Last week Robin, mom to eight cats and a wonderful cat rescuer, called me about her cat Loki who was screaming and jumping every time he chewed some food. It was evident to her that he had a dental issue. When we examined him we told her she had nailed the diagnosis. He had cavities and severe dental disease. He was scheduled for anesthesia, dental radiographs and multiple dental extractions and crown amputations. He is now pain free.
It is quite rare for a cat or a dog to express dental pain in such a straightforward manner. Much more commonly the dental pain creeps up slowly on both pet and their family. The family never followed through or was never taught about tooth brushing. The vet keeps talking about the brown material (calculus) on the teeth and how to remove it with a complete oral health assessment and treatment (COHAT) but there are other pressing matters to attend to so the procedure is never scheduled.
Meanwhile the calculus, which contains bacteria, infects the adjacent gums and the ligament attaching the tooth to the socket (periodontal ligament). The infection can spread to the bony socket holding the tooth and cause an abscess and an infection in the bone.
It is always amazing to me how much infection can be in a dog or cat’s mouth with exposed nerve endings and all they do is sleep more and become much less active when they are awake. It happens so gradually that many times the family attributes the lethargy to aging or arthritis. The calculus covers the surface of the tooth and looks like the tooth itself. The stench of the bacterial infection is attributed to “dog breath.”
A complete oral health exam and treatment (COHAT) is a 12-step process which includes a history and physical exam, an oral survey to check for missing teeth, extra teeth, cancer, pockets in the gums surrounding teeth, and sub-gingival scaling. Sub-gingival scaling is critically important. This involves removing tartar and debris from the part of the tooth you can’t see — the part under the gum. This is where infection starts.