Feline Dentistry Flashcards
What are the 3 common oral conditions seen in cats
Chronic ulcerative gingiviostomatitis (CUGS)
Tooth resorption
Eosinophilic granuloma complex
Describe feline chronic ulcerative gingivostomatitis (CUGS)
Inflammation of the mucous lining of any of the structures of the mouth (more severe than periodontal disease)
May be immune mediated (can be from pasteurella bacteria, plaque bacteria, or calicivirus)
Debilitating and leads to loss of all teeth in cats
Severe oral inflammation, oral ulcers, foul breath, resorption of hard dental tissues, large painful areas in oral cavity and dysphagia
What is the treatment of CUGS
extensive long term care
Treatments have dangerous side effects with some drugs
Whole mouth extractions may be needed
What are the clinical signs of CUGS
Gingival bleeding is earliest sign
Inflamed gingiva and mucosa may appear swollen, cobblestone texture, bright red or raspberry like
Spontaneous hemorrhage with light touch of gingiva
Hypersalivation (ropy and thick)
Stop eating due to pain
Diagnosis of CUGS
Full mouth exams
Full mouth radiographs
Periodontal charting
Photographs for comparisons
History and complete physical exam
CBC, thyroid and biochemical tests
Tests for viral infections such as FELV or FIVA
Autoimmune tests
Food allergy testing
Under anesthesia: examining all surfaces for color, shape, texture, pain response and gingival bleeding
Biopsy
How many stages does treatment of CUGS come in
4
what is stage 1 of treatment of CUGS
Complete oral assessment including X-rays
All teeth affected by resorption or periodontitis should be extracted (even retained roots)
Antibiotics, NSAIDs, pain meds
Aggressive home care (plaque cannot build up)
Dental checks every 6 months
Dental cleanings every 6-12 months
What is stage 2 of treatment of CUGS
If the cat does not respond to stage 1
Numerous tooth extractions (minimally all caudal teeth) make sure all roots and ligaments are removed (extract canines and incisors if affected by gingivitis)
Dental checks every 6 months
What is stage 3 of treatment of CUGS
if the cat does not respond to stage 1 or 2
extraction of ALL remaining teeth (whole root and ligament)
Omega interferon?
What is stage 4 of treatment of CUGS
If cats don’t respond to stage 1-3
Long term antibiotics and steroid therapy
Euthanasia
How many cats never respond to treatment of CUGS
30%
What is the equivalent of CUGS in dogs
CUPS: chronic ulcerative proliferative stomatitis
Uncommon
Immune mediated: plaque
Severe gingivitis and gingival recession
“Kissing lesions” on mucosa that touch plaque
Similar treatment to CUGS
What is tooth resorption in cats (AKA: FORL)
Just under 50% of population affected
Effects: resorption if the tooth and proliferation of gingiva/pulp to cover lesions
Clinical signs: behaviour changes due to pain, decreased appetite, dropping food
Describe the etiology of tooth resorption
Unknown cause
Results from activation of odontoclasts which are responsible for remodelling of teeth
These continue to resort the tooth structure until the entire tooth is lost
At the same time proliferation of the gingiva which covers the lesion
Tends to occur at and just below the gumline (but may only affect the root)
Commonly seen in many areas
What is needed to accurately diagnose and treat tooth resorption
Whole mouth Radiographs
What are the most commonly affected teeth in tooth resorption
Premolars and then molars and then canines
Mostly on the buccaneers surface of the teet
Most common teeth affected at 307/407
Describe the lesions seen in tooth resorption
Extremely painful
Jaw tremors occur under anesthesia with probing
Behaviours changes indicate how painful they are
What are the clinical signs of tooth resorption
Starts with focal gingivitis (especially around 307/407)
Progresses to invasion of the gingiva into an enamel defect on the tooth
Once the pulp cavity is reached a jaw tremor will occur
Then you get loss of enamel and dentin and a visible hole in the tooth occurs
Crown is eventually lost and the guns grown over the roots
How many stages are there of tooth resorption
5
Describe stage 1 of tooth resorption
Mild dental hard tissue loss
Cementum +/- enamel effected
Tiny defect in tooth surface felt with explorer
No jaw tremor (not painful)
Often no other evidence in mouth (not yet gingivitis)
May be difficult to see on radiographs
Describe stage 2 of tooth resorption
Moderate dental hard tissue loss
Cementum +/- enamel with progression into loss of dentin
Does not extend into pulp cavity
Defect in tooth surface felt with explorer
No jaw tremor (not painful)
Focal gingivitis, gingiva grows into defect
He’s tissue loss seen on radiographs
Describe stage 3 of tooth resorption
Deep dental hard tissue loss s
Cementum +/- enamel with loss of dentin and extend into pulp cavity
Defects in tooth surface felt with explorer
Tooth still has integrity/shape
Jaw tremor present (painful)
Focal gingivitis and gingiva growing into defect
Obvious hard tissue loss on radiographs
Describe stage 4 of tooth resorption
Extensive dental hard tissue loss
Cementum +/- enamel and loss of dentin into pulp cavity
Most of the tooth integrity is lost (mostly eaten away)
Defects felt with explorer
Focal gingivitis and gingiva growing into defect
Dramatic hard tissue loss visible on radiographs
Describe stage 5 of tooth resorption
Loss of crown
No visible crown on exam
Gingiva has grown over the roots, usually a hard bulge where tooth use to be
Remnants of hard tissue only visible on X-ray as irregular radiopacities
Gingivitis is usually resolved
No longer painful
No treatment needed is there is no gingivitis
