Vet can ease cat’s toothache

I receive many letters from concerned cat owners regarding cat cavities, wondering how they get them, how to tell if their cat has a cavity, and how to treat and prevent them.

According to board-certified veterinary dentist Dr. Jan Bellows in Weston, Fla., cats get tooth cavities but they are not the same as those in people.

In people, cavities are caused by bacteria that eat through the enamel and erode sensitive dentin: outward-in.

Cat cavities, also referred to as neck lesions, are properly termed feline resorptive lesions, called RLs.

“They were originally called “neck” lesions because they most often occur at the “neck” of the tooth, which is where the body (root) meets the head (crown),” explains Dr. Veronika Kiklevich, a veterinarian practicing dentistry in San Antonio. “The tooth is a little thinner there just naturally.”

Unlike human cavities, cat cavities originate from the inside of the tooth and move outward: inward-out.

Also, feline RLs do not come from eating too much cotton candy or drinking too much soda pop. One thing they do have in common with human cavities is pain.

“Of course, as these lesions erode closer to and finally into the pulp, the pain is not just pain,” says Kiklevich. “It is the mother of all pain!

“Pulp exposure, or even near pulp exposure, as with a cavity, will get most people screaming at their dentist for help right away! And in addition to pain, the chronic inflammation has been shown to adversely affect the heart, kidneys and pancreas.”

Unfortunately, we know more about what does not cause cat cavities than what does.

Research has shown that the lesions are not due to early neutering, feline leukemia virus or immunodeficiency virus status. The two distinct types of RLs, I and II, appear to have different causes.

Dr. Alex Reiter at the University of Pennsylvania School of Veterinary Medicine has found that those cats suffering from Type II lesions have significantly higher amounts of vitamin D in their systems.

Continuing research is focusing on feline diets as a possible cause. More than 40 percent of 50 canned cat foods sampled had in excess of 30 times the vitamin D required by felines.

Diet may be one of several causes that must interact together to cause RLs.

Reiter is also studying use of medication, which may reverse the progression of disease.

We do know that cat cavities are common. Now that’s a mouthful, no pun intended!

According to Bellows, recent studies have revealed that nearly half of all cats older than 5 years will have at least one tooth affected, and 20 percent have at least two. Most affected cats can be diagnosed by seeing a small red area at the gum line.

“Years back, when our family vacationed in Santa Fe, New Mexico,” Dr Bellows related, “while my wife went shopping, the kids and I would examine the outdoor cats, betting if I could find a cavity on their teeth. Most of them had at least one.” (Note: Only veterinarians could or would examine feral cats while on vacation!)

Young cats can be affected, but most cats are older than 5 when resorptions are diagnosed.

“Common signs in cats include drooling or difficulty eating,” says Kiklevich. “A cat owner can self-diagnose by touching a Q-Tip to the red spot on the tooth. It will be extremely sensitive, since RLs generally affect the pulp or sensitive part of the tooth.”

Unfortunately some lesions are recognizable only by X-rays taken by a veterinarian. Since only 5 percent of the veterinary practices have dental X-ray machines, you may be referred to a dental veterinary specialist.

To find a dental specialist in your area log on to www.avdc.org.

Although veterinary dentistry and oral surgery are practiced with the same equipment and materials as human dentistry, unlike human cavities, RLs should not be filled because they start at the inside of the tooth. To date, extraction (removal) of the tooth is the treatment of choice.

Before surgery, each tooth must be evaluated for RLs.

Speak to your veterinarian beforehand to discuss the procedure thoroughly. For more information visit Bellows’ Web site, www.dentalvet.com, under feline dentistry.

Cats must be placed under general anesthesia to perform extractions.

To make the procedure safe, patients are evaluated beforehand with blood and urine tests, and possibly electrocardiograph, and chest films. Safe gas anesthetics are used, and the patient monitored during and after the procedure.

According to Bellows, this is a delicate operation because cat teeth are so small and fragile.

“About half the tooth is located below the gum line and, in Type I lesions, unless this part is removed, the cat will have continued pain. Once the tooth is extracted, the pain is gone.”

Prevention of feline RLs is still up in the air.

Daily brushing will help control plaque, as will special dental diets. We hope that in the future there will be a vaccine or medication to give cats and rid them of this painful problem that will affect nearly half of all our feline buddies.

Twice yearly, it is a great idea to take your cat to your veterinarian for a nose to toes checkup. The veterinarian very carefully will check the teeth, especially the one behind the lower canine, and if it is painful, get X-rays and treatment.

Your best friend will thank you – purrsonally.