Gum Disease in Cats
What is the most common dental health issue in cats? Is it the same as in people? For people, cavities are the most prolific dental issue. However, for cats, gum disease takes the top spot as the most common problem in the mouth. Why is this? And what can pet owners do to prevent gum disease (also known as gingivitis and periodontal disease) in their feline companions?
Generally speaking, it can be said that humans consume more sweet and acidic foods and drinks—major sources of tooth decay—than cats do. But at the same time, people are more apt to brush their teeth, which can slow the progress of both tooth decay and gum disease; or, if done effectively with regular cleanings, can prevent them altogether.
Cats, on the other hand, are not as inclined to brush their teeth as their owners are. While humans are brushing away the sources of disease in the mouth, cats are unwittingly allowing them to multiply and provide a haven for dental disease. In addition, the higher alkalinity in the mouths of pets (compared to humans) encourages plaque formation—the first source of disease. So in cats, cavities take a back seat, while gum disease takes control.
How Does Pet Gum Disease Start and Progress?
Before we talk about how to prevent pet gum disease, let’s talk more about what causes it, and how it progresses. As we mentioned above, sources inside the mouth can harbor disease. What are these sources? And how do they lead to disease?
These are important questions in our quest to prevent gum disease in companion animals. The disease progresses in four phases, and the first phase is home to the first source of the disease. This is where our fight should begin for the best chance of victory.
Phase 1: Plaque
While our pets eat, both large and small giblets of food can get stuck between their teeth and under the gum line. There, especially under the gums, bacteria collect to feast on the food remnants. Saliva also gets into the mix. Saliva, food debris, and bacteria are the elements of plaque.
Plaque is a clear (or slightly yellow or gray) film that sticks to teeth and accumulates there by the hour. It is a soft substance, so it brushes away easily with a daily hygiene routine. But what happens if plaque is not removed, as can happen particularly under the gum line? Enter the next phase in the progression of gum disease, where things get a bit harder.
Phase 2: Tartar
Two processes occur within any plaque that is left to remain on your pet’s teeth. First, the bacteria in plaque convert any sugars found within food debris into acids that cause tooth decay. Second, minerals in your pet’s saliva turn the plaque itself into dental tartar.
Tartar (or dental calculus) is a hard, yellowish substance that attaches strongly to teeth both above and below the gum line. It does not come off with simple brushing. So how do you remove tartar and prevent gum disease at this early phase? It must be scraped off with dental instruments, but that is not as simple as it sounds.
A dentist’s scraping of tartar from the open surface of teeth may seem relatively easy from a human standpoint. But if you have ever had a professional teeth cleaning, you may well agree that under the gums is a completely different “animal.” Removing the tartar of a pet—from above and below the gum line—requires the special tools and skills of a veterinarian to do it thoroughly and safely.
Phase 3: Gingivitis
At this point, the tartar in a pet’s mouth has been left to continue building up on the teeth and into the gum tissue. As the hardened tartar digs into the soft tissue, the immune system is called upon to resist the incursion, and the gums turn red from irritation and inflammation (a sign that the body is fighting back). This condition is called gingivitis, which is named after the gingiva, or gum tissue.
As gingivitis progresses, the bacteria within new layers of plaque work their way under and into the gums. The likeliest result of this, to one degree or another, is infection. If irritation and inflammation were not enough, infection is the first true signal of disease.
Technically speaking, gingivitis is defined solely by the inflammation of the gums, and it is the last phase in the progression of gum disease that is reversible. However, if infection occurs, here begins the phase of gum disease from which a pet may never fully recover.
Phase 4: Periodontal Disease (or Periodontitis)
The bacteria that reside within plaque—and reach far under the gum line—release harmful toxins. Along with advancing tartar, these toxic secretions cause damage to gingival tissue. These attacks on our companion’s sensitive gums trigger a natural healing response that, unfortunately, makes matters worse.
When the body recognizes the infection occurring in a fur baby’s mouth, the immune system jumps into action. White blood cells are summoned to the battle, joined by other chemicals that increase gum inflammation. With good intentions, the stimulated immune system attempts to destroy the enemy bacteria, but enzymes secreted by white blood cells—with intent to kill the bacteria—inadvertently destroy more dental tissue in the process.
