preventive dental care

Ask These 13 Questions Before You Schedule Your Cat’s Dental Procedure

dental-procedure

Guest post by Andrea Tasi, VMD

This post was first published in September 2015 and has been updated.

Andrea Tasi, VMD owns and operates Just Cats, Naturally, a housecall based, feline-exclusive practice dedicated to the holistic, individualized approach to each cat. Dr. Tasi uses classical homeopathy, nutritional therapy, and behavior and environment-related techniques to help healthy cats stay well and help ill cats regain their health. Whenever one of Dr. Tasi’s feline clients needs any kind of dental work, even just a routine cleaning, she makes sure that her clients as these questions before scheduling a procedure.
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Tooth Resorption: A Painfully Common Dental Disease in Cats

cat-yawning-teeth-tongue

Guest post by Dr. Karen Becker

When a kitty has oral disease, it generally has one of four causes:

  • Periodontal (gum) disease
  • Oral cancer (especially squamous cell carcinoma)
  • Feline stomatitis (an autoimmune disorder that causes painful inflammation of the mouth, throat or pharynx)
  • Tooth resorption

Tooth resorption is also referred to as cervical line lesions, resorptive lesions, feline odontoclastic resorptive lesions (FORLs), and (inaccurately) cavities. Of the four major feline oral diseases, tooth resorption is the most common. Estimates are the condition affects between about 30 to 40 percent of healthy adult cats, and from 60 to 80 percent of kitties who visit the vet for treatment of dental disease.Continue Reading

This Trendy Dental Procedure May Do Your Cat More Harm Than Good

cat-chewing-on-wood

By Dr. Karen Becker

Nonprofessional dental scaling (NPDS), also known as anesthesia-free dentistry, is gaining popularity with an increasing number of pet owners. These are well-meaning pet guardians who may be fearful of anesthesia or may not be able to afford professional veterinary dental care. They want to provide some form of oral care for their pets, so they opt for NPDS.

However, anesthesia-free dentistry is essentially a cosmetic procedure that addresses only the parts of your pet’s teeth you can see. The question many pet healthcare professionals are asking is whether NPDS procedures are doing more harm than good. One of the biggest concerns many veterinarians have with just scraping teeth is that the mouth is full of blood vessels, which can launch oral bacteria into the bloodstream. Once the bacteria is in the bloodstream it can infect other organs like the valves of the heart, resulting in a disease known as vegetative valvular endocarditis. (Read the American Veterinary Dental College’s (AVDC) position statement on dental scaling without anesthesia.)Continue Reading

Brushing Your Cat’s Teeth: The Most Effective Way to Prevent Dental Disease

brushing your cat's teeth

Dental disease is the most frequently diagnosed health problem in cats. Seventy to ninety percent of cats have some level of dental disease. If left untreated, it can lead to health problems for your cat, ranging from bad breath, dental pain and loose teeth to systemic illnesses that can be life-threatening.

The most effective way to prevent dental disease is to brush your cat’s teeth. Ideally, you get your cat used to this when she’s still a kitten, but even older cats can learn to accept having their teeth brushed.

All the cats who came before Allegra and Ruby had dental problems. Feebee, my first cat, needed to have his teeth cleaned once a year. Amber also needed annual dental cleanings, and for the last two years of her life, she had to have her teeth cleaned twice a year. Buckley had stomatitis, a condition in which the affected cat essentially becomes allergic to her own teeth. The outward signs of this condition are red, inflamed, and often ulcerated gums, and this can be very painful for the cat. Buckley eventually had to have all her teeth removed.Continue Reading

Anesthesia in veterinary dental care

Guest post by The Animal Medical Center 

When people go to a human dentist, we sit in the dentist’s chair, often time grasping the armrests tightly with white knuckles in anticipation of the procedure about to happen. When the dentist or hygienist tells us to say “ahhhhhhhh” or turn our head, or open our mouths, we may be reluctant, but we can follow their directions to facilitate their work. When they place x-ray films or digital sensors in our mouths and tell us to hold them while they walk out of the room, we do as they say.

