Periodontal disease is the most frequently diagnosed illness in cats and can cause all manner of other health problems from infection to organ failure and heart disease (specifically the dreaded bacterial endocarditis). In rescue we occasionally receive cats who need tooth extractions or who suffer from chronic dental problems or oral diseases such as stomatitis. Some breeds are more predisposed to dental problems and gum disease than others: Abyssinians and Somalis are notoriously susceptible to gingivitis, while Siamese, Persian, and Himalayan cats have high rates of tartar accumulation and receding gums.
A Personal Perspective
I personally have been lucky with my cats’ oral health. Rivers, who is 7 years old, has never had a dental cleaning; I know, because although he came to rescue just a year and a half ago, he was surrendered by his owner, and I was able to obtain complete medical records. When I took Rivers’ companion, 8-year-old Moby, for his annual checkup last month, the veterinarian recommended hand-scaling of his teeth, which she could do then and there. This procedure was like the sort of teeth-cleaning you and I experience on a routine basis, in contrast with a full dental cleaning performed under general anesthesia. At eight, Moby is still two or three years away from being a senior cat and many years away from being a geriatric cat, but according to my vet, she would rather not subject any cat to general anesthesia for dental cleaning if the cat has only a modest accumulation of plaque and tartar and will tolerate the procedure. I was dubious, given that Moby is a big cat at 17 pounds and has his own opinions, but sure enough, the vet swaddled him in a large towel, had a technician hold him, and within a short time had done the job. Moby just looked bemused during the procedure and calmly accepted a tribute of cuddles afterward.
NOTE: Sometimes one encounters the argument that hand-scaling without anesthesia cannot be effective and can even be dangerous. Often this argument is articulated by someone who derives personal benefit from performing dental procedures under general anesthesia. In this and all other cases where your cat’s health is at issue, the wisest course is to find a veterinarian whom you trust and follow his or her advice.
The only one of my cats whose teeth I brush on a regular basis is Akashi. I first took her to the veterinarian within a week after adopting her from a shelter. At that time she was apparently two years old but was still small and frail, presumably from lack of adequate nutrition. A year later, after eating plenty of grain-free, mostly raw food, she had blossomed into a lovely, medium-sized Ragdoll girl with an opulent coat and a large fluffy tail. However, when I took her to the vet for her annual visit, I was chastened: there was nothing badly wrong, the vet told me, but Akashi had more plaque and tartar on her teeth than would be expected of a cat her age. Before hand-scaling Akashi’s teeth, the vet gave me three options for ensuring that Akashi did not develop more serious dental issues in the future:
- Switch from feeding Akashi mainly finely ground raw meat and bones, and consider incorporating a tartar-control kibble into her diet. This step I was reluctant to take. I had hoped that the raw diet, in itself, would have benefits for Akashi’s teeth, but even Lisa Pierson, DVM, one of the luminaries of the feline raw-feeding world, remarks on her webpage that “Unfortunately… I have been ignoring my cats’ dental health when using finely ground meat and bones and they are paying for it with unhealthy mouths.” She recommends feeding bigger chunks or gizzards, but I am reluctant to do so; I suspect that the experience of single-handedly– in fact, bloody-handedly–saving the life of a dog who was choking on a bone left me forever skittish on this issue. And I would be uneasy feeding Akashi any significant quantity of kibble, because she drinks so little water.
- Try dental treats, such as Greenies®. Akashi adores them, but they give her diarrhea. I have tried the experiment twice. I will not do so again.
- Brush her teeth. Okay, I’ll try that, I said. I think my alacrity took the veterinarian by surprise.
- Before undertaking a tooth-brushing regimen, have your cat’s teeth examined by your veterinarian. Many cats who have periodontal disease exhibit no symptoms, and there might be an existing problem your veterinarian should address before you start brushing your cat’s teeth. (As with people, brushing is a prophylactic procedure. It does not remove existing tartar buildup, for example.)
- Do not brush your cat’s teeth within the first ten days after a dental procedure.
- If your cat exhibits any evidence of mouth pain, definitely do not try to initiate tooth-brushing. Instead, work with your veterinarian to determine whether tooth-brushing makes sense for your cat. For problems such as stomatitis or oral disease that has systemic causes, different sorts of management protocols are likely to be in order.
- Do not expect to be absolutely thorough. For the first several weeks of actual brushing, I did not even try to brush all of Akashi’s teeth at every session. Rather, I thought of her mouth as being divided into four quadrants—upper right, lower right, upper left, and lower left—and would aim for one quadrant at every session. Over time, we increased the number of quadrants per session.
- Do not complicate the task by trying to brush the inside surfaces of the teeth. The cat’s tongue does that job reasonably well. Try to brush the outside surfaces, especially those of the upper molars.
- Be prepared to waste a bit of money trying different flavors of toothpaste until you find one that your cat likes. Akashi likes the malt-flavored enzymatic toothpaste. Fortunately, it is very readily available. Do not use toothpaste meant for people or toothpaste containing fluoride.