Dental problems are common and painful health concerns in cats. Around 80% of cats over 4 years old have dental disease. Although it can affect any age, sex or breed, it’s most common in older cats, certain breeds and in cats with other illnesses. Dental problems can start even before birth and continue to develop throughout your cat's life. 1 in 4 of the cats who have to visit a vet do so because of dental disease. Common problems include inflamed sore gums, eroded teeth and tartar (scale, calculus). Untreated dental disease causes pain and suffering for many cats. A healthy diet, daily dental care and regular check-ups will help your cat have a healthy mouth and a better quality of life.

What are the dental problems in cats?

Cats are born without teeth, but their baby teeth come in between 3 and 6 weeks old Cats have 26 baby teeth and 30 adult teeth. Baby teeth fall out as adult teeth come in. Adult teeth are all present by 6-7 months old <insert photo>

Cats get 3 main types of dental problems.

• Stomatitis - Disease of the gums, tongue and cheek.

• Periodontal disease - Diseases of the tissues that hold the tooth in place

• Feline tooth resorption or FORLS - Erosion and holes of the tooth root and crown.

Other, less common problems include:

• Broken teeth - trauma (road accident, fall, blow to face)

• Overcrowding - having too short a face for all the teeth

• Malocclusion - poor alignment of teeth (from birth)

• Dental abscesses

Tooth decay in cats

Cats don't eat sugar and sweets the way humans do, so they aren't prone to the cavities (caries) and decay this causes in humans. However, tooth decay is still a problem in cats and can result from any (or all) of the following:

• Bacteria from rotting food particles trapped between teeth.

• Poor diet and poor dental care.

• Tooth root abscesses.

• Gingivitis - often a disease in itself. Also worsens tooth decay.

• Other illnesses -Chronic kidney disease, cancer of the gums or jaw.

The process of tooth decay in cats

• Bacteria in the mouth grow on the surface of the tooth

• A sticky invisible layer called plaque forms..

• Plaque is hard to remove from teeth - Chewing and tongue movements help to break it down.

• Poor diet and poor dental care will worsen plaque formation.

• Tartar, also called dental calculus or scale, forms when plaque hardens on the tooth.

• Tartar has a rough surface and attracts bacteria.

• Dental tartar/scale is a hard yellow to brown material.

Tartar worsens tooth decay by:

• Attracting more bacteria and helping them stick to the tooth.

• Wearing away gum, which exposes tooth roots, eventually weakening the teeth.

Acid produced by the bacteria and plaque attacks teeth. When plaque and bacteria gets onto the gums, it makes them red and inflamed. This is called gingivitis.

Painful gingivitis and swelling Gingivitis is the first warning sign of decay affecting the gums and other structures which support and anchor the tooth. This is called periodontal disease.

Feline tooth resorption - FORLS.

The second biggest dental problem in cats is feline tooth resorption or FORLS:

• Affects between 20 and 75% of adult UK cats

• Tooth roots and then tooth crowns are actively destroyed by the body's own cells.

• A progressive illness -leading to broken or missing teeth and inflamed, painful gums.

Dental (tooth) injury.

Broken teeth from accidents, including road accidents, falls from a height or a blow to the face)

• Certain medicines given to a young kitten or to mum during pregnancy damage the developing tooth

• Serious illness affecting mum in pregnancy

• Some infectious illnesses

• Poor diet

How to tell if your cat has dental problems

Symptoms of dental problems will relate to pain, difficulty biting or chewing food and decay. This includes:

• Dropping food, eating on one side of mouth

• Eating soft food and leaving kibble

• Dribbling saliva, bleeding from the mouth.

• Halitosis (smelly breath)

• Rubbing/pawing at mouth

• Losing weight

• Staring unkempt coat from reduced grooming

• Becoming quiet and withdrawn

Cats rarely show obvious symptoms of pain. This doesn't mean they dont feel it. Cats are prey animals as well as hunters. They don't want to look like a victim, so they hide pain well and ‘suffer in silence’. But many cat owners report that their cats have much happier and friendlier personalities after dental surgery. Which would confirm that the disease has indeed been painful for them!

What are the risks of dental problems in cats?

Higher Risk Cats

Various lifestage, breed and health factors affect your cat's risk of having dental problems. These include:

• Increasing age

• Eating a poor diet

• Retaining temporary (baby, milk or deciduous) teeth - most common in brachycephalic breeds.

• Having certain Viral illnesses - FIV, FeLV, Feline Calicivirus.

• Being a brachycephalic (short-faced) breed - suffering from dental overcrowding and poor tooth alignment.

Overcrowding physically damages and loosens teeth. It also results in food trapped between teeth and tooth decay. Cats with malocclusion may inadvertently bite down on their own gums and lips.

Complications of dental problems in cats.

Undiagnosed and untreated dental disease can lead to other serious and life-threatening illnesses. This happens when bacteria from the affected teeth and gums spread through the blood or airways to other parts of the body. Potential illnesses include

• Chest infections and bronchopneumonia

• Septicaemia

• Kidney disease

• Damaged heart valves and muscle (bacterial endocarditis)

• Above all, dental disease causes reduced quality of life for cats.

How do vets diagnose what's causing dental problems in cats?

A complete physical check-up during::

• New kitten checks.