February is Veterinary Dental Month. Our pets need the same dental care as we do; maybe more, since they don’t brush or floss twice a day. Our pets are not as cooperative when it comes to saying “ahhhhhhhh” or when it comes to following directions, yet they often experience the same anxiety as their owners when a stranger is poking and squirting things around their mouths.

There has been recent movement to perform anesthesia-free dental cleanings on veterinary patients. The rationale for performing dentistry on awake dogs and cats is that it will be cheaper for the client and safer for the patient. This movement is in direct opposition to the American Veterinary Dental College’s position statement entitled, “Companion Animal Dental Scaling without Anesthesia.”

I understand that many people are reluctant to perform proper dental procedures because of the need for general anesthesia, especially in the older patient. I am a firm believer that “age is not a disease,” and age should not be the deciding factor in determining the safety of general anesthesia for any patient. Pre-anesthesia testing can help determine the risk associated with general anesthesia and aid in the decision whether or not to perform a dental procedure. These tests help determine the function of the internal organs such as the liver, kidneys, heart and lungs, which are necessary to help the body safely handle anesthesia.

Proper anesthesia starts with the pre-op testing but also involves choosing the proper anesthetic drugs safest for each pet. The Animal Medical Center’s Dental Service always places an intravenous catheter to administer drugs, fluids and emergency drugs if needed. We also place an endotracheal, or breathing, tube to protect the airway and deliver the anesthetic gas and oxygen mixture to the lungs. Anesthetized dogs and cats at the AMC are connected to various monitoring equipment to measure the vital signs such as pulse rate, blood oxygen levels, blood pressure, electrocardiogram, and carbon dioxide levels. Finally, we monitor at regular intervals to make sure the vital signs are stable. If any painful procedures need to be performed, we also have the ability to utilize local anesthesia to minimize the amount of general anesthesia needed.

There are many advantages to performing any dental procedures under general anesthesia. First, when we scale the calculus (also known as tartar) off the teeth, there are often large or small pieces of calculus removed. If an animal is properly intubated with a breathing tube, then this calculus cannot be aspirated into the lungs or “swallowed down the wrong pipe.” The biggest advantage to working on a patient under general anesthesia is the ability to work around every side of every tooth. In the awake patient, the veterinary dentist has a very limited view of most of the teeth in the mouth. It’s easy to see the outside of the front teeth, but virtually impossible to evaluate the inside surfaces of many teeth and impossible to see many of the back teeth. A proper cleaning involves cleaning off all of the calculus from every surface of every tooth, both above and below the gum line. In the awake patient, the area below the gum line cannot be seen, yet under anesthesia it is much easier to fully visualize this area.

Once the teeth are cleaned, they need to be evaluated for periodontal disease. This involves gently probing under the gum line in several areas around each tooth in the mouth to measure periodontal pockets, or separation of the gums from the tooth root surface. Imagine trying to do this in an awake dog.

Approximately 75% of cats presenting for dental procedures have a decay of their teeth called tooth resorption. These are holes or decay in the teeth that often start at the gum line. They are quite painful and diagnosed by probing along the gum line with an instrument called an explorer. Again, this is not the type of procedure that could be tolerated by a cat without general anesthesia.

Proper dental procedures require intra-oral x-rays to make a diagnosis. A piece of film or a digital x-ray sensor is placed in the pet’s mouth. The person taking the x-ray steps out of the room and exposes the film or sensor and then walks back in the room. Not too many awake pets will tolerate this type of procedure.

Finally, with 75% of cats having tooth resorption and 80% of all dogs over the age of 5 years having periodontal disease, most veterinary dental patients need some type of surgical procedure to correct the abnormality. Finally, it is much easier to perform oral surgery when I’m not working on a moving target.

Given the complexity of the procedures necessary to clean, diagnose and treat a pet’s mouth, it is easy to understand why general anesthesia is so vital to performing proper veterinary dental care. My recommendation to anxious pet owners over the years is to use a little general anesthesia every year in order to maintain a healthy mouth, rather than wait until the mouth has severe disease and needs several hours of surgery to clean up a messy and painful mouth.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit http://www.amcny.org. To make an appointment, please call 212.838.7053.

