Dental disease in cats differs dramatically from dental disease in dogs. Even with minimal tartar accumulation cats can develop a very aggressive dental disease in which the body’s own tissue eats its way into the neck of the tooth (neck lesions), eventually entering the nerve chamber, weakening the tooth until it fractures into sharp fragments. This is a very painful problem. Another cat specific oral disease is stomatitis, where the gum tissue itself becomes raw, bloody and painful.
Cats hide dental pain even more effectively than dogs. This is a form of predator avoidance – predators attack the sick and injured so pets by nature hide dental pain well until it becomes too severe to hide. Symptoms of dental disease in cats include bad breath from decaying gum tissue and, reluctance to chew dry food, pawing at their face, or a red spot on the gum where it attaches to the tooth (sign of an underlying neck lesion).
The medical problems associated with dental disease are almost exclusively underneath the gums. This area can only be examined and treated under general anesthesia. At Warwick Animal Hospital prior to starting the procedure, we run a full blood panel to look for pre-existing problems that might affect the choice of anesthetic drugs and an ECG to evaluate the heart.
The general anesthetic regimen is individualized based on physical examination, blood panel results, and ECG to maximize its safety for your pet. An IV catheter is placed prior to anesthesia and IV fluids are administered throughout the procedure to maintain blood pressure and to maintain blood flow to the kidneys. Without IV fluids, blood flow to the kidneys drops dramatically under anesthesia, causing permanent loss of some of the functional nephrons. In younger pets with healthy kidneys this damage goes unnoticed, but in older pets with marginal kidney function the drop in blood flow can push them over the edge into kidney failure. Since kidney disease is a primary cause of death in older cats it is critical that the remaining kidney function is preserved.
Once anesthesia is induced, we place an endotracheal tube to administer oxygen and a gas anesthetic, to maintain respiration, and to seal off the respiratory tract from bacteria-laden fluid from the mouth during the cleaning procedure. Pulse oximetry and anesthetic monitoring allow us to watch the oxygen saturation of the hemoglobin in the red blood cells and the heart so the anesthetic level can be adjusted for maximum safety.
Antibiotics are given before the procedure begins to protect your cat’s internal organs from the bacterial shower cleaning releases into the bloodstream. Pain medication is administered as well.
The teeth and gums are carefully examined, then the teeth are cleaned by ultrasonic scaling which uses high frequency vibrations to remove plaque, bacteria, and calculus from the teeth. After ultrasonic scaling our technicians perform sub-gingival curettage, removing tartar, plaque and calculus present on the tooth under the gum line.
The next step is probing for neck lesions under the gum line. If a significant neck lesion is found the tooth needs to be extracted. This helps prevent spread of the problem to adjacent teeth. When neck lesions were first being addressed thirty years ago we tried salvaging these damaged teeth with amalgam or glass ionomer filling materials, but we found that once the cat’s body has mounted an attack against a tooth the cat’s body will eventually win that battle and the cat is much better off having the damaged tooth extracted.
In some cats neck lesions and stomatitis becomes so severe the only effective treatment is a full mouth extraction. While it may sound extreme, cats with the severe form of this problem are in severe pain and the extractions are the only way to eliminate that pain.
Your cat is monitored throughout recovery and wakes up from anesthesia in the arms of a caring staff member. The IV catheter is left in place until just before going home and is replaced by a small bandage at discharge.
At Warwick Animal Hospital all dental cleanings are performed by Licensed Veterinary Technicians with a combined experience of over forty years. All extractions are performed by a veterinarian. The work performed on each tooth is charted and recorded by the doctor and the technician. At pickup time the technician will go over all the home care instructions with you and will answer any questions you might have.