The activity that creates all of this damage and destruction is called periodontal disease, or periodontitis. It includes the invading plaque bacteria, the digging of tartar into the gums, and gingival inflammation and infection. In this phase, gum disease also includes damage to the soft tissues and bony material that support teeth. The bone and gums shrink and pull away, thus starting a loosening of the teeth.
Periodontal disease is defined as inflammation around teeth and an infection that destroys the bone and soft tissues that anchor the teeth within the jaw. But not mentioned in the technical definition is the frequent pain. And since animals usually hide their pain, parents may not realize the irreversible damage that is occurring within their pets.
Since we know that gingivitis is reversible but periodontal disease is not, it is before the periodontitis phase that we want to diagnose any inflammation at the gum line, and not wait until lasting damage has occurred to treat it. It is very difficult and expensive to correct damaged or lost tissue...and to compensate for further complications of gum disease.
What Are Complications of Cat Gum Disease?
Tooth Root Abscess
Now that the bacteria in plaque can find their way inside the gums (through the breaches made by advancing tartar and the destruction caused by periodontal disease), the harmful microorganisms can also work their way deeper under the gums to the tooth roots. Once there, they continue their attack, but now they target the roots of the teeth and their attachment to the jawbone.
The destruction that bacteria cause at the tooth root triggers white blood cells to accumulate and fight the infection. The result is a tooth root abscess or an accumulation of pus within the inner structure of the tooth. Dental treatment by a veterinarian is needed to remove an abscess and prevent the spread of infection.
Tooth Loss and Jaw Fracture
It started with an innocent-looking plaque that can be easily brushed away. It hardened into tartar that darkened your pet’s teeth. It began digging into the gum line. Then bacteria found their way inside and started infecting and destroying the tissues that support the teeth. Without a supportive structure to anchor the teeth, they will loosen and eventually fall out.
Loss of a strong dental sub-structure can also mean a weakened jawbone. When this occurs, it is not uncommon for cats to suffer jaw fractures. This is a major setback to a cat’s quality of life from something that started so innocently.
Organ Damage and Heart Disease
If an infection at the gums or tooth root goes untreated, organ damage can result. Organ damage occurs when bacteria from the infection enter a pet’s bloodstream, spread throughout the body, and destroy organ tissue—just like they did at the gum line. In the end, disease begets disease. What do we mean?
Gum disease in cats has a strong correlation with heart disease. This is because the bacteria that wreak havoc in periodontitis travel continually to the heart through the bloodstream. There, the bacteria attach to the chambers and arteries in and around the heart, accumulate, and restrict the flow of blood.
The heart, liver, and kidneys are common targets of organ damage from gum disease that started with innocent-looking plaque. We want to discover and treat gum disease long before complications occur. But how can we tell if our pet has gum disease, and what treatments are available? Most importantly, how can we prevent it in the first place? To answer these questions, let’s first take a look at symptoms and see how gum disease is diagnosed in cats.
What Are the Symptoms of Cat Gum Disease?
Within pets, gum disease is a silent war that starts invisibly, and when “battle scars” finally begin to appear, cats typically have already been suffering silently from the pain. By the time a parent notices something is wrong in their cat’s mouth, gum disease may well have advanced to an irreversible stage. Is there a way to recognize early signs of gum disease in cats, while the disease is still reversible?
Yes! But remember, many pets show no outward signs or symptoms associated with pain. So it is important to identify gum disease at its earliest stages. Also, keep in mind that some signs may seem like what is normal for your cat because they start subtly, and advancement could be slow enough that you may not recognize that the symptoms are getting worse.
Symptoms of Gingivitis
Listed below are signs of gingivitis. How far gingivitis has progressed will determine how severe the symptoms appear:
- The buildup of yellowish plaque, especially at the gum line
- Red and swollen gums, or inflammation, particularly on only one side of the mouth and on just one or two teeth; inflammation can appear on both sides and more teeth in advanced gingivitis
- Bleeding gums when they are touched or when eating (advanced); blood may be seen on a chew toy or mingled in saliva or the water bowl
- The buildup of brownish tartar (advanced)
- Pungent breath, or halitosis (advanced)
Symptoms of Periodontal Disease
If gingivitis is not identified early, or not prevented with regular dental cleanings, signs of periodontal disease may appear:
- Include the symptoms of gingivitis (above)
- Pain when eating, which can be indicated by:
- excessive drooling
- pawing at the mouth
- difficulty picking up food
- chewing on only one side of the mouth
- chattering teeth while eating
- vocalizing while eating or yawning
- aversion to the head or face being touched
- resistance to tooth brushing
- loss of appetite, and turning away from food
- loss of weight
- irritability or moodiness
- Pustular (or pus) discharge around the teeth
- Lumps or bumps in or around the mouth or under the eyes
- Light bone loss
- Receding gum line (advanced)
- Exposed tooth roots (advanced)
- Heavy bone loss (advanced), partly indicated by (bone loss in the upper jaw):
- nasal discharge
- Loose, broken, or missing teeth (advanced)
If you notice any of the above symptoms of gum disease in your pet, please contact your veterinarian for help.
