La Salle University, Bogotá, Colombia; Postgraduate specialization in veterinary dentistry, University of São Paulo, Brasil; Director, DentalVet veterinary dentistry service, Bogotá, Colombia
Feline dentistry is a very important field, because although there are many similarities in dentistry in dogs, it is also important to know certain considerations and conditions that may occur in the oral cavity of cats.1 The main thing is to know the normal anatomy of the oral cavity of these animals, in order to recognize when there is something wrong in it, and thus know how to treat it. First, regarding the anatomy of the feline is that some of the premolars and molars have been lost in the domestic cat evolutionarily. For example the first (05) and second (06) permanent premolars are absent in cats, so the closest canine premolar may be wrongly numbered as tooth 05.2
Among the main conditions of the oral cavity of cats we must know the difference between periodontitis and gingivitis, in order to differentiate them from other common inflammatory conditions in cats.3
Periodontal disease is a common finding at the clinic in cats.3 Periodontitis occurs when plaque induces inflammation affecting the gingiva (gingivitis) and begins to affect other tissues of the periodontium. The periodontium consists of the tissues surrounding and supporting the teeth, including the gingiva, cementum of the tooth, the periodontal ligament, and alveolar bone.2 After gingivitis and periodontitis, there may be a chronic oral infection, bacteremia, pain and eventually tooth loss, so it is important to understand that gingivitis can be a reversible condition if adequate control of bacterial plaque is made, while periodontitis is irreversible and progressive condition.3
In addition to recognizing gingivitis and periodontitis, it is very important to differentiate gingivostomatitis, a condition that can occur in cats of all ages, being more common in its inception in animals under 2 years of age.4
Feline chronic gingivostomatitis is characterized by severe chronic inflammation of the gingiva, the buccal mucosa, and the caudal region of the oral mucosa; the palate, oropharynx and tongue occasionally are affected.5
A retrospective study of 101 cats with chronic gingivostomatitis found that all cats had periodontitis, and 77% of cats had semi-generalized or generalized alveolar bone loss, which was a significantly higher proportion than in cats without chronic gingivostomatitis.6
The most successful treatment for animals with gingivostomatitis is the extraction of all premolars and molars including the periodontal ligament, making sure not to leave any retained root; some cats eventually require total dental extractions to present some improvement, but this is mostly in cases in which the inflammation extends around the canines and incisors.2 The explanation for extractions of premolars and molars, is to remove the place where plaque adheres, based on the opinion that these animals may have an exaggerated inflammatory response to bacterial plaque. Most cats have an excellent response to this treatment, which allows that a long-term drug treatment is not necessary.7
Among the most prevalent dental conditions in felines, it should be noted resorptive lesions, which are defined as an odontoclastic destruction of the teeth of cats and are classified into two types. In type 1 resorption lesions there is no replacement for bone tissue, while in type 2 lesion, the root structure has been lost and there is a replacement by bone tissue.2 The pathogenesis of the resorption lesions in cats is not fully known, but many theories have been proposed about.8
Resorptive lesions are often covered by hyperplastic or hyperemic gingiva, and/or plaque or calculus.9 Frequently, these lesions are described to originate in the cervical portion of the tooth, or at the cement-enamel attachment of the tooth, just after the gum line, although in many cases are more apical lesions in radiographic examination with no apparent injury in the cervical part of the tooth.1
References
1. Wiggs RB, Lobprise HB. Veterinary Dentistry: Principles and Practice. Philadelphia, PA: Lippincott-Raven; 1997.
2. Niemiec BA. Small Animal Dental, Oral and Maxillofacial Disease: A Color Handbook. London, UK: Manson publishing Ltd; 2011.
3. Perry R, Tutt C. Periodontal disease in cats back to basics - with an eye on the future. J Feline Med Surg. 2015;17(1):45–65.
4. Diehl K, Rosychuk RA. Feline gingivitis-stomatitis-pharyngitis. Vet Clin North Am Small Anim Pract. 1993;23(1):139–153.
5. Hennet PR, Camy GA, McGahie DM, Albouy MV. Comparative efficacy of a recombinant feline interferon omega in refractory cases of calicivirus-positive cats with caudal stomatitis: a randomised, multi-centre, controlled, double-blind study in 39 cats. J Feline Med Surg. 2011;13(8):577–587.
6. Farcas N, Lommer MJ, Kass PH, Verstraete FJ. Dental radiographic findings in cats with chronic gingivostomatitis (2002–2012). J Am Vet Med Assoc. 2014;244(3):339–345.
7. .Hennet P. Chronic gingivo-stomatitis in cats: long-term follow-up on 30 cases treated by dental extractions. J Vet Dent. 1997;14(1):15–21.
8. Okuda A, Harvey CE. Etiopathogenesis of feline dental resorptive lesions. Vet Clin North Am Small Anim Pract. 1992;22(6):1385–1404.