Issue number 25.1 Other Scientific
Published 23/08/2023
Also available in Français , Deutsch , Italiano and Español
The first step in detecting oral disease is to perform an initial oral examination in the awake animal. However, in order to thoroughly detect disease a complete oral examination must be performed under general anesthesia.
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A dental explorer, periodontal probe and intraoral radiography are essential tools for the diagnosis and staging of most dental problems.
The most commonly diagnosed oral diseases in adult cats are chronic periodontitis, dental fractures, and tooth resorption.
Advanced periodontal disease is commonly diagnosed in cats (Figure 1). A major contributing factor to its development is the lack of adequate oral hygiene at home. The adoption of preventive pediatric health plans and adequate geriatric presurgical profiles, as well as the presence of specialists in oral surgery and anesthesia, are crucial aspects for ensuring appropriate periodontal treatment in such patients. Staging of periodontal disease is essential for the decision-making process, which can range from calculus removal and dental polishing to surgical extraction.
Figure 1. Stage 4 periodontal disease of teeth 107 and 108, with severe gingival recession and furcation stage 3 (furcation exposure), covered by calculus and plaque 1.
© Dr. Javier Collados
Tooth extrusion (Figure 2) is a sign of advanced periodontal disease in cats. Adequate periodontal probing and intraoral radiography (Figure 3) are very important when staging these teeth, as they are essential components in the decision-making process for managing the condition.
Figure 2. Extrusion of tooth 304 due to advanced periodontal disease.
© Dr. Javier Collados
Figure 3. An occlusal intraoral radiograph of the mandibular canines and incisors shows signs consistent with bone loss due to periodontal disease.
© Dr. Javier Collados
A tooth fracture is characterized by structural alteration (and in most cases loss) of dental tissue secondary to external trauma to the oral cavity. Note that fractures are frequently missed on the initial oral examination performed on a conscious animal. As in periodontal disease, classification is essential for decision making. This is particularly important in adult patients, since fractures involving exposure of the pulp chamber or cavity (complicated fractures, root fractures) that have not been adequately treated can lead to clear signs of pulp disease, such as dental abscesses, fistulas, etc. (Figure 4 and 5).
Figure 4. Complicated crown fracture of tooth 404 (note the severe abrasion of the lower incisors, as well as an enamel defect on tooth 304).
© Dr. Javier Collados
Figure 5. Intraoral radiograph of the mandibular canines and incisors shows signs consistent with severe periapical disease and regional osteolysis of tooth 404.
© Dr. Javier Collados
Tooth resorption (TR) is a primary dental disease characterized by progressive tissue destruction of one or more permanent teeth due to the action of odontoclastic cells. The condition frequently manifests with resorption of the crown and/or neck of the tooth, along with reactive gingival hyperplasia (Figure 6).
Figure 6. Signs of tooth resorption. There is evident dental resorption in the mesiovestibular gingival third of the crown of tooth 204. Reactive gingival hyperplasia covers the defect.
© Dr. Javier Collados
The underlying cause is complex and has not been clearly established. Although TR is not unique to adult animals, its progression in different stages and the appearance of obvious signs in the oral cavity are usually observed in adult animals. Nevertheless, radiography is essential for the diagnosis and treatment of TR in cats.
In some cases, there may be no indication that the crown of the tooth is affected, despite radiological evidence of severe root resorption (Figure 7 and 8).
Figure 7. Clinical examination of teeth 304 and 404 reveals no signs of dental resorption at the level of the crown, and mild gingivitis around tooth 301.
© Dr. Javier Collados
Figure 8. Despite the lack of clinical signs, intraoral radiography shows signs of advanced tooth root resorption (class TR4c) of teeth 304 and 404, and signs of tooth resorption in tooth 301 1.
© Dr. Javier Collados
Note teeth are identified using the American Veterinary Dental College (AVDC) classification system.
Acknowledgement: many thanks to Dr. Carlos Rice for reviewing the English version of the original Spanish article.
https://avdc.org/avdc-nomenclature/ (downloaded May 15, 2014).
Javier Collados
Javier Collados, Dentistry and Oral Surgery, Sinergia Veterinaria, Madrid, Spain Read more
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