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Preventive Dental Care for Your Cat

Dental disease is the most frequently diagnosed health problem in cats.  Seventy to ninety percent of cats have some level of dental disease.  If left untreated, it can lead to health problems for your cat, ranging from bad breath, dental pain and loose teeth to systemic illnesses that can be life-threatening.

Normal teeth in cats should be white or just a little yellow.  Gums should be light pink and smooth (except in breeds with pigmented gums).

What is dental disease?

Dental disease begins with a build up of plaque and tartar in your cat’s mouth.  Without proper preventive and therapeutic care, plaque and tartar buildup leads to periodontal disease, which manifests in red and/or swollen and tender gums, bad breath, and bleeding.  When the gums are swollen, they can be painful – a good rule of thumb is that if it looks like it might be painful, it probably is.

As bacteria from the inflammation and infection associated with periodontal disease is released into the bloodstream, this can lead to damage to other organs such as the heart, kidney and liver, resulting in serious health problems.  Dental disease in cats can also be an indicator of immune system disorders.

One common dental problem that generally shows up around the age of four or five in 25-70% of cats are feline odontoclastic resorptive lesions, also known as neck lesions, cavities or root absorptions.    Patients affected with FORLs may drool, bleed, or have difficulty eating.  A portion of affected cats do not show clinical signs.

What are the symptoms of dental disease?

  • bad breath
  • decreased appetite
  • changes in eating habits
  • drooling
  • chewing on one side of the mouth
  • loose or missing teeth
  • red or swollen gums
  • pain when mouth or gums are touched
  • bleeding from the mouth

Since cats are such masters at hiding pain, they frequently don’t show any symptoms until the situation is literally life-threatening.  They will eat even when their level of chronic mouth pain would send a person to the emergency room.  They almost never paw at their face, even with loose or abscessed teeth.  They can get pretty smelly breath from eating cat food, so it’s tough to tell by smelling the breath whether your cat has dental disease or has just eaten.  But even though they don’t show us much in the way of outward symptoms, chronic dental/periodontal disease can cause severe and often irreversible damage to internal organs.

What can you do to prevent dental disease in your cat?

Regular veterinary exams, at least once a year, and twice a year for cats seven and older or for cats with a known history of dental problems, are a must.  During the exam, the veterinarian will assess your cat’s teeth to determine the degree of dental disease.

Since our cats won’t just sit still and open their mouths to have their teeth cleaned like humans, dental procedures for pets require general anesthesia, something that makes many pet owners nervous.  While there are always risks with anesthesia, they can be minimized with a thorough pre-anesthetic check up, including bloodwork to assess kidney and liver function and rule out other underlying health issues.  This will allow your veterinarian to customize the anesthesia to your pet’s health status and potential special needs.  Keep in mind that leaving dental disease untreated may present a far greater risk than anesthesia.

What can you do at home to keep your cat’s teeth healthy?

Brushing

The most effective way to prevent dental disease is to brush your cat’s teeth.  Ideally, you get your cat used to this when she’s still a kitten, but even older cats can learn to accept having their teeth brushed.

Diet

Contrary to what you may have heard, dry food does not clean your pet’s teeth.  Most cats don’t chew their kibble long enough for any of the scraping action that is the theory behind this myth to kick in.  What little they do chew shatters into small pieces.  Some pet food manufacturers offer “dental diets” that are made up of larger than normal sized kibble to encourage chewing, but in my years at veterinary practices, I’ve seen many cats swallow even those larger size pieces whole.  Additionally, dry food leaves a carbohydrate residue in the cat’s mouth that actually encourages growth of tartar and plaque.

Cats do best on a grain-free canned or raw diet.  In fact, the moisture in these diets may actually help wash away some of the plaque, rather than allowing it to adhere to teeth.  Additionally, the enzymes present in raw food may help prevent plaque.  You can also give your cat raw chicken necks to chew on.  Never give cooked bones to your cat, they are brittle and can splinter and lodge in your cat’s intestines.

