Published by: Ingrid King. Last Updated on: November 1, 2022 by Crystal Uys

cat-with-toothbrushUpdated January 11, 2018

Dental disease is the most frequently diagnosed health problem for cats. According to the American Veterinary Dental Society, an astounding 70 percent of cats show signs of oral disease by age 3.

How dental disease starts

Normal teeth 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 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. Cats are masters at masking pain – when in doubt, assume that your cat 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.

Cats rarely show symptoms of dental disease until it is in its advanced stages.

Cats will continue to 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 seven and older or for cats with a known history of dental problems.

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

Brush your cat’s teeth

Brushing your cat’s teeth is the single most effective thing you can do to ensure good dental health throughout your cat’s life. And before you say “my cat would never let me brush her teeth,” think again. Ideally, you get your cat used to having her teeth brushed when she’s a kitten, but with a little patience and persistence, even older cats will accept having their teeth brushed.

The Cornell Feline Health Center developed a 4-week training program that should get most cats used to having their teeth brushed. I followed this program pretty closely, and it was much easier than I expected.

If you absolutely cannot brush, MAXI/GUARD Oral Cleansing Gel (affililate link*) is very effective and can be rubbed on the gums with your finger. Read my review here.

Dental treats

There are a lot of dental treats and so-called “dental diets” on the market. Almost all of them are dry foods or treats. And I don’t believe that they work. Most cats don’t chew dry food or dry treats long enough for any of the scraping action that is the theory of how these diets and treats supposedly work to kick in. What little they do chew shatters into small pieces. Some pet food manufacturers offer a “dental diet” that is 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.

The only dental treats I recommend are the  CET Enzymatic Oral Hygiene Chews for Cats (affiliate link*.) The enzymes in these treats are supposed to reduce the build up of tartar and plaque. The ingredients are not the greatest, but they’re not horrible, either. The individual treats are about an inch long, so they’re pretty big – the size of a small mouse – and it does take a while for my girls to chew them.

If you feed raw, you can give your cats raw chicken necks. Gnawing on the bones will help scrape away tartar and plaque. NEVER give cooked bones to your cats, they can splinter and cause intestinal perforations. Even though I feed raw, giving raw chicken necks exceeds my comfort level – not because I’m worried about them chewing on the raw bones, but because the one time I tried it, they dragged them all over the (carpeted) house.

Regular veterinary exams

Cats should see the vet at least once a year, cats seven or older twice a year. A thorough dental exam should be part of every veterinary visit.

Professional cleaning under anesthesia

Even with regular home care, your cat may need periodic professional cleanings. Cat guardians are often reluctant to perform proper dental procedures because of the need for general anesthesia, especially in the older 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.

Do not let anyone tell you that it’s possible to perform a thorough anesthesia-free dental cleaning on cats. Anesthesia-free dentistry is essentially a cosmetic procedure that addresses only the parts of your pet’s teeth you can see. An additional issue 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. Anesthesia-free dental cleanings may do more harm than good.

Severe dental disease

In addition to periodontal (gum) disease (inflammation of the gums, also known as gingivitis), there are two other common dental diseases that are seen in cats.


Stomatitis is is one of the most painful and frustrating conditions cats can develop. With this severe inflammation of the oral cavity in cats, 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. The condition is frustrating to diagnose and treat. For more information, read Stomatitis: painful for cats, frustrating for guardians and veterinarians.

Feline oral resorptive lesions

Also known as  feline odontoclastic resorptive lesions (FORLs), and (inaccurately) cavities, tooth resorption is the gradual destruction of a tooth or teeth caused by cells called odontoclasts. Tooth resorption usually starts on the outside of a tooth at the gum line. The condition is most common in premolars in the lower jaw, but can occur in any tooth. This is a painful condition, which needs to be addressed by a veterinary dentist. For more information, read Feline Tooth Resorption: A Painful Common Dental Disease.

Oral cancer

The oral cavity is a common site for cancerous growths in cats. The most common malignant oral tumor in cats is squamous cell carcinoma. The prognosis for this fast-growing, invasive tumor is usually not good, so it is vital to identify and treat it early.

Allegra and Ruby’s experience with dental disease

Allegra had extensive dental work done in October of 2015, Ruby in January of 2017. I wrote a four-part series for each about each experience here.

*The Conscious Cat is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to products on Amazon and affiliated sites. This means that if you decide to purchase through any of our links, we get a small commission. We only spread the word about products and services we’ve either used or would use ourselves.  

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