It's really important that you keep an eye on your cat's dental health. Dental problems and gingivitis are considered together since they may be closely inter-related.
True dental caries, the process of decay to which human teeth are so susceptible, is very rare in the cat, though occasionally, true caries of the tooth table is encountered, particularly involving molar teeth. Affected teeth should be extracted, as should teeth in which injury has led to the tooth shattering, cracking or breaking off so as to expose its central sensitive pulp.
A more common problem than caries is erosion of the junction of the crown and the root, which may lead to the crown shearing off from the root, either under normal wear or when an attempt is made to extract the tooth. The root is very likely to be infected and should be extracted.
Abscesses may form at the root tip of any tooth and may produce marked pain. After the diagnosis has been established by radiography, the tooth should be removed to allow the abscess to drain. One of the upper cheek teeth has roots which terminate in the bone just below the eye; occasionally abscessation around these roots may reveal itself as a distinctly fluid-feeling swelling below the eye or as a small hole in the skin from which pus discharges. If there is any doubt, radiography will confirm this diagnosis and extraction of the tooth is necessary.
Dental calculus, periodontitis and gingivitis
Dental calculus, also known as tartar, consists of mineral-impregnated bacterial plaque. Tartar may build up on any tooth, but is most common on the outer faces of the molars and premolars, and on the inside surface of the incisors. Calculus accumulates with age and is more likely to occur in animals fed soft diets.
Calculus tends to accumulate around the junction of the gum with the tooth and, as this occurs, a niche is produced in which bacteria can flourish. As a consequence of this bacterial infection, the gum becomes inflamed (gingivitis) and retracts from the base of the tooth. It may also become ulcerated and the infection may spread to the gum. The retraction of the gum allows infection to track down the outside of the tooth root (periodontitis) and a discharge of pus (pyorrhoea) from around the teeth results. The tooth root may also become infected and eroded.
In early cases, all that is needed is for the cat to have the tartar removed by 'scaling' under general anaesthesia. In severe, established cases, it will be necessary to take swabs to identify the organisms involved in the infection and to give long-term antibiotic therapy. After antibiotics have been given for three or four days, all the involved teeth should be taken out. This sequence avoids the risk of septicaemia following extraction.
Calculus usually reforms after scaling and, once it has been initiated, dental attention is likely to be required increasingly often. It is suggested that the feeding of dry cat food may help to limit the problem. If dry food is fed, free access to water should be allowed to avoid the risk or urinary tract disease.
Hyperaemia of the gum margin
In kittens, a narrow band of reddening of the gum margin just below the teeth is a common finding. This appears to present no problem to the cat and resolves without any treatment. Owners need not be particularly concerned unless other signs of disease are associated with it. A specific and rather more extensive and dramatic gingivitis (gum inflammation) has been reported in kittens three-and-a-half to seven months of age. The cause of this condition is not known and it often fails to respond to treatment.
The condition may disappear spontaneously when the cat cuts its permanent adult teeth.