Feline Dentistry

Tooth Resorption (TR) in cats is broadly divided into two main categories; those associated with inflammation, and those characterised by replacement. They are divided into two types which have 4 or 5 stages, according to AVDC nomenclature.

TR associated with inflammation may present as “apple core” lesions on the roots or as apical external inflammatory root resorption associated with necrotic pulp. The former group are usually treated by extraction while the latter may be candidates for root canal therapy, or extraction. Teeth affected by Type 2 resorption may be treated by “crown amputation” or “crown amputation and intentional root retention”. Some teeth affected by Type 2 resorption may have one root affected and the other not, in which case crown amputation of the affected root and complete extraction of the other root would be indicated. Dental radiography is essential for diagnosis, treatment and monitoring.

Endodontic disease is disease of the tooth which affects the endodontic (pulp) system. This is commonly due to crown fracture and pulp exposure. Treatment will be root canal therapy or extraction depending on the tooth affected. Canines can undergo endodontic therapy and remain functional for many years. The larger premolars and mandibular molar 1 may also be salvaged by endodontic therapy. Fractured teeth, and others with endodontic disease will need to be extracted if endodontics cannot be performed on them. Teeth severely affect by periodontal disease may also become endodontically compromised and these will need to be extracted. 

Malocclusion can be defined as abnormal positioning of the teeth, affecting mastication and or causing trauma to soft tissues and or other teeth. Malocclusions can have inherited, congenital, developmental or acquired causes. Inherited supernumerary teeth in Burmese cats has recently been described (Emslie and Tutt) in which affected cats have supernumerary maxillary 4th premolars positioned palatally to the normal P4, resulting in malocclusion. Extraction of these teeth is essential to the treatment. All affected cats seen so far are related to one ancestor. Trauma can cause secondary teeth to erupt in the wrong direction, which may necessitate extraction. Orthodontic therapy may be performed in specific cases as long at the aetiology is not inheritance. 

Trauma to the head and face can be extensive. Numerous teeth may be fractured during one traumatic episode. Other trauma can include degloving of the chin which may be so extensive as to affect the gingiva and oral mucosa of the whole mandible/s. Separation of the maxillary gingiva and alveolar mucosa is also possible. Cats involved I road traffic accidents may suffer injuries to numerous parts of the mouth, head and other organs. Highrise syndrome is associated with differing levels of trauma and often include: TMJ subluxation, luxation or fracture; cleft of the hard and soft palates; fracture of the hamulus of the pterygoid bone with associated contusions; and severe swelling and contusions of the caudal oral area which may affect deglutition and breathing and will affect treatment choices.

Burmese cats are over represented in the group of cats affected by Feline Oro-facial Pain Syndrome (FOPS). In severe forms of this syndrome, cats are reported to cause severe and extensive injuries to their tongue and or face, resulting in laceration of the tongue and deep excoriation wounds of the face which has been described a mutilation. Initially this was thought to be associated with recent dental treatment but subsequently is was suspected to be as a result of a trigeminal neuropathy which responds in most cases to anti-seizure medication (phenobarbitone). Rusbridge et al reported that 14/16 treated cats showed beneficial response to treatment. Warning signs that an “attack” may be impending are; licking, chewing, gagging, and distressful pawing at the mouth. An “attach” resembles a frenzy which is very distressing to both the cat and their owner (or anyone else who may be exposed to this).