Tooth resorption in cats.

My pet’s teeth are WHERE?

No one knows the cause for tooth resorption. But we hope this information helps you better understand what it is and how it can be treated.

A common feline oral malady is tooth resorption (TR). Greater than half of all cats older than three years old will have at least one tooth affected by resorption; it affects dogs less frequently. These tooth defects have been called cavities, neck lesions, external or internal root resorptions, feline odontoclastic resorption lesions (FORLs), and cervical line erosions.

Tooth resorptions are usually found on the outside of the tooth where the gum meets the dental surface. The lower jaw premolars are mostly affected, however tooth resorption can be found on any tooth.

The cause is unknown, but theories supporting an autoimmune response, calicivirus, and metabolic imbalances relating to calcium regulation have been proposed. Commonly the resorption starts at the gum line and progresses, eroding sensitive dentin. Some affected cats show pain and jaw spasms whenever the lesion is touched. Others show increased salivation, oral bleeding, or difficulty eating. Most times it is up to the veterinarian or astute owner to diagnose tooth resorption.

There are five recognized stages of tooth resorption. Initially in stage 1 only an enamel defect is noted. The lesion is usually minimally sensitive because it has not entered the dentin. In stage 2, the lesion penetrates enamel and dentin. When resorption progresses into the pulp chamber (nerve) stage 3 has occurred. In stage 4, large amounts of the tooth’s hard structure have been destroyed. By the time stage 5 has occurred, most of the tooth has been resorbed, leaving only a bump covered by gum tissue.

Intraoral x-rays are essential to evaluate all the teeth to determine the best course of therapy. Depending on what is seen in those intraoral x-rays, treatment for tooth resorption involves either extraction of the entire tooth and roots, or a partial tooth extraction. In cats affected by stage 5 without inflammation, treatment is not necessary

Tooth re—what now?

Tooth resorption in dogs and cats has gone by many names over the years. Your veterinarian may call it a cervical line lesion, a neck lesion or a feline odontoclastic resorptive lesion (FORL). The most accurate title is tooth resorption.

Tooth resorption is a destructive process that eats away at teeth and is common in both dogs and cats. Depending on the kind of tooth resorption your pet has, it may or may not be immediately painful and may or may not require immediate treatment. But either way, it’s important to know that all tooth resorption gets worse over time. So even if you don’t treat it immediately, you may eventually need to treat it to avoid pain and loss of function.

What caused it?

Tooth resorption in cats used to be called “feline cavities,” but that’s inaccurate. For the most part, it’s not tooth decay caused by bacteria. Except in the case of abscesses in the root of the teeth, the cause is unknown. Unfortunately, once a pet is diagnosed with tooth resorption, he or she is likely to have more lesions in the future—with the exception of a tooth root abscess.

How do we see this?

Signs of tooth resorption can vary and especially depend on whether or not the tooth hurts.

For dogs. Dogs with tooth resorption may yelp when chewing, lose their appetite, stop enjoying chewing or not chew on the affected side, resulting in a buildup of plaque and tartar.

For cats. Pain in cats with tooth resorption is often more difficult to detect because of their natural tendency to hide when they’re not feeling well. Signs in cats to look out for include loss of appetite, increased hiding, decreased activity, increased aggression or grouchiness, red gums, bleeding in the mouth, turning the head when chewing or chewing on one side, missing teeth, teeth that suddenly ‘fall out’ or ‘break off,’’ or a new preference for soft foods.

If you notice any of these signs in your pet, get it checked out by a veterinarian. Since tooth resorption is usually very painful, your veterinarian may prescribe pain medication until your pet can be admitted for dental work.

What does this look like?

Not all tooth resorption is alike. There are three types of tooth resorption in cats and six types in dogs. Tooth resorption can either create holes in the tooth or turn the tooth roots to bone. If tooth resorption is diagnosed in your pet, then dental radiographs (x-rays) are needed to determine the type of tooth resorption so we know whether the tooth needs to be removed immediately or treatment can be delayed. If the tooth hurts, removal of the tooth is always recommended.

Are x-rays necessary?

Yes, x-rays are always necessary, since sometimes a tooth can look completely normal during a physical exam and tooth resorption is only detectable on a radiograph.

How is it treated?

Most types of tooth resorption are very painful in both dogs and cats, and extraction of the affected tooth is the only way to relieve pain. In some cases, tooth resorption may not be painful and may not require immediate treatment, but the disease is progressive, and any tooth with a resorptive lesion will require extraction when it becomes painful. You may also elect to have teeth that aren’t hurting yet removed early to prevent the possibility of tooth pain.