Q:  Our cat, Snickers, recently changed her eating habits and is now refusing to eat dry food. When she does eat, we have noticed that she chews very slowly and carefully. We think her mouth might hurt, but she won’t let us take a look. When we are able to get close enough to her mouth, her breath smells funny. What do you think could be the problem? Thank you.

A:  Snickers may be suffering from a problem called tooth resorption.  This problem is very common in adult cats; in fact, studies have shown up to 67% of adult cats suffer from this problem.  This problem has also been referred to as “feline oral resorptive lesions” (or FORLs) and is a really common cause of tooth loss in older cats.

The problem often starts as a hole in the tooth at or near the gum line and progresses into the substance of the tooth, extending into the nerves and blood vessels in the center of the tooth.  The lesion can be covered by gum tissue (potentially the body’s attempt to heal or protect the area) or calculus, and so may not be visible.  Sometimes a portion of the tooth, or even the entire crown, can be lost as the lesion progresses.  You should bring Snickers to your veterinarian for an examination.  But, it is likely it will be necessary to anesthetize her and to take oral x rays in order to diagnose and treat the problem because some of these lesions can be very small, or on the inside (tongue side) of the mouth, or sometimes only even visible on x ray.

Tooth resorption lesions are painful but they can be hard to detect.  Cats often will not show overt or obvious signs of pain.  However, some more subtle signs you might notice include: a preference for soft food over kibble, preferring to drink room temperature water instead of cold water, drooling, making a chattering sound when chewing, reluctance to hold toys in the mouth, or chewing preferentially on one side of the mouth.  We often see excessive calculus in areas of the mouth with these lesions because the kitty is avoiding chewing in this area; this may be responsible for the change in Snicker’s breath.

Although veterinarians have tried solutions such as restorations or fillings in the affected teeth; all of the lesions progress despite treatment.  So, the only treatment for these teeth is extraction of the entire tooth; or in some situations, extraction of the crown portion of the tooth.  Unfortunately, despite extensive research, the cause of these lesions is still uncertain and there is no way to prevent them.  Cats with tooth resorption are prone to having other affected teeth in the future; so routine cleanings, oral examinations, and dental x rays are ideal in these patients so that the problem can be detected and treated right away.   Kitties with resorptive lesions tend to do really well after the lesions are extracted–many times owners report increased energy, happiness and appetite after the procedure.  The good news about resorptive lesions is that by getting rid of these troublesome teeth, we are often able to dramatically improve our patients’ comfort and well being!  

[doctor name=”Donna Bucciarelli”]