How Do We Diagnose and Treat Cat Gum Disease?
While we strongly encourage pet owners to regularly check their companions’ teeth at home for signs of gum disease and to call us if they see any of the above symptoms, a diagnosis can only be made by a veterinarian. The reason? Some symptoms of gum disease are also indicative of several other health issues.
To start, your veterinarian will perform an oral examination of your furry feline to look for accumulation of plaque and tartar, inflammation of the gums, and infection of any dental tissue. If gingivitis or periodontitis is indicated, the vet will also inspect any gap between affected gums and the nearest tooth. If a gap is more than two millimeters wide, some level of disease is certainly present.
At this point, your pet’s veterinarian will recommend a thorough dental cleaning to remove as many of the disease-bearing agents as possible: plaque, tartar, and the bacteria they harbor. If your cat has teeth cleaning at least once every year, this procedure will be relatively quick and easy.
The vet will also recommend dental X-rays to be taken of your cat under general anesthesia. Why full anesthesia? Because your pet must remain perfectly motionless during both the teeth cleaning and the radiographs. And just like for your dental X-rays, the X-ray plate must be inserted into the mouth to get images. While you may be willing to open wide and hold still for those X-rays, this is much more difficult to explain to your cat! The movements of a scared cat could cause injury by dental tools and could result in blurred, unclear X-rays.
Clear X-rays will reveal whether any of the underlying dental structures have lost normal density and definition. Bone loss within the jaw will also show up on the images, indicating advanced periodontal disease. Certainly, pet parents will be relieved to know the cause of their fur baby’s symptoms by their vet’s diagnosis!
Of course, the diagnosis provides only part of the relief. Pet owners also want the vet to heal their companion. The preservation of your cat’s teeth and overall health are our motivations behind these procedures. The sooner the doctor can make a diagnosis, the sooner we can start effective treatment and help avert the effects of gum disease. If your veterinarian recommends dental treatment, please give it serious consideration. What treatments might the vet perform?
Treatment of Four Stages
Depending on the severity of the damage to your cat’s teeth and gums, the veterinarian will recommend specific treatments. The extent of damage determines which treatment the vet recommends. In all cases, the vet will perform a dental cleaning to remove plaque and associated bacteria. Then, the vet will determine which treatment to administer based on the disease’s stage, or amount of damage.
In Stage 1 of gum disease, inflammation is present along the gum line of at least one tooth. After removing bacterial plaque and tartar, the vet will polish the teeth to help prevent further buildup. At-home care will likely be recommended to help prevent or at least slow the reaccumulation of plaque and tartar.
Stage 2 of cat gum disease is marked by gum tissue loss. Treatment for gum tissue damage includes a deep and thorough cleaning of these periodontal pockets where the bone that surrounds the tooth has been destroyed. An antibiotic gel may also be applied to help promote healing.
Treatments for Stage 3 (bone tissue loss) may include a procedure called guided tissue regeneration, a therapy aimed at helping to restore lost bone tissue around important teeth. If successful, this therapy helps to reverse bone loss, provides stability to teeth, and can make them significantly healthier long-term. Periodontal surgery may also need to be performed to remove diseased tissue.
Finally, Stage 4 gum disease requires tooth extraction to treat tooth root exposure, tooth root abscess, periapical bone loss (bone loss at the top of the root of a tooth, often secondary to infection), tooth fracture, and other significant and painful conditions. This is done to remove the source of infection and pain and to prevent bacterial infection from spreading and causing more damage to other teeth. In all stages of the disease, the veterinarian will do their very best to save your feline’s teeth before extraction becomes necessary. Following the doctor’s recommendations for treatment and at-home recovery will help ensure your cat heals with optimal quality of life.
