Cat Cavities?

By: Alex Betzen, DVM

TVMA Member
Houston, TX.

Published February 2016

While February is the dedicated National Pet Dental Health Month, it is important to consider that our pets need dental care year-round. I personally find dentistry to be one of the most rewarding aspects of veterinary medicine. Cats visit us in the morning with gingivitisa common and mild form of gum disease (periodontal disease) that causes irritation, redness and swelling (inflammation) of your gums, pain, discomfort, “toothaches,” cracked and broken teeth, bad breath and other dental maladies, but by the afternoon, the broken teeth are fixed, bad breath gone, plaque, tartar and calculus are removed and sources of oral pain addressed. Not many aspects of medicine and surgery can have such quick results and improvements!

Cats, for the most part, get very different oral cavity diseases than people. These differences are from diet, different oral bacteria and a different composition of saliva. Cavities are rare in cats compared to people and are actually much different than the ones you and I get. Cavities, in fact, would be a misnomer, so I’ll call them by their proper name: Feline Tooth Resorptive Lesions (TR).

TR occurs in just under half of the cats in the U.S. There have been many proposed causes for TR. Initially, it was thought stomach acid from hairball regurgitation was damaging the teeth; this probably isn’t the case. Nutritional deficiencies (and excesses) have been proposed as a cause. Chronic viral infections, viral infections at the time of tooth development, low pH in diets and, of course, genetics have also been considered as factors. Currently, too much vitamin D in diets is thought to be the underlying cause. Only time and additional studies will reveal the truth.

Whatever the underlying cause, the damage to the tooth can be quite impressive. Tooth resorption provides a good description of what happens. The cat’s immune system literally attacks and destroys the tooth. Imagine the pain of a chronically broken tooth with the pulp cavity exposed. It is easy to see why cats can have such painful mouths and require anesthesia for accurate evaluation.

Resorption Stages

Resorption Stages

Diagnosis and treatment are are much more definitive than the cause. Serious pathology can occur below the gumline. Thus, intraoral radiographs are necessary to accurately diagnose and treat feline tooth resorption. For example, there are times when resorption will occur almost entirely below the gum line. These tooth roots will turn into bone, making removing the teeth difficult or nearly impossible. Look at the images below to see my point:

Photo courtesy of the Merck Manual

Photo courtesy of the Merck Manual

Without the radiograph, we wouldn’t even realize there is a retained portion of root (black arrow) that needs to be extracted for the best outcome.

Feline TR is a unique and common oral cavity disease that causes significant pain. One of the most rewarding things that I’ve heard from clients is their 8-year-old cat is acting like a kitten again after having their teeth cleaned and painful teeth addressed. While I’m glad we have an entire month devoted to promoting oral health in pets, our animals may have painful teeth year-round. Please talk to your veterinarian about a complete oral exam performed under anesthesia to be able to fully evaluate your pet’s oral health needs and provide the appropriate care.

Alex Betzen, DVM, is a graduate of Kansas State University College of Veterinary Medicine, who practices at Westbury Animal Hospital in Houston, Texas.