Periodontal disease
General information
Other common/scientific names: gingivitis, periodontitis
Periodontal disease affects the supporting tissues of the teeth and includes a wide spectrum of disease severity. Gingivitis is the reversible stage of the disease and involves inflammation of the gingiva (or gums). Periodontitis involves inflammation of the deeper structures of the tooth, as well as bone loss. Periodontitis is considered to be irreversible, although progression of the disease may be controlled by treatment. Chronic periodontitis causes bacteria in the mouth to enter the bloodstream, which may then result in disease of the heart, kidneys, and/or liver.
Periodontal disease is the most common oral disease of cats.
Causes
Plaque is the primary cause of periodontal disease. Plaque forms when the normal fluids in the mouth coat the teeth and gingiva and allow bacteria normally present in the mouth to adhere to them. Unless this plaque is removed, it will thicken and extend between the tooth and gingiva, reaching the underlying structures of the tooth. It is this bacteria-rich plaque that causes the inflammation, tissue damage, and bone loss seen with periodontal disease. With chronic periodontitis, this bacteria may even get in the bloodstream and cause injury to other distant organs, such as the the heart, kidneys, and/or liver.
Plaque is a soft substance with a cream or gray color. When present in thin layers, it can be very difficult to see unless a disclosing solution is used or it is scraped from the teeth. Minerals present in the saliva cause plaque to undergo mineralization, which leads to the formation of calculus (commonly called “tartar”). Calculus is bulky, brittle and can range from brown to gray or black in color. Calculus provides a rough surface for the formation of more plaque, thus leading to further periodontal disease. Other things that also encourage plaque formation are crowded teeth, retained deciduous teeth, foreign bodies (including food and hair) caught between the teeth, and sticky, soft food. Diseases which decrease a cat’s resistance to infection (e.g., diabetes, FeLV and FIV) can also promote periodontal disease.
Infection
Although periodontal disease is caused by bacteria-laden plaque, all normal animals carry these bacteria in their mouths. There is no evidence of cats spreading the disease to other cats, nor to other animals, including humans.
Cardinal symptom
• Bad breath
• Gum inflammation
• Calculus
Symptoms
Bad breath and inflammation of the gums (gingivitis) are often seen early in periodontal disease. Calculus formation, pus coming from under the gums, loose or missing teeth, difficulty eating, and/or facial swelling may be seen as the disease progresses.
Diagnosis
A thorough examination of the mouth and dental x-rays will be used to diagnose periodontal disease. Dental x-rays are an important diagnostic tool since up to 60% of periodontal disease may be hidden below the gum line.
Treatment
Early periodontal disease can be treated with dental scaling and polishing (with the cat under anesthesia), followed by good oral hygiene at home to control plaque formation. More advanced periodontal disease may require those measures as well as surgical procedures to try and save the affected teeth. In severe periodontal disease, extraction of teeth may be required. Medications such as antibiotics, pain relievers, and anti-inflammatories may also be given to cats with periodontal disease.
Prognosis
With early treatment of periodontal disease, the prognosis is excellent. Severe periodontal disease, however, could result in extensive bone loss and other secondary problems, and thus has a poorer prognosis.
Prevention
Periodontal disease is considered to be a preventable disease. If there is daily removal of plaque, no disease will develop. Plaque removal is best done by daily brushing of the cat’s teeth; however, this can be difficult or impossible in many cats. Oral rinses or gels, better accepted than brushing in some cats, may also help with plaque removal. There are also specially formulated dry cat foods and cat chews that can help the cat to “clean its own teeth” by chewing. Frequent dental scaling and polishing may be needed in cats that will not tolerate other prevention methods.