Dental treats 

Dental treats such as Greenies are simply dry food in disguise, and won’t do anything to prevent plaque.  The chlorophyll added to some of these treats may help your cat’s breath smell better, but this may mask more serious health problems.

Dental sprays or water additives

There are a number of dental sprays and water additives on the market that claim that they can prevent and even eliminate plaque.  Be very careful when evaluating these products.  Some may help, but others, at best, do nothing except provide cosmetic benefits by making the teeth appear whiter and masking more serious disease, and at worst, may actually harm your cat.  Any product taken internally can have harmful side effects, even if it’s “natural” or “herbal.”  Be especially wary of “proprietary formulas” and/or products that don’t disclose their ingredients.

I brush Allegra and Ruby’s teeth every night. Despite counseling clients in the veterinary clinics I worked at on how to do this, I confess that I never did it with my own cats until I got these two. I used a four-week program to get them used to having their teeth brushed, and they both took to it surprisingly well. So don’t rule out brushing your cat’s teeth with an immediate “no way” response. Give it a try. It may just be the best thing you do for your cat’s health.

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Amber’s Mewsings: Amber Gets Her Teeth Cleaned

sunny evening 006

You may remember that a couple of weeks ago, I had to undergo the dreaded bi-annual exam (you can read all about that ordeal here), and Fern, my vet, decided that I needed to have my teeth cleaned.  That finally happened last week.  Let me tell you, it was not a fun day.

I politely waited for Mom to get up like I do every other morning, and I led the way to the kitchen.  At first I thought Mom was just really tired that morning, because instead of feeding me, she just gave me fresh water.  Then she made her coffee.  Hello!  My food always comes before her coffee!  She kept saying “I’m sorry, Amber, I can’t feed you this morning.”  Well, sorry didn’t quite cut it, we were talking about breakfast here, and I made my displeasure known in no uncertain terms.  When that didn’t get the desired result, I tried flattery and rubbed against Mom’s legs and purred.  Still no breakfast.  When she took her coffee into her office and started doing her computer stuff, I knew we had a serious problem.  I kept trying to remind her that she was forgetting something, but no breakfast appeared.  After about an hour of this, I gave up and curled up for a nap.  Maybe this was just a bad dream and I’d wake up and breakfast would be served.

Well, things only went downhill from there.  Mom woke me up from my nap – and I immediately knew it wasn’t for breakfast.  She grabbed me off the nice and soft window perch I’d been sleeping on and stuck me into my carrier.  I knew resistance would be futile, but I still complained at the top of my voice.  I know it upsets Mom when I cry, but I was spitting mad!  Before I knew it, I was in the car and we were on the way to what I knew by now would be to the dreaded cat hospital.  I could have cried all the way there, but I decided to go easy on Mom and just grumbled occasionally.

Once we got there, I refused to come out of my carrier, knowing full well that they have ways to get me out, but I wasn’t about to make it easy for them.  Fern was there, and two other women who, okay, I’ll admit it, had good kitty vibes, but I wasn’t feeling too friendly, so I ignored their pathetic attempts to make nice with me.  Mom dragged me out of the carrier while one of the women was holding on to it, and then Mom put me on the scale.  She was happy with what she saw there, so at least that was good.  Apparently, the measly rations that have passed for breakfast and dinner around here are working and I’ve lost a couple of pounds since my last visit to the cat hospital.  After being weighed, Mom put me on a table with a soft towel on top that was really nice and warm.  I have to admit, that felt pretty good, but I also knew it was supposed to give me a false sense of security.  Sure enough, seconds later, I felt a needle being stuck in my hip, and something cold and burning was injected into me.  A few seconds after that, I started feeling really weird – fuzzy and kind of tired.  I don’t remember much after that.

