As plaque deposits build up, they harden into calculus (tartar) and enlarge the pocket (sulcus) between the tooth and the gum. This enlarged sulcus traps debris and creates a fertile environment for bacterial growth. Saliva, which normally washes out the sulcus, can no longer do its job effectively and clear out the sulcus. Multiplying bacteria invade the gingival tissue. The gums become swollen and are liable to bleed when probed. Fortunately, at this early stage, the teeth have not lost their supporting bone structure. So if gingivitis is detected early and treated promptly, its effects are reversible.

When gingivitis is apparent, we are now performing laser surgery to help reduce the gingivitis of the mouth. This procedure is performed during the dental prophylaxes.

Periodontitis

Periodontitis, the advanced stage of periodontal disease, occurs when bacteria, their waste products, and other toxins cause the gums to ulcerate. Over time, an increasing buildup of calculus causes ever-deepening pockets to form around the teeth. Eventually, the alveolar bone begins to erode. Finally, erosion of the gingival and alveolar bone advances to such a degree that the teeth no longer have anything to support them. The become loose and fall out. (These lost teeth are almost always healthy teeth.) Unfortunately, periodontitis is not reversible. But if treated early enough, it can be controlled.

What You Can Do

Plaque forms every 6 to 8 hours. And merely rinsing your cat’s mouth will not remove the buildup. To effectively remove plaque, you need to brush your cat’s teeth - preferably every day. While brushing takes discipline, it doesn’t take a lot of time - no more than 15 to 30 seconds. Admittedly, most cats do not clamor to have their teeth brushed, but most will tolerate it if you set up a routine, stick to it, treat brushing like a game, and always remember to reward your cat afterward.

What Your Vet Can Do

Your cat’s doctor is also your cat’s dentist. Your veterinarian should examine your cat’s gums and teeth at least once a year - more often if your cat needs it. (Some cats build up plaque faster than other.)

To catch problems early, it is essential that the owner and veterinarian work as a team. An observant owner may notice subtle changes in a cat’s mouth or behavior that he or she can bring to the veterinarian’s attention during a routine checkup. Alerted to potential trouble spots, the vet can the schedule time for a detailed oral examination.

The Dental Visit

Given that cats are usually ready with "tooth and claw," your veterinarian will need to give your cat a general anesthetic to carry out a thorough and detailed examination. (If your cat is older, don’t put off treating your feline senior citizen because you fear putting the venerable lady or gentleman "under." Instead, talk with your vet about the anesthetic protocol that is appropriate for your cat’s circumstances.)

After first anesthetizing your cat, the vet removes calculus and plaque from its teeth. The veterinarian may also scale the roots of the teeth, smoothing roughened root surfaces to make it more difficult for plaque to adhere (the equivalent of deep scaling in human dentistry). Next, the veterinarian mechanically polishes the teeth and roots, then flushes the sulcus because the feline patient is unable to "rinse thoroughly" for itself. The vet then examines each individual tooth and records the findings. "It’s like examining 30 patients," explains Dr. LeVan. "You look at every tooth and measure the pockets."

If any disease is evident, the vet either deals with it immediately or plans future treatment. Finally, the veterinarian may apply a fluoride treatment. Fluoride provides four major dental benefits: it hinders the growth of bacteria; it desensitizes dentin and pulp (the sensitive layers beneath the tooth enamel); it hardens tooth enamel; and it helps minimize bone and tooth loss. However, only your veterinarian should apply fluoride. Fluoride treatment, although beneficial when used judiciously, has a downside: too much fluoride can be toxic for cats.

Undeniably, feline dental care requires an investment of time and money. But consider the benefits. Caught early enough, periodontal disease is treatable. We know that daily home care slows down the buildup of plaque, which in turn slows down the progression of periodontal disease. We also know that regular oral hygiene makes cats feel better and possible prolongs lives.

Feline Dentition

During its lifetime, a cat has two sets of teeth - a deciduous set and a permanent set. Deciduous teeth are those 26 needle-sharp "baby" or "milk" teeth that are replaced during the first 6 months of life with 30 permanent teeth - incisors (12), canines (4), premolars (10), and molars (4). Indeed, one way to tell a young cat’s approximate age is by looking in its mouth. Permanent incisors (the 12 small front teeth) usually appear around 4 months of age, and the permanent canines (the four front "fang" teeth) at around 6 months.

Become familiar with your cat’s dentition. If a cat retains deciduous teeth, such as deciduous canines, these teeth may displace the permanent canines. And too many teeth can lead to overcrowding, which can cause a cat’s teeth to rotate.

Too few teeth can also lead to dental problems. Although it is not unusual for a healthy cat to have an incomplete set of permanent teeth, an owner should find out whether a missing tooth is actually missing or whether the tooth was broken earlier and is now covered with gum tissue. Should that be the case, the broken buried tooth will eventually become infected and cause problems.

Brushing: The Best "Medicine"

Given that owners can prevent the development of gingivitis - the early stage of periodontal disease - by brushing their cat’s teeth daily, we make no apologies for reprinting the following advice from a previous Catnip article.

Week 1: Fun Time

Don’t attempt to clean your cat’s teeth yet. In the first week, just accustom your cat to your daily inspection of its teeth. Establish a routine. Every day at the same time, lift your cat onto a table or counter. Firmly holding the cat’s head with one hand, pull back its lips and examine its teeth. Make sure you look at all the teeth - top and bottom. Rub your finger along the gums. During this inspection, reassure your cat. After the inspection, praise your cat, give it a favorite treat, or play with it for a few moments. It’s important to reward your cat at the end of each session so it associates daily dental care with a pleasurable experience. Hint: Resort to bribery!

Week 2: Practice Makes Perfect

Introduce your cat to the toothbrush (or a cotton swab). Every day at the same time, rub the toothbrush (the human variety is fine) or swab along your cat’s gums just as you did with your finger during the first week. Let your cat rub its whiskers along the toothbrush bristles. (Many cats will do this without prompting.) Try dipping the toothbrush in tuna fish-flavored water. At the end of each session, tell your cat how swell it is and reward it with its favorite treat or toy. Hint: Don’t rush. Let your cat think it’s his or her idea.

Week 3: The Real Thing

Introduce toothpaste. Use a reputable brand of feline - not human - toothpaste. Human toothpaste contains agents that are harmful to cats if they ingest them. Detergent, for instance, a foaming agent in human toothpaste, is an irritant that can cause gastric problems in cats.

Contrary to popular belief, salt and baking soda are not effective plaque removers. What’s more, these compounds contain sodium - which is potentially dangerous to older cats with heart disease. Once you have established a tooth-brushing routine, do the same thing at the same time every day. Hint: Reward yourself as well as your cat!