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Treating Heavy Tartar or Gingivitis
Give your cat oral hygiene products. These help decrease the amount of bacteria in the mouth and are useful as part of a dental care regime, especially for cats prone to gum infections or bad breath. An example of such a product is Hexarinse. To use, dip a clean cotton tip into the liquid and wipe the dampened bud over the surface of your cat’s tooth enamel and along their gum line. The active ingredient in Hexarinse is chlorhexidine, a mild anti-septic. It repels bacteria for 12 hours, so it works best on teeth that are already clean. It will help to prevent plaque buildup, but it will not get rid of existing tartar. Repeat the treatment twice a day. Never dip a used cotton bud back into the Hexarinse, as it could contaminate the solution.
Note signs of tartar buildup. The accumulation of tartar can actually prevent your cat’s mouth from closing and opening normally. You may get a clue this is about to happen when your cat spends a lot of time working his jaw up and down when not eating, or if there is a "clicking" sound as he opens and closes his mouth. Tartar also contains bacteria, which means that when it rubs against your cat's gums, it can cause infections and bad breath. If there is an infection, you may notice red gums and bleeding along the gumline.
Schedule an appointment for dental descaling. This involves an ultrasonic descaler machine using high frequency sound to blitz the tartar off the teeth without scratching or damaging the enamel. This is an atraumatic process (it shouldn't cause your cat any pain). To gain access to all of your cat’s tooth surfaces, your vet will give your cat a general anesthetic. After the machine removes the initial layer of plaque and tartar, your vet will hand polish each tooth and check for any additional dental issues.
Talk to your vet about giving your cat antibiotics. Broad spectrum antibiotics such as amoxicillin-clavunate penetrate well into the gum tissue and saliva so that they can fight the infection. Amoxicillins are bactericidal (kill bacteria) and act by inhibiting cell wall synthesis. Most cats will need to be given their antibiotics twice daily in pill form or as an oral rinse. If the gingivitis is mild (a faint red line along the border between gum and tooth) a 5-day course is sufficient. If the gingivitis is severe (touching the gum gently provokes bleeding) then a minimum of 2 weeks is necessary. Keep in mind that many veterinarians are moving away from using antibiotics unless it is absolutely necessary, so your veterinarian may not offer this as a treatment option.
Debulk tartar. This process has a greater risk of damaging the enamel, scraping the gums, and generally not getting the teeth particularly clean. However, it does have its place if a localized lump of tartar is causing problems. Debulking refers to cracking off (using dental forceps, which are like blunt pincers) in order to remove a lump of tartar that is rubbing against another tooth or causing a sore on the inside of the cheek. There is no particular rule for doing this, other than inserting a blunt point between the gum and the tartar and applying sharp pressure parallel to the tooth in the direction away from the gum.
Addressing Other Dental Problems
Get antibiotics for a root infection. Tooth root infections can be identified as pus oozing between the gum and the tooth, a swelling on the face over the site of the tooth root, or through dental x-rays. Antibiotics are essential (see remarks for gingivitis). Unfortunately, many infections recur after a course of antibiotics is complete. Then, the extraction of the affected tooth becomes the best option.
Arrange for an extraction if a tooth is fractured. If you see visible cracks on a tooth or if your cat avoids eating on that side of their mouth, make an appointment with your vet immediately. After taking a series of radiographs, your vet will discuss whether to perform a root canal or extraction. Your cat will need to be given anesthesia either way and should make a full recovery.
Watch missing teeth closely for infection. As cats age it is common for them to lose a number of teeth. Feeding them soft foods can help with the pain. However, bacteria can grow in the space left behind from missing teeth. Take your cat to your vet at least every year to get these teeth inspected.
Agree to pain medications or surgery for possible jaw issues. If you notice that your cat eats very slowly or can’t close its mouth completely, then its jaw may be damaged or malfunctioning. When you take your cat in to see the vet, they will order images. Because jaw problems can be very painful your vet will likely prescribe pain medications and may even suggest a surgery to strengthen the jaw bones.
