“Doctor, I don’t know what it is, but Tiny has the absolute worst breath I’ve ever smelled.  Do you think it could be his diet?”  Mrs. Schmidt placed her 6 year old, 18 pound cat “Tiny” on the exam table and I began to examine him.  Most cats don’t have the best smelling breath, but I could smell Tiny’s without even opening his mouth.  I always start my exams at the head, so after I looked at his eyes and ears, I pried open Tiny’s mouth.  I couldn’t argue with Mrs. Schmidt, her cat’s breath could knock you over and the reason was apparent, he had an abscessed tooth.

The rest of Tiny’s teeth were not in good shape either, but the site of infection was the source of the smell.  His left, fourth upper premolar tooth had root exposure and a pocket of pus above it.  I finished examining the rest of his body, and other than being about 4 pounds overweight, the dental disease was his only other problem.  I asked Mrs. Schmidt about Tiny’s diet.  It consisted of a variety of canned foods and table scraps.  Tiny had never previously had his teeth cleaned, and Mrs. Schmidt did not brush his teeth at home.

I explained that over time, plaque and tartar had built and led to gingivitis.  Bacteria were then trapped under the gums and festered to cause the pocket of infection.  It was too late to save the abscessed tooth, but hopefully by cleaning the other teeth and flushing around the gums, we could save the rest.  We scheduled Tiny’s dentistry for the next day.  A pre-anesthetic blood panel was performed, and Tiny’s only abnormality was a slightly elevated white blood cell count.  This was expected with the infection.

Tiny was placed under general anesthesia, given antibiotics, and full mouth dental x-rays were taken.  All of his teeth were probed for pockets, cavities, and root exposure.  The dental x-rays and probing found that other than the abscessed tooth, 3 other teeth were unstable and had root exposure.  Tiny’s four problem teeth were extracted, then we hand scaled and then ultrasonically scaled his teeth.  The dentistry was finished by polishing the remaining teeth and then applying a protective coating to the teeth.  Tiny recovered uneventfully from his anesthesia and went home later that afternoon.

The next day my receptionist called Mrs. Schmidt to see how Tiny was doing, and she reported that he was doing well.  Taking his antibiotics and pain reliever without a hitch, and voraciously hungry.  It took more than a few extractions to keep him from eating.  Mrs. Schmidt also reported that Tiny’s breath was the best that it had ever been.  She said that she would try to limit Tiny’s canned food and replace it with some Prescription Diet t/dÒ which helps prevent plaque buildup but that brushing his teeth was not going to be feasible for her.  When I saw Tiny a few months later for his annual physical exam, his teeth and breath were good and he was maintaining his heavy weight of 18 pounds.

You probably don’t think about your cat’s teeth very often.  Unless your cat has bad breath or you observe that it is having trouble eating, you might not realize that significant plaque, tartar, and gingivitis are present.  70% of cats have some oral disease by the age of three years. During routine physical examination, your veterinarian should be assessing your cat’s dental health and letting you know when it is time for preventive cleaning or treatment of a dental problem.

At home you can monitor your cat’s dental health by looking at the teeth and gums on a monthly basis.  Plaque and tartar cover affected teeth and make the teeth appear yellow to brown.  Gingivitis makes the gums red and puffy.  In early stages of gingivitis, a thick red line may be visible at the tooth/gum interface.  Once dental disease has started, there is not a lot you can do at home to cure it.  The best treatment is to have the teeth cleaned by your veterinarian and then start preventive care at home on clean teeth.

There are various home care options.  A few food manufacturers produce dental diets that help prevent plaque buildup.  There are also dental treats.  If you want to brush your cat’s teeth at home, use specific cat toothpaste that is meant to be swallowed and will taste good to your pet.  Dental rinses and wipes can help too.  Dry foods tend to cause less plaque buildup than canned, so a mix is probably best unless another health problem dictates a special diet.

To do a safe and adequate job, a cat’s teeth must be cleaned under general anesthesia.  As you can imagine, a cat is not going to allow safe probing and scaling of its teeth without the help of drugs.  Since a thorough dental procedure involves flushing the mouth with water and antiseptics, it is safest to have the cat under general anesthesia with a tube into his airway.  This prevents aspiration of fluids and keeps an open airway.

Many senior cats have advanced dental disease, but their owners are concerned about the risks of anesthesia.  If a physical examination and blood panel rule out any other health problems, short acting inhalant anesthetics and other precautions can be used to make the procedure safe and successful.  It is more dangerous for a cat to have a constant site of infection that can spread elsewhere in the body than to go through a controlled dental procedure performed by a conscientious veterinarian.

February is National Pet Dental Health Month and a good time to get your cat’s year started off with good teeth.  Don’t let your cat become another Tiny.  Most cats with advanced dental disease still eat relatively normally, so don’t miss problems and work with your veterinarian to keep your cat’s teeth in great shape.

Written by Dr. Wexler-Mitchell of The Cat Care Clinic in Orange, CA
Copyright © 2011 The Cat Care Clinic