Introduction:

A cat grows two sets of teeth during its lifetime. The first set comprises 26 deciduous teeth, otherwise known as baby teeth. They start to appear when a kitten is about four weeks old, and by six weeks of age or so, the full complement is present. By the time the kitten is about six months old, the deciduous teeth will have fallen out and been replaced by 30 adult teeth - tailor-made by Mother Nature for catching prey, ripping it to pieces and chewing it up. They're also useful for self-defense.

Common terms:

Gingival = tissue over the bone and is the first line of defense

Periodontal = tooth supporting structures made up of Bone, Ligaments and Associated structures

Tooth made up of Enamel, Dentin, Root, Root canal with vessels

Plaque is bacteria mixed with glycoprotein's that form a film on the teeth

Calculus is when the plaque mineralizes to a hard shell.

Diseases of the mouth:

Feline gingivitis: The gingival tissue overlies the bony alveolar processes of the maxilla and mandible and surrounds the tooth. It is the first line of defense against periodontal disease protecting the bone and supporting tooth structures. Any inflammation of these tissues is termed gingivitis.  Both gingivitis stages one and two are reversible with professional care and a daily client periodontal maintenance homecare program.

Feline periodontitis: A disease of the tooth-supporting apparatus. Inflammation of these tissues leads to progressively destructive changes and loss of bone and periodontal ligament. Attachment loss can be 25 percent to 50 percent.  This is stage three and four depending on bone loss. Radiographic changes of horizontal, vertical, furcation and oblique bone loss are common. Oral radiology diagnostics are essential in feline periodontitis. Soft tissue, bony tissue and dental changes evidence numerous areas of pathology because of inflammation from plaque bacteria.

Periodontitis is an irreversible form of periodontal disease that can be controlled with professional care and exceptional individualized client periodontal maintenance homecare programs.

Feline Resorptive Lesions: Many names have been assigned over the years to this pathology, including feline dental resorptive lesions, feline odontoclastic-osteoclastic resorptive lesions, subgingival resorptive pathology and feline cervical resorptive lesions.

The etiology of these lesions is unknown and they are commonly found at the cementoenamel junction of the tooth just under the gingival margin covered with hyperplastic gingival. Minor lesions can progress leading to pulp involvement, root resorption and the crown being dissolved.  Radiography is essential for diagnosis and treatment. Many times, lesions can be identified below the gum line only with radiology. We never try to touch these teeth in an awake patient to search for these lesions instead we use general inhalation anesthesia with preemptive pain control to prevent further wind up in you cat. If exploration without anesthesia is attempted it will precipitate a severe pain reaction if the lesion is in into the pulp tissue.

All cats with advanced periodontal pathology should undergo full-mouth oral radiology for periodontal assessment and to examine for resorptive pathology; resorptive lesions are non-restorable lesions with extraction being the course of treatment as the lesions approach pulp tissue.

Feline gingivostomatitis (FGS) also know as Lymphocytic-plasmacytic gingivitis/stomatitis (LPGS) syndrome or Feline oral inflammatory disease is a severe oral disease that affects some cats where the body becomes allergic to plaque around the teeth. The allergic response appears as marked inflammation at the area where the tooth meets the gum line. While the specific cause of FGS is unknown, it is not believed to be related to feline leukemia virus, feline immunodeficiency virus, sex, spaying or neutering, or diet.  Some bacteria may play a role in the severity of the disease. Severe inflammation around the teeth exists with FGS. In many cases there are also inflammatory lesions in the back of the throat (stomatitis). Affected cats may have difficulty chewing hard food. Oral pain may cause a decrease in self grooming, resulting in a scruffy hair coat.  An examination usually reveals inflammation completely surrounding the teeth. The maxillary and mandibular cheek teeth are most commonly affected. In severe cases, the canines and incisors are also involved. In 20% of affected cats, the pharynx appears cobblestone red.  There are many options that may give short-term response including antibiotics, steroids, laser therapy, as well as interferon and other immune modulators. Extraction of the teeth behind the canines will resolve approximately 60% to 80% of the stomatitis cases leading to a prognosis that is good to excellent.

By having your cats mouth checked twice a year at regularly scheduled exams early problems in the mouth can be identified and treated before more severe health issues arise.