When I woke up, Mom was holding me in her arms.  My mouth felt strange – a little sore, and there was this odd flavor coating all my teeth, nothing a cat should ever have to taste.  It smelled like what Mom’s mouth smells like after she brushes her teeth.  I shudder to think they used that paste stuff I’ve seen her use on me while I was asleep.  Mom says it’s called a fluoride treatment, but I say it tastes and smells nasty.  My throat was sore, like something had been shoved down it and then pulled out again.  Mom told me it was a breathing tube, but I don’t really know what that means, nor do I care to!  I felt really weird – I wanted to wake up but I couldn’t really control how to move my head or the rest of me.  But at least Mom was holding me, and that really helped.  Eventually, I felt a little better. I was able to lift my head and look around a little bit.  I can’t say that I cared much for what I saw.  Fern and the two women who were responsible for everything that was done to me were still there.  They were now torturing another cat on the table I had been on earlier.

After what seemed like forever, Mom put me back in the carrier.  This time, I wasn’t putting up any fuss about going in there – I’ve been through this enough to know it meant we were going home!  Once we got home, I still felt pretty crummy – just out of sorts, restless, tired, but yet not able to relax.  My eyes felt strange, and I couldn’t see all that clearly.  The things I did see don’t normally exist in my house, so I’m not sure what that was all about.   Mom says it’s the drugs they gave me.  Finally, after a few hours of tripping like this, I was able to relax enough to take a nice long nap.

I know how important it is to keep my teeth nice and clean, but I sure am glad that this is over with for hopefully at least another six months.  And in all fairness, I know this is just as stressful for Mom as it is for me –she worries about me, and I love her for that.

The Importance of Good Dental Health for Your Pets

cat dental health

Dental disease is the most frequently diagnosed health problem for pets.  Dogs and cats are particularly prone to tooth and gum diseases.  An astounding 80 percent of dogs and 70 percent of cats show signs of oral disease by age 3, according to the American Veterinary Dental Society.

Normal teeth in both cats and dogs should be white or just a little yellow.  Gums should be light pink and smooth (except in breeds with pigmented gums). 

Oral disease begins with a build up of plaque and tartar in your pet’s mouth.  Without proper preventive and therapeutic care, plaque and tartar buildup leads to periodontal disease, which manifests in red and/or swollen and tender gums, bad breath, and bleeding.  When the gums are swollen, they can be painful – a good rule of thumb is that if it looks like it might be painful, it probably is. Pets are masters at masking pain – when in doubt, assume that your pet is experiencing at least some discomfort.

The inflammation and infection associated with periodontal disease can lead to damage to other organs such as the heart, kidney and liver, and lead to other serious health problems.  Dental disease can also be an indicator of immune system disorders, particulary in cats.

Common indicators of oral disease in dogs include bad breath, a change in eating or chewing habits, pawing at the face or mouth and depression.  If you notice any of these, don’t wait until your dog’s next annual check up, take him to the veterinarian for a thorough exam.

Cats rarely show any symptoms at all unless the situation is literally life-threatening.  They will eat even when their level of chronic mouth pain would send a person to the emergency room.  They almost never paw at their face, even with loose or abscessed teeth.  They get pretty smelly breath from eating cat food, so it’s tough to tell by smelling the breath whether your cat has dental disease or just had breakfast.  But even though they don’t show us much in the way of outward symptoms, chronic dental/periodontal disease can cause severe and often irreversible damage to internal organs.  So it’s important to get regular veterinary exams at least once a year, and twice a year for cats six and older or for cats with a known history of dental problems. 

Since our pets won’t just sit still and open their mouths to have their teeth cleaned like humans, dental procedures for pets require general anesthesia, something that makes many pet owners nervous.  While there are always risks with anesthesia, they can be minimized with a thorough pre-anesthetic check up, including bloodwork to assess kidney and liver function and rule out other underlying health issues.  This will allow your veterinarian to customize the anesthesia to your pet’s health status and potential special needs.  Keep in mind that leaving dental disease untreated may present a far greater risk than anesthesia.

For more information on anesthesia for pets, read this guest post by Dr. Louise Murray about Safe Anesthesia for Pets.

A special thank you goes to Dr. Fern Crist of the Cat Hospital of Fairfax for her contribution to this article.