Cats are afflicted with a very common painful condition known as feline odontoclastic resorptive lesions (FORL). This occurs when the teeth slowly breakdown and resorb. It is typical that several teeth are affected at once and the pulp is exposed, which is very painful. It is estimated that as much as 50 percent of cats are affected by this disease process.
No one knows for sure why this is happening. What is known is that the odontoclast cells are breaking down the dense outer layer (enamel) and bony second layer (dentin) and exposing the soft inner layer (the pulp). The pulp contains nerves and blood vessels and causes significant pain when damaged. Eventually the whole tooth will fall apart and become resorbed. Some cats lose all of their teeth, others just a few. These odonoclasts are actually normal cells that are supposed to break down the roots of baby teeth and are now going rogue.
The signs of FORL usually relate to chewing problems. Owners should be concerned when they see their cats swallow kibbles whole, tilt their heads to the side when chewing, salivate, drop kibbles, and eventually stop eating. An oral exam shows small holes at the gum line, jagged teeth, teeth that are covered with bleeding gum tissue, and eventually missing teeth. A thorough exam by your veterinarian is necessary to understand the severity of the disease process. The best way to diagnose the resorptive tooth lesions is to take dental radiographs. The cat will have to be anesthetized or sedated to take these x-rays.
Treatment is relatively straight forward. The veterinarian and technician will recommend a full dental cleaning under gas anesthesia. After the tartar is removed from the teeth with an ultrasonic scaler, radiographs are taken and a plan is made. The owner is called to discuss any teeth that require extraction. These extractions can be simple “pulling” of teeth or actual surgical procedures using a drill to remove each root. These surgical extractions involve suturing the gum tissue over the open areas to seal up the defects and prevent pain and infection. There are even some severe cases where all of the teeth are removed. These cats are much happier and will thrive without the resorptive lesions. The good news is that the oral cavity is the fastest healing area of the body and these patients will eat soft food the next day.
No one knows the cause of this dental condition in cats. It is a mystery that continues. An annual physical exam is very important to identify the problem early and save cats from excessive pain and discomfort.