E is for (complete oral) Exam

While February is Animal Dental Health month, the kitty's mouth is not just about teeth.  Evaluating the soft tissues (gums, tongue, cheeks and lips) and the lower and upper jawbones (mandible and maxilla) are also part of a good oral exam.

A very symmetrical lynx

An extreme example of asymmetry

When we look at your kitty's mouth, we are looking for symmetry of shape, texture and color.  Remember, if you find something strange, look on the other side of the face/tongue/head and if it looks the same on both sides, there is a good chance that, for your kitty, it is not pathologic.

Freckles are often seen in orange tabbies

Freckles and spots of color on the lips, tongue and cheeks of your kitty can be normal, but changes in color or texture of the tissues, as well as new growths, are rarely normal.

Mild chin acne

  Some of the less dangerous problems that we can see include feline acne.  Feline acne is much like human acne.  Plugged pores fill with sebaceous debris and cause inflammation.  In extreme cases, there is severe swelling and infection.  Some things that help prevent feline acne include good hygiene--help your kitty out if she is unwilling or unable to adequately groom her chin.  Grooming habits often degrade in our geriatric patients.  A warm damp cloth is often sufficient, though you can use a very mild

Severe chin acne

soap--rinse it well!  Also, use stainless steel or crockery food dishes as plastic, even if cleaned regularly, can hold grease and food particles.  Some cats may also benefit from a hypoallergenic diet

 
Other problems include ulcers in the mouth or on the tongue.  These can be immune mediated problems like a "rodent ulcer", inflammation due to an exuberant reaction by the kitties immune system to the plaque on his teeth, or even cancerous conditions.

Rodent ulcer on the lip

Rodent ulcers are collections of inflammatory cells leading to thickening of the tissue.  No one cause has been implicated, but steroid therapy is often successful. 

Ulcerations from stomatitis

However, some ulcers in the mouth--such as stomatitis from dental disease and ulcers secondary to viral infections--will worsen with steroid therapy.

ALWAYS KNOW WHAT YOU ARE TREATING!!!

SCC invading mandible

Cancer is, of course, a possibility when we have ulcers, new pigmentation or growth in the mouth.  The most common oral tumor of kitties is a squamous cell carcinoma (SCC).  These are very

SCC visible next to the canine tooth

aggressive cancers not just growing in the soft tissue, but invading and destroying bone.  If caught early--when they are small--they may be curable, large tumors are difficult to address without removing large parts of the jaw.  Routine oral health exams can help find these and other problems, hopefully to address them in a timely fashion and give us and kitty a chance to fix them.

As always, take advantage of your veterinarian's knowledge and abilities--make an appointment to have your feline friend's annual oral exam today!  You and your veterinarian will be able to make the best plans to keep your kitty smiling.

Sure you are, Grumpy Cat. 

D is for Dental?

What is a dental?

You have advanced gingival disease Mr Crocodile.

This is a very good question.  "Dental" has been used as a catch-all term for anything from the groomer brushing your kitty's teeth, to a quick and dirty tartar removal, to full out oral surgery and endodontics (root canals et cetera).


What is usually meant by "dental" is an oral prophylactic cleaning.  This should include an anesthetic cleaning using an ultrasonic scaler and/or hand scaling tools to remove dental calculus followed by a polishing to help smooth out any defects in the tooth enamel.  Scaling should clean both the crown of the tooth (above the gumline) and below the gumline (periodontal scaling).


After the cleaning, the mouth should be "mapped".  This is when we

Basic feline (and canine) dental map template

systematically evaluate the health of the mouth tooth by tooth, noting wear, gum recession, cavities, missing and extra teeth, rotated or impacted teeth--et cetera.  Then the mouth is radiographed (x rayed) so we can evaluate the teeth roots--teeth can look perfect above the

Pathologic jaw fracture

gum, but below are abscessed through the jaw--this can even lead to jaw fractures or holes into the sinuses!

Then your veterinarian will evaluate all this information and make any further recommendations.  What we want is to find a clean and healthy mouth without any gingival, crown or root disease.  But if further disease is found we talk to you and may proceed with further treatments--or recommend seeing a Veterinary Dentist.

When you are talking to your veterinarian about having your cat's teeth cleaned, make sure you know what their practice includes in their cleaning and evaluation.  A cleaning should be under anesthetic to allow for a complete and safe cleaning and evaluation (both visual and radiographically/xrays).  Anesthesia should include a endotracheal tube (this is a tube placed into your cat's windpipe allowing for both the delivery of gas anesthesia and to protect his precious airway and lungs from being swamped by the fluid and debris loosened when the teeth are appropriately cleaned.  The cleaning itself should be done by a trained and licensed veterinary technician and in most states it is illegal for unlicensed veterinary assistant to perform this service.  Anesthesia should be monitored with at least an esophageal stethoscope--but we feel like it should include IV fluid therapy and support, blood pressure and blood oxygenation measurements.  The health of the teeth and diagnosis and any further surgeries are required to be done by a licensed veterinarian. 

Many groomers and some veterianrians have --for years--offered "dentals" which are either simple tooth brushing (harmless but a misrepresentation of the service) or worse, scaling the tartar off the teeth when your kitty is fully awake and conscious also known as a non-anesthetic dental cleaning.  Why is this bad? you say.  I don't like the notion of my cat under anesthesia.  Balanced anesthesia is very safe and allows for a complete and stress free complete exam and cleaning. 

Removing all the disease of tartar and plaque from teeth will definitely make your kitty healthier.  It will make her teeth stronger and last longer.  It will remove the underlying source of disease a dirty mouth provides. 

Clean teeth = happy cat!

Talk to your veterinarian about your furry feline friend's teeth.  If it is time for an dental cleaning, make the plan, make the appointment, and make her feel better!