Holey Teeth, Catman! Resorptive Lesions and Your Cat

What do you think is the biggest cause of tooth loss in the cat?

a) Gum disease

b) Resorptive lesions

c) Trauma (such as a fall or accident)

d) Caries

e) Something else.

If you answered (b) then give your cat a stroke, because this is the correct answer.

Indeed, resorptive lesions are startlingly common. Experts estimate that 20 – 60 % of all cats have them, and that figure jumps to 75% in cats aged five years or older.

At this point, how many of you are scratching your heads because you don’t know what resorptive lesions are? Don’t worry. You aren’t alone. This article should help you fill in the gaps in your knowledge about holes in feline teeth.

What the heck are ‘resorptive lesions’?

Actually, these used to go by a different and equally unmemorable name – FORLs (Feline Odontoclastic Resorptive Lesions.)

The word ‘resorptive’ is a hack of the word ‘re-absorb’ and refers to how these teeth have a nasty habit of melting away. First, a small hole appears in the outer layer of the crown, the enamel. Over time this deepens, eroding inwards through the dentin until it finally eats into the pulp cavity. Ouch!

Indeed, resorptive lesions are painful, precisely because they drill down into the living part of the tooth and expose it. Even if the tooth doesn’t snap off, those sensitive nerves and blood vessels in the pulp are open to the elements, which hurt.

Also, resorptive lesions weaken the tooth. Think of this like removing bricks out of a wall near the foundations. Take out enough bricks and it doesn’t take much to push the wall over. Hence, why resorptive lesions are the biggest cause of lost teeth in cats.

Could my cat have resorptive lesions?

If you have four cats aged five or more, statistically speaking, three of them may have damaged enamel. Scary, isn’t it?

For those that want to be sure, simply lift the lip and take a look. Resorptive lesions usually start near or just below the gum line. You can often spot them as small holes in the enamel, although those beneath the gum line need probing and radiographs to find them.

Clues that your cat is bothered by those resorptive lesions include:

• Suddenly becoming a messy eater
• Dropping food out of the mouth
• Swallowing food without chewing
• Changing preference from dry to wet foods
• Poor appetite
• A dull, starry coat (because grooming is painful)
• Drooling saliva
• Grumpiness
• Pain when you touch their mouth

Any of this sound familiar?

Are the resorptive lesions your fault?

No.

Resorptive lesions are different from tooth decay in people (caries) and no-one is sure why they happen. However, as with many veterinary mysteries there are wealth of theories, which as yet are unproven.

• Plaque triggers cells called ‘odontoclasts’ to eat away at the enamel
• An autoimmune response where the body attacks its own teeth
• Viral infections
• Changes in calcium metabolism
• High levels of Vitamin D in some cat foods
• Altered pH in the mouth.

What action should you take?

Get your cat’s mouth checked by a vet.

Indeed, this is one of the problems your vet is alert for at your cat’s annual health check. That said, lesions below the gum line need to be actively found. These can be screened for when the cat has dental attention under anaesthesia.

Typically the vet uses a special dental probe and slides it gently into the gingival pockets (the fold where the gum meets the crown) and feels for roughness or sensitivity. In addition, dental x-rays are the gold standard for finding holes in roots.

The resorptive lesions are graded on a scale of 1 – 5. Grade 1 is the most superficial and not currently causing pain, whilst Grade 5 is a snapped off or missing tooth.

For all but Grade 1 and 2 lesions, your vet will advise removing the teeth. There is no effective way of filling the teeth, because the enamel just keeps on melting back, so any implant would fall out. This means the best and most humane treatment is removing the painful teeth.

For lesions that are still superficial, the vet may elect to leave them alone for now, but advise you they may need extracting 6 – 12 months down the track. This being the case, rather than give the cat another anaesthetic later in the year, some cat guardians prefer to have these ones removed as well, which is fair enough.

What can you do to prevent the problem

There’s no sure fire way of preventing resorptive lesions, but you can reduce the risk.

Firstly, get regular dental checks, such as every 6 – 12 months. Where necessary, let your vet descale and polish the teeth so they are clean, and plaque kept under control.

In the meantime, introduce dental hygiene into your cat’s daily routine. Just like us, tooth brushing is the gold standard. Believe it or not, this isn’t as hard as it sounds. There are some really tasty pet toothpastes on the market, which most cats love the taste of. It becomes considerably easier to brush your cat’s teeth if she’s eager to lick at the toothpaste.

In addition, there are the cat equivalent of mouthwashes, which keep bacteria at bay. Vets stock a product called Dentasept, which is an ultra-sticky gel that sticks to the teeth and disinfects them for 12 hours at a time. You can dab this onto the teeth with a cotton tip or your finger.

Alternatively, there are water additives which can go some way to improving your cat’s oral health.

One thing is for sure, don’t ignore dental disease in your cat. Having painful teeth is no joke, and thanks to resorptive lesions, cats are more likely than other species to have painful mouths that need treatment.