• Annual health check and vaccinations..

• 3-6 monthly dental check up.

This examination reveals:

• Poorly aligned, missing or loose teeth.

• Inflamed sore gums.

• Retained baby teeth.

• Smelly breath.

• Stained teeth and build-up of tartar (scale or calculus).

It's impossible to assess your cat's mouth when they’re awake. Your vet will advise a general anaesthetic to carefully examine your cat's teeth, gums and tongue when they are asleep. Further tests include

• Dental x-rays - often essential to examine the roots of teeth and the jaw bone where they’re anchored.

What’s the treatment for dental problems in cats?

Vet treatment for dental problems depends on the problem and the severity. Treatment possibilities include extractions, removing all the hard calculus where bacteria are gathered, and cleaning the teeth and gums thoroughly to give the mouth a ‘fresh start’.

• A general anaesthetic - your cat sleeps through the procedure.

• Cleaning teeth using an ultrasonic scaler and handheld dental tools to remove lumps of scale.

• Removing loose, broken or rotten teeth.

• Removing teeth with defects due to resorption.

• Removing tooth roots where the crown is missing and gum is inflamed.

More specialist techniques:

• Dental polish.

• Dental crowns.

• Dental fillings are usually unsuitable for cats because their dental cavities are due to active resorption rather than bacterial decay.

Treatment for birth defects and malaligned teeth: For brachycephalic breeds, malaligned and crowded teeth are such a feature of the breed shape that potential problems can't be ‘cured’ or prevented as a kitten. Some degree of dental disease is inevitable. For cats with an individual overbite or misplaced canine teeth, options include:

• Removing teeth that damage gums or other teeth. The tooth removed may be otherwise healthy.

• Flattening crowns (tips) of teeth to reduce gum injury.

• Specialist orthodontic care.

Home care for cats with dental problems.

There are no home remedies to correct problems with tooth alignment. Any procedures suggested online, in chat forums or elsewhere are unethical and dangerous to your cat. Chipping of calculus by hand can also lead to emergency problems with broken teeth and bleeding. If your cat has dental problems, they should see their vet for a full examination. Your vet will be able to advise on treatment that is safe and in your cat’s best interests.

• Call your vet for the next available appointment

• Feed smaller, more frequent meals of soft food.

• Encourage your cat to drink as much as possible, even if they refuse food

Pet owners have the biggest influence on their cat’s dental health.

• It’s never too late or too early to start brushing your cat’s teeth.

• Keep your cats after a dental operation. Start brushing immediately to prevent plaque and bacteria from returning. This can happen within 24 hours!

• Feed a healthy diet. A special dental care diet, such as Hills t/d, is ideal.

Tips for preventing dental disease in cats.

The risks of dental decay in later life can be dramatically reduced if you start brushing or cleaning your cat’s teeth while they’re still a kitten. What you’ll need:

• Cat toothpaste. There are some specifically designed toothpastes to help break down plaque.

• Toothbrush or finger brush or microfibre cloth.

• Pet parent patience and perseverance.

• Cooperation!

<insert link and photos to tooth brushing tips> Effective cleaning means:

• Cleaning all of the teeth-including the back ones.

• Cleaning the inside surfaces next to the tongue.

• Paying close attention to brushing the margin between the base of the tooth and the gum. This is where all the plaque and bacteria start to build up.

Although brushing is the best way to protect your cat's teeth, some cats won't cooperate with this attention! Alternatives where brushing isn’t tolerated include dental rinses, gels, sprays and water additives.

• Reduce plaque and dental disease by preventing bacteria from sticking to the teeth

• Flavourless options available

• Safe if used according to manufacturer's directions

Other measures for dental health:

• Special diets for dental health - Science Plan Oral Health for cats, Hills t/d, Purina Dental Health

• Dental chews and treats - Encourage the chewing and tongue action which helps to remove plaque and calculus from teeth.

But smaller dental treats are often swallowed without chewing and certain dental products may be unsuitable for your cat. Check that chew toys are:

• Not too hard for your kitten or senior cat’s mouth

• Free of dangerous chemicals

• Well made. to prevent splintering or easy destruction

• Free of glass eyes or other small decorations that can come loose and be swallowed

Some edible chews will be unsuitable for cats with other illnesses because they may be:

• Too high in fat content

• Too full of calories

Always check the feeding instructions or ask your vet for advice The Veterinary Oral Health Council awards a seal of approval to dental products which effectively slow down plaque and tartar formation.This includes diets, toothpastes, sprays, washes, food additives.chews and treats. Check if this seal is present on products you select. Protecting future generations Living with dental problems is challenging and painful. Certain dental problems are inherited. They pass from mum or dad to the puppy before it’s born. Fewer kittens and cats will have these dental problems if we avoid breeding from cats with dental problems. This includes breeding cats with faces too short to hold the teeth

When to worry about dental problems

Call a vet if your cat:

• Has facial swelling and poor appetite, sudden onset or after a blow to the face

• Has unexplained bleeding from their mouth

• Is physically unable to pick up food or chew

• Is distressed, pawing at their face and unable to settle

Joii can help with advice on:

• Recognising the symptoms of dental disease

• Brushing your cats teeth

• Alternatives to brushing

• Choosing age-appropriate chew toys and diets