FAQs on Dental Diseases

What exactly are feline resorptive lesions?
Feline resorptive lesions are a common cause of severe pain in cats. Feline resorptive lesions (otherwise known as feline odontoclastic resorptive lesions or neck lesions) are a very common cause of dental pain in our feline friends. In fact, studies have shown that once cats reach middle age, at least half of them will have one or more resorptive lesions near or under the gumline, with the number of lesions increasing with age. Similar lesions also occur in other species, including man and dogs, but are relatively rare.

Resorptive lesions start as small holes in the structure of the tooth, which progress in size until they cause large defects. They are not the same as caries (or cavities) in humans, which result from bacterial acids eroding the enamel (usually due to a sugary diet). Feline resorptive lesions are caused by the cat’s own cells (called odontoclasts) destroying the tooth from underneath the enamel.
Affected teeth are very sensitive, and if the nerve is exposed they can be intensely painful. Often the crown of the tooth snaps off, leaving a painful retained root in the jaw. If your cat has unexplained “missing teeth”, they may well have been lost through this process.

Signs that your cat may be suffering from resorptive lesions include reluctance to chew, chewing on one side, drooling, pawing at the mouth, lethargy or bad breath. However, many cats will not show their discomfort until the pain becomes unbearable. Visible defects in the tooth, localised inflammation, swelling of the gum to cover the lesion, or an area with increased buildup of tartar may be seen. Small lesions are often only detected under anaesthesia.

Treatment usually involves extraction, as fillings are ineffective (the resorptive process simply continues inside the tooth structure underneath the filling). Dental radiographs are very useful in determining the extent of the lesions and the best course of action. Despite years of research, veterinary dentists still do not understand what exactly triggers the cat’s odontoclasts to attack its own teeth – this makes it hard to recommend any effective preventative measures.

What to do if you see a broken pet tooth?
Broken dog teeth (and cat teeth) should be assessed by your vet as soon as they are noticed. If the fracture is fairly small and does not expose the pulp (living tissue inside the tooth) there is a reasonable chance the tooth will survive. However, such teeth should be monitored closely as infection through the exposed dentine, or inflammation resulting from the injury may still cause the tooth to
die in the following weeks. Sealing the exposed dentine can help protect the tooth from infection, this is a quick procedure and is done under anaesthesia.

Teeth with exposed pulp will become infected and die if left untreated. In some cases, particularly in young animals with a very recent fracture, the tooth can be saved by a procedure called vital pulpotomy. However, in most cases root canal therapy or extraction are the best options. Doing nothing (‘wait and see’) is not a fair option for the animal as chronic infection of the tooth and jaw will
invariably occur.

What to do with persistent baby (deciduous) teeth?
Dogs and cats have two sets of teeth, just like humans. The deciduous (baby) teeth are replaced by the permanent (adult) teeth between about 3-6 months of age. Sometimes the deciduous teeth do not fall out, which can lead to overcrowding, increased susceptibility to periodontal disease and abnormal positioning of the permanent teeth, sometimes with painful consequences. This is most commonly seen with the canine teeth (fangs) and incisors (front teeth).

It is strongly recommended that persistent deciduous teeth are removed to protect the health of their permanent counterparts. Your vet can check for these at about six months of age – if your pet is being desexed at this time it is the perfect opportunity to address any problems.

What to do if your pets teeth are discoloured?
Discoloured teeth can occur for many reasons, and should be evaluated by your vet. Often it is due to tartar or stains on the tooth surface, which can be removed by professional cleaning under anaesthesia.

When the actual tooth itself is discoloured, this is generally a sign that the tooth itself is dead or dying. These teeth are often grey, pink or tan in colour. A recent study showed that over 90% of such teeth had dead tissue inside the pulp chamber – this acts as a reservoir for bacteria and leads to chronic infection that neither the immune system nor antibiotics can resolve. In most cases dogs and cats will not alert us to their discomfort until the infection bursts through the jaw bone as an abscess. Unfortunately for them, this can take months,or evenyears. Treatment may involve extraction or root canal therapy.

Less commonly, teeth can be discoloured from the time they erupt due to developmental problems such as poor enamel development – these teeth may benefit from sealants, or even restoratives (fillings or crowns).

Cat and dog dental problems affect four out of five pets
Cat and dog dental disease are arguably the most common diseases we see in small animal practice, with an estimated four out of every five cats and dogs over the age of three suffering from periodontal disease, broken teeth, resorptive lesions and other dental conditions that warrant treatment to relieve pain and resolve infection. Younger animals are not immune from dental problems, with persistent deciduous teeth and malocclusions being the more common problems in puppies and kittens. Left untreated, these conditions can result in lifelong discomfort, pain and infection.