For more information on treatment for the four stages of gum disease that afflicts both cats and dogs, please see the What is the Treatment of Pet Gum Disease? section of our Dog Gum Disease page.
How Can We Prevent Gum Disease in Cats?
Prevention of gum disease in cats proceeds in virtually the same manner as it does for their owners. Here are some of the strategies for preventing gum disease in cats:
Routine Dental Exams and Cleanings
The definitive strategy for preventing pet gum disease always includes regular dental examinations and cleanings by your veterinarian; there is simply no other way to undertake the complete care of your pet’s dental health. How often your pet needs dental cleanings, however, depends on the other aspects of a preventive strategy—more specifically, whether pet parents include them and to what extent.
Daily Dental Hygiene
Do you remember the first thing you learned to do to protect your teeth? For most of us, it was learning as children to brush our teeth with a “pea-sized” amount of toothpaste on a toothbrush. Our parents brushed our teeth for us when we were babies, and now it’s a regular part of our daily routine (although the “pea” may have grown into a short “green bean”!).
Here are some tips for effective toothbrush training for your cat:
- Start short and simple. Begin with short daily sessions simply to get your pet used to having toothbrush bristles move against their teeth and under their gum line.
- Reward and lengthen the time. Reward your pet when they allow you to brush them for even brief moments, getting them accustomed to longer and longer periods of toothbrush time.
- Be patient and gentle. Remember to never use force or harsh tones to get your pet to accept the brushing, but be patient and gentle. Before long, your pet may learn to welcome it!
Work with your veterinarian to establish your cat’s oral hygiene regimen. Talk to him or her if you need instructions or more tips, such as for finding and using the proper toothbrush, and for the best pet-formulated toothpaste for your furry bestie. If your cat has difficulty with toothbrush training, your veterinarian can offer suggestions for that too. But even if your feline does not accept the training, all is not lost. With routine cleanings and other aids, we can still help prevent gum disease in your pet.
Dental Diets and Treats
If “you are what you eat,” then pets are what you feed them. How important it is that we think about your cat’s diet in conjunction with his or her dental health, especially given the direct association between the mouth and food. If gum disease starts in the mouth, surely your cat’s food can help beat it to the punch!
Some cat diets are of a special “dental” variety that is formulated to directly address the causes of gum disease. Your veterinarian can recommend food and treats that:
- Help clean teeth. This variety of edibles has a “scrubbing” effect on your pet’s teeth to help remove plaque while they eat.
- Enable tartar control. This is achieved by enzyme ingredients to reduce the ability of plaque to harden into tartar.
- Are nutritionally balanced. A specially-formulated diet can help fight the bacteria that reside in plaque and maintain dental and overall health.
Of course, dental diets and treats do not replace brushing. Rather, they are additional weapons in an arsenal aimed at defending your companion’s dental health. Discuss with your veterinarian which diet and treats are best for your cat to help fight gum disease.
Pet Safe Chew Toys
Not all cats are inclined to chew toys, but those that do have another aid in their fight against gum disease. But not all chew toys are created equal. Pet-safe toys that promote dental health will:
- Help clean teeth and gums. These toys include rubbery ones like rubber balls and those that hide a treat inside. Allow your pet to chew on them every day. But avoid those made from rawhide, as pieces that get chewed off can cause gastrointestinal upset or blockage if swallowed.
- Help prevent tooth fractures. Avoid hard chew toys, such as those made from nylon or animal bones, hooves, and antlers. These can cause your pet’s teeth to crack or break, giving more opportunities for advancing plaque bacteria and tartar, as well as causing discomfort and difficulty eating.
Talk to your cat’s veterinarian if you are not certain about how safe a toy is for your cat. The vet may also be able to recommend a chew toy that encourages chewing, such as the kind that conceals treats.
“Early and often” is a common catchphrase for preventive health care strategies. It applies well to the prevention of cat gum disease. If your veterinarian can diagnose it in the initial stages (early), through the benefit of regular exams (often), we can not only treat the disease but perhaps also reverse it.
Keep a close watch on your companion for the symptoms of gum disease. Maintain an oral hygiene regimen for them, along with a proper diet and safe chew toys. Schedule routine dental appointments with your veterinarian and stay vigilant against the advances of plaque and tartar. These recommendations can help keep your cat healthy and happy!