Supporting Dental Health at Home
Experiment with different textures of food. If your cat has dental pain, then providing a liquid food that the cat can lap up will help to give her the calories she needs until she can be treated at the vet's office. Look for foods that are soft and pate-like, but that also have high amounts of calories. Mash these soft foods up to make them even softer. Bizarrely, some cats with sore mouths like dry kibble. Don't be afraid to offer a variety of foods and see what works best for your pet.
Give your cat an anti-plaque/tartar food. A successful way to removed mild tartar staining from teeth is to feed your cat a product designed to remove staining, such as Hills TD diet, exclusively for 1 month. These types of food have a tooth descaling action. As your cat moves the food around in its mouth, the rough texture grinds down any tartar build-up. However, this works best in cats with healthy gums and only light tartar staining. Do NOT use this diet if your cat’s gums are sore. The abrasive nature of the food is likely to further damage the gums.
Brush your cat’s teeth. Get a pet toothbrush and dip in it water or apply a cat-friendly toothpaste. Rub your cat’s gums and teeth in gentle, circular motions. Doing this once a day can help to remove dangerous bacteria and debris from your cat’s mouth. Start gradually, getting your cat used to the feel of a brush against its teeth. As your cat feels more comfortable with the process, extend the amount of time you spend brushing. Only use toothpaste designed specifically for cats. Some human toothpastes can be toxic to cats and other pets.
Checking for Dental Problems
Lift your cat’s lips. Hold your cat’s head steady with one hand and use your other one to gently pull up the upper lip on both sides. This will let you look at the outer surfaces of the teeth to determine if they are discolored, irritated, or damaged. Then, repeat the process by pulling down your cat’s lips to see its lower teeth and gums.
Open your cat’s mouth. If you are right handed, use your left hand's forefinger and thumb to make a "C" shape. Invert the "C" over your cat's head so that the thumb rests on the left corner of the mouth, and the tip of the forefinger on the right corner. Apply gentle pressure to between the lips, so that your cat must slightly open its mouth or risk biting its own lips. To hinge your cat’s mouth open, hook the forefinger of the right hand onto the point of the lower jaw and press downwards.
Ask for assistance holding your cat in place. If you are at the vet’s office, an assistant will be happy to help you secure your cat and open its mouth. If you are at home, another person can help by gently placing their hands on the sides of your cat’s shoulders and pressing down lightly. This will hold your cat still, so that you can get a good look at its teeth and gums. It always works best if your cat starts off in a laying position on a solid surface, such as the floor or a secured table.
Look for signs of healthy gums. Healthy gums are pink just like our own gums (some animals have natural pigment present, in which case the gums may be shaded grey or black). The gums should sit snug up against the tooth crown, with no exposure of the tooth roots. There should be no angry red line, or bleeding where the gum joins the tooth.
Check for signs of diseased gums. A cardinal sign of gum disease is bleeding or inflammation where the gum meets the tooth; this is known as gingivitis and is usually a sign of infection. Gingivitis can create sores, and is often associated with bad breath because bacteria love to colonize the inflamed gum tissue.
Assess your cat’s teeth to determine if they are healthy. Teeth are made up of a crown (the visible part above the normal gum line) and the root. In a normal mouth, only the crown is visible because the root is embedded in the jawbone and covered by gum. The enamel should be clean (not covered with tartar) and not fractured or chipped. The teeth should be firm in the jaw.
Look for signs of diseased teeth. Diseased teeth may be either coated in tartar, loose, or broken, or they may have holes in the enamel, or tooth root infections. Most commonly, cats either have heavy tartar (mineral deposits coating the teeth) which can cause gum recession, or they can have weak enamel that dissolves, leaving holes that penetrate to the nerve (these are called "feline odontoclastic resorptive lesions" or FORL). FORL is a painful condition, even though some cats learn to eat and live with it. Once a cat displays FORL, they are more likely to develop additional lesions throughout their lifetime.
Set up an appointment with your cat’s vet. They will assess your cat’s mouth and create a long-term treatment plan. If your cat needs to have a tooth extraction performed, then it will need to be done in a vet’s office under anesthesia. Only a professional extraction can minimize trauma to your cat’s gum and jawbone.
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