Feline Tooth Resorption Lesions

Tooth resorptions (TR) are a common and painful dental problems that affects about 25-75% of all adult cats. Tooth resorption lesions often affect multiple permanent teeth and can occur anywhere on the tooth surface. Tooth resorption results in erosion and destruction of the enamel of the tooth, causing pain, inflammation and infection. TRs were originally called feline “neck lesions” because they commonly seemed to affect the “neck” region of the tooth. Early lesions can appear like a subtle, small area of inflamed gum growing over the tooth. Some TRs are much more obvious with evidence of an actual hole in the surface of the enamel. However, many TRs cannot be seen externally in the mouth at all and can only been identified with dental X-rays.

As seen in the picture below, there is a resorptive lesion present on the tooth. The gum surrounding the tooth is inflamed and bleeding. When we assess a patient’s teeth under anaesthetic, we use a special probe to check for any deficits in the bone surrounding the tooth and also to check for exposure of the furcation (where the roots begin to branch). Sometimes when the probe is introduced, it can reveal exposure of the furcation. If this occurs, we will strongly recommend removal of the tooth.

Resorptive lesion visible on examination

There are a few causes of these nasty lesions however the precise cause is still unknown despite numerous studies! What we do know is that it is a complex disease that develops as a result of multiple causes:

Incorrect diet: soft food, excessive vitamin D intake
Genetics: studies suggest certain breeds have an increased susceptibility
Ongoing dental disease

Cats are true masters at hiding any signs of pain and discomfort. This means it can be very difficult for owners to identify resorptive lesions in their cats. Some subtle signs to look out for include:

Foul smelling breath, brown calculus accumulation on teeth, inflamed gums
Increased salivation or drooling
Lethargy, sleeping a lot
Changes in food preferences or textures
Poor appetite, weight loss
Nasal discharge, sneezing
Repetitive jaw movement when eating, drinking, grooming
Oral pain- teeth grinding

3 main ways to detect tooth resorption lesions:

1. Visual: Red spot of gum overlying lesions, actual tooth resorption detect may be apparent

2. Probing: using a specific feline dental probe placed under the gum margin under anaesthetic.

3. Digital Radiology (x-rays): this is the most accurate and sensitive tooth to diagnose tooth resorption lesions.

In the dental x-ray above, we can see the destroyed bone underneath this set of teeth. The blue line shows where the bone in the jaw currently lies, and the red line shows where the bone is meant to sit to cover the tooth roots. The gums can very easily hide this bone loss, which is why it is essential to perform dental x-rays to fully examine the extent of dental disease. These hidden lesions can cause immense pain and result in infections if left untreated.

In this dental x-ray, the circles show where the teeth are starting to become destroyed. Sometimes this is visible to the naked eye as the loss of bone within the tooth causes the tooth to change colour. However, this is not always the case. The arrows are pointing to the tooth roots which are in the process of being resorbed (as evidenced by the lack of margins around the roots, as well as how patchy the area where the roots are meant to sit appear). The most accurate way to determine these lesions is by performing dental x-rays under anaesthetic.

Treatment:

First it is vital to perform a thorough and complete dental assessment of your cat’s mouth while they are under general anaeshesia. We carefully perform dental probing into the gum pockets to detect further lesions before obtaining a full set of dental radiographs for assessment.
Once all tooth resorption have been identified, the next step is to perform a thorough dental scale and polish to remove tartar and plaque which are one of the triggers of this disease.
Unfortunately, extractions are the only effective treatment for tooth resorptions. If lesions are noted during your cat’s dental procedure, we will recommend removal of the affected tooth.
We believe it is very important that all our patients receive adequate multi-modal pain relief when undergoing surgical procedures. For cats undergoing teeth extractions, we administer injections of pain relief before and after their surgery in addition to placing local nerve blocks when they are under anaesthetic. Most cats will also receive pain medications to go home with.
Regular dental checks by your vet are recommended every 6 months to detect early lesions before significant pain occurs.

Now that you know a little more about feline tooth resorption lesions, there are a few things you can do at home to manage your cat’s dental health. We always recommend Plaque Off, Maxigard wipes and Maxigard gel. Plaque off is a flavourless seaweed product that helps to soften the plaque on the teeth. It helps to prevent build up of more tartar on the teeth, and in combination with dental biscuits, it helps to scrub off the soft plaque on your cat’s teeth. Maxigard gel and wipes contain zinc which helps to turn the bad bacteria in the mouth into good bacteria. This helps with bad breath and plaque build up as well! Maxigard wipes are small round wipes that are soaked in the Maxigard solution. The wipes have the added benefit of mechanical action to soften and manually remove plaque on the teeth. If your cat allows tooth brushing, this is also another good option!

If you suspect that your cat has dental disease, feel free to speak to our friendly staff to book an appointment. We are also able to set up reminders for you to receive whenever you choose so you know when you are due to bring your furry friend in for their dental check ups.

Dr. Renee has two fur babies, Lady Stop and Chihiro Ophelia Princess of Genovia (Chi Chi for short). She has a strong passion for surgery, medicine and behaviour. She hopes to share some of her knowledge with you in her monthly blog posts!

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