cleaning at the hospital, when the amount of bacteria in the cat's mouth is substantially eliminated.

Step Two: Once your cat allows you to handle its mouth, gently rub your finger along their teeth and gums. Put some cheese, peanut butter, tuna or clam juice on your fingers - it will make the procedure more acceptable to your cat.

Step Three: When your cat accepts fingering, start using a washcloth or gauze pad on your finger to rub along the teeth and gums. Wipe all teeth with strokes from the gum line to the tip of the tooth. Do this for one or two weeks until your cat is familiar with having the gums and teeth rubbed. Some people try adding a few drops of flavored water (clam, tuna, cheese) on the gauze so their pet will look forward to this treat.

Step Four: In a few weeks you should be able to progress to a soft toothbrush. After a week of using a dry toothbrush, add a small amount of special cat toothpaste. Begin by brushing the front teeth and then the large upper and lower teeth in the back. The bristles should be held at a 45 degree angle to the tooth surface and be moved in an oval direction. Pay attention to the crevice where the gums meet the teeth, as this is where odour and infection begin.

IF I BRUSH THE TEETH REGULARLY WILL MY CAT STILL NEED ROUTINE DENTAL CLEANING?

For most pets the best approach is to brush the teeth regularly and also have dental cleaning performed periodically (usually annually). Although brushing is an important aid to dental hygiene, it is usually used in addition to, and not in place of, periodic dental cleaning.

WHAT IF I GET STARTED BRUSHING MY PET'S TEETH AT HOME AND HAVE PROBLEMS?

If you have problems, talk to us and we can demonstrate the brushing procedure for you.

MY CAT HAS HAD A DENTAL PROPHYLACTIC CLEANING, CAN I START BRUSHING RIGHT AWAY AFTER THE CLEANING PROCEDURE?

Just like us, when we have our teeth cleaned by a dental hygienist we do not feel like brushing our teeth right away. Gums may be sensitive to touch and may bleed. Usually 3-4 days should be sufficient time to wait. If your cat had extractions or more involved dental procedures you should consult your veterinarian.

IF I CANNOT BRUSH MY CAT'S TEETH, ARE THERE ANY ALTERNATIVES?

Yes, there are a number of other things that can be done. Of course brushing is the most effective preventative measure, because it combines mechanical and chemical cleaning. However, some cats will just not cooperate at all. For those, the next best option is application of an oral gel on the gums. This will not require brushing. Other alternatives are enzymatic chews, antibacterial oral rinse, tartar controlling food, tartar controlling treats.

IS IT TRUE THAT DRY FOOD WILL PREVENT DENTAL TARTAR ACCUMULATION?

Feeding dry cat food will help to reduce the amount of plaque and tartar accumulation but it will not eliminate it. Hard food or biscuits are not enough to keep the mouth plaque-free.

IS IT BAD TO FEED MOIST FOOD TO MY CAT?

Diet is a major factor in the development of plaque and tartar. Soft and sticky foods may contribute to periodontal disease. However, soft food is essential for your cat's health, especially for health of the urinary tract. Please ask us about this important fact.

MY CAT WILL NOT ACCEPT ANY OF THE RECOMMENDED HOME DENTAL CARE PROCEDURES - WHAT DO I DO?

If you are not able to do anything, you should have your veterinarian perform a dental examination of your cat every 6-12 months, especially if your cat is over 10 years of age. Regular prophylactic dental cleaning is essential in keeping good dental health. It will prolong your cat's life. Please remember that there is no substitute for professional dental cleaning. We must work together to ensure a long and happy life for your pet. Thank you for letting us help maintain your cat's dental health.