Feline dental disease

Question 1

How does tooth reabsortption occur?

Answer 1

Destruction of hard dental tissue by odontoclast cells
Replaced with granulation tissue

Question 2

What do odontoclast cells normally do?

Answer 2

Responsible for repair, remodelling or destruction

Question 3

What are the clinical signs of tooth reabsorption?

Answer 3

*cold sensitivity
*possible weight loss
*hypersalivation
*pawing of face
*halitosis

Question 4

What are the classifications of tooth reabsorption?

Answer 4

Type 1
Type 2
Type 3

Question 5

What is a type 1 lesion?

Answer 5

Inflammatory cause
Associated with periodontal disease
Neck / cervical area lesion location

Question 5

What is a type 1 lesion?

Answer 5

Inflammatory cause
Associated with periodontal disease
Neck / cervical area lesion location

Question 6

What is a type 2 lesion?

Answer 6

*Replacement reabsortption
*Root material replaced by bone
*cats usually >4y/o

Question 7

What is a type 3 lesion?

Answer 7

Features type 1+ 2 present on same tooth

Question 8

What is the treatment for type 1 tooth reabsorption?

Answer 8

*type 1- crown resorbing, roots intact
= teeth to be weakened + predisposed for fracturing
=Surgical extraction

Question 9

What is treatment for type 2 tooth reabsorption?

Answer 9

*type 2 - roots replaced by bone, crown partially intact
=if partial replacement reabsorption of root = must remove remaining root + associated pulp
=Surgical extraction
-If tooth fully resorbed/ghosted
= subgingival crown coronectomy (crown amp)

Question 10

What is the perfect candidate for subgingival crown coronectomy?

Answer 10

*advanced type 2 TR confirmed via x-ray
*lack of periodontal ligament structure
*no recognisable root canal system
*no periapical pathology

Question 11

What is the crown amputation technique?

Answer 11

*Create envelope flap to access cemetoenamel junction
*using fine round burr - cut along long axis of crown
*Aim to remove tooth structure just below the level of the alveolus
*smooth edges via alveolectomy
*close gingival opening with no tension (4.0 monocryl)

Question 12

Why shouldn’t you atomise the root?

Answer 12

*mandible may be completely sectioned
*Painful + unnecessary
*root remnant still visible on radiograph
*High speed burr = damage to alveolar bone

Question 13

What is feline chronic gingivostomatitis syndrome? FCGS

Answer 13

Gingivitis + inflammation of the mucosa
EXTREMELY PAINFUL

Question 14

What are factors affecting feline chronic gingivostomatitis?

Answer 14

*calicivirus status
*Immune status of animal
*Biofilm formation
*Associated dental disease
*Environmental stress (multi-cat household)

Question 15

What are the clinical signs of FCGS?

Answer 15

*severe inflammation of back of mouth (bright red)
*ulceration
*gingival hyperplasia
*screaming when eating
*dysphagia
*halitosis
*poor coat quality
*weight loss

Question 16

What investigations would you do regarding FCGS?

Answer 16

*Full blood work (FELV/FIV, CKD) -PRIOR TO GA

UNDER GA
*dental radiography - check for retained roots
*throat PCR swab for calicivirus + FHV
*Take photos
*Biopsy if not bilateral

Question 17

what is FCGS aim of treatment?

Answer 17

*reduce burden of oral antigen in cat’s mouth long term
*improve welfare of patient by considerably reducing their pain
*Reduce inflammation of oral soft tissues

Question 18

How is surgical treatment of FCGS carried out?

Answer 18

*full mouth dental radiographs needed
full scale + polish
1.removal of any diseased teeth/roots
2.’Full mouth extraction (all PM’s + M’s)
3.FULL MOUTH extractions (canines + incisors)

Question 19

What does medical management of FCGS contain? (adjunct to surgery)

Answer 19

*Pain relief
-NSAIDs (meloxicam)
-Buprenorphine
-Gabapentin
*Antibiotic therapy (5d prior + 4-6wks post-op)
-Amoxicillin-clavulanate (synulox)
-Clindamycin tablets
-Injectable solution if can’t tablet
*Plaque reduction
-Hexarinse / Dentisept
-Teeth brushing daily (owner/cat compliance)

Question 20

When considering management what needs to be done with food bowls?

Answer 20

*Use ceramic - harbour less bacteria
*Less likely to cause hypersensitivity reaction
*Plastic / metal bowls removed

Question 21

When would you use Feline recombinant interferon Omega? regarding FCGS

Answer 21

*use for non-responders of surgical management

Question 22

What dietary supplementation would you give a cat with FCGS?

Answer 22

*vitamin supplementation - omega-3 oils