Periodontal disease is the inflammation and infection of some or all of the tissues and structures surrounding and supporting the teeth. These include the gingiva, cementum, periodontal ligaments and alveolar bones. It is one of the most common diseases in companion cats, affecting all breeds and genders, and tends to worsen with age and bacterial accumulation due to poor dental care. Other terms used to refer to periodontal disease include gingivitis, gum disease and periodontitis.
How Periodontal Disease Affects Cats
The clinical presentation of periodontal disease can vary widely depending on the severity of inflammation and extent of plaque and calculus accumulation on individual affected teeth. Cats may not show any clinical signs, despite severe disease. Alternatively, cats with periodontal disease may have bad breath and obvious inflammation, swelling, soreness and redness of the gums. As the disease progresses, their gums may appear to recede, owners may notice teeth staining and the gums may bleed or become ulcerated. Over time, affected teeth commonly become loose and fall out. The condition is quite painful, and cats may with periodontal disease often resist close inspection of their oral cavities even more vigorously than normal. They may have additional behavioral changes, including reclusiveness or aggression.
Cats can also suffer from oral odontoclastic resorptive lesions – called FORL – which is a relatively new but relatively common feline syndrome of unknown origin that involves reabsporption of the cat’s teeth. Roughly 50% of companion cats over 5 years of age are thought to have at least one tooth affected by this particular disorder. FORL lesions resemble and can accompany periodontal disease; they are painful and can cause inappetance, hypersalivation and oral bleeding.
Causes of Feline Periodontal Disease
Periodontal disease occurs in all breeds and genders of cats, and becomes more common with increasing age. Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) infections predispose cats to developing periodontal disease, because the cat’s normal host defense mechanisms are weakened or impaired.
Progressive periodontal disease typically is bacterial in origin. The causative organisms typically are part of the normal bacterial flora found in the cat’s mouth, and multiple types of bacteria may contribute to the condition. Feline periodontal disease tends to involve Peptostreptococcus, Actinomyces and/or Porphyromonas bacterial species. Without proper diet and dental care or due to immunosuppression, the host-parasite balance becomes disrupted, allowing the bacteria to aggregate, adhere to the teeth and form plaque, which in turn thickens, mineralizes and transforms into calculus. Over time, this inflammatory process destroys the periodontal ligaments and causes reabsorption of the alveolar bone, pain, tooth loosening and tooth loss.
Preventing Feline Periodontal Disease
Fortunately, feline (and canine) periodontal disease is usually preventable by regular home dental care. A number of products are available for companion animal oral hygiene, including brushes, liquid, gels, pastes and washes to reduce plaque build-up, although it is somewhat more difficult to use these products in cats than in dogs. Special dental diets are commercially available to provide complete nutrition for cats while at the same time helping to reduce plaque and calculus accumulation. Soft-food diets are a known risk factor for feline periodontal disease. While cats may be finicky eaters, they should be fed at least party (if not wholly) a crunchy kibble diet, unless otherwise recommended by a veterinarian, for acceptable dental health. Finally, regular (usually annual) check- ups will let the veterinarian assess the cat’s mouth for signs of periodontal disease and perform appropriate dental cleanings or other steps to prevent progression and complications of the condition.
In many cases, affected cats will need to be placed under general anesthesia for a complete dental examination and thorough cleaning both above and below the gum line, scaling, polishing and extracting badly decayed teeth. Anitibiotics and other topical or oral medications may be recommended as well.
The prognosis for cats with periodontal disease is quite good as long as owners provide routine home dental care and an appropriate diet. If the condition is not treated, it is possible for the bacterial infection to enter the bloodstream and spread to distant organs. This can cause bacteremia or septicemia, conditions which can be extremely dangerous and potentially fatal.