What is Feline Tooth Resorption?
Feline tooth resorption refers to painful erosions on the surface of the cat’s teeth that extend into the sensitive inner part of the tooth called the dentin and can also affect the tooth root underneath the gumline. These lesions, also referred to as Feline Oral Resorptive Lesions (FORLs) or Neck Lesions, are common in cats over 3-5 years of age and can often be noted on a routine oral exam with your veterinarian. The exact cause is unknown, but one theory is that resorption is an immune-related process where the cat’s body has recognized the teeth as foreign objects and begins to attack them, resulting in severe inflammation at and beneath the gum line. Once the teeth begin this process, saving them is impossible and they will gradually break down and become “resorbed” into the body. This is unfortunately an incredibly painful process that can last months to even several years if left untreated.
Signs of Tooth Resorption
Oftentimes, there will be no outward symptoms and the lesions will only be discovered incidentally by your veterinarian. Although the lesions are painful, many cats are stoic and will not give any indication that anything is amiss, causing them to “suffer in silence.” Therefore, treatment is always recommended even if your cat seems normal. With more advanced lesions, your cat may show difficulty chewing hard food or treats due to oral pain. Some cats will resort to swallowing their food whole to avoid the pain of chewing it, after which they may regurgitate whole pieces of kibble. They may begin drooling more or there may be blood in the food or water dishes. You may notice behavior changes in your kitty, such as hiding more, becoming less playful, or shying away from handling.
Once tooth resorption has been noted, your veterinarian will recommend full mouth dental radiographs to determine how many teeth are affected and to what degree. Not all lesions are visible on routine exam, so we often cannot be certain of exactly how many teeth are affected or will need to be extracted until the time of the dental cleaning and radiographs. Often, tooth resorption is symmetrical and affects the lower premolars first. Resorption can be mild or advanced and the treatment will vary depending on the pathology. With mild resorptive lesions, the tooth root is still intact on x-rays whereas, with advanced resorptive lesions, the root and periodontal ligament will already have begun to break down. The goal is always to remove as much of the affected tooth as possible; however, with advanced lesions, portions of the resorbed root often need to be left in place to avoid trauma to the jawbone. The gums will then be sutured (stitched) over the extraction site. Once the tooth is extracted, the cat’s body will then break down the remaining subgingival dental structures.
X-ray of mandibular pre-molar showing severely resorbed roots and crown destruction
Although it may seem drastic to have your cat’s teeth extracted, this is a common procedure, and most patients recover very well. Dental nerve blocks will be administered prior to the extractions to help prevent pain. Your vet will recommend a softened diet for 2-3 weeks following extractions and will send home pain medications to help keep your feline companion comfortable. Many pet parents comment that following recovery, their cats seem happier, more social, and more affectionate because they are no longer in constant pain.
Prevention of Resorptive Lesions and Monitoring
Unfortunately, vet professionals do not fully understand why only certain cats develop tooth resorption. There does seem to be a link with periodontal disease (advanced tartar and gingivitis) so we recommend that all cats receive adequate dental care including annual dental cleanings and even tooth-brushing at home, if possible, to remove plaque before it begins to form tartar. If your kitty will not tolerate tooth-brushing (and many won’t!) you can use water additives and dental treats as an alternative. Once a cat has one tooth that is affected by resorption, other teeth will commonly be affected, so we strongly advise a thorough dental exam every 6 months and dental x-rays every 12 months to detect problems early. Teeth that show evidence of resorption should be extracted as soon as possible to avoid discomfort for your cat.
Frequently Asked Questions
What is tooth resorption in cats?
Tooth resorption in cats is a painful condition where erosions develop on the surface of a cat’s teeth and extend into the sensitive inner part of the tooth called the dentin and can also affect the tooth root. These lesions are common in cats over 3-5 years of age and can be discovered during a routine oral exam with your veterinarian or can also affect the root of the tooth, meaning that they can only be detected on dental x-rays.
Are resorptive lesions painful for cats?
Feline resorptive lesions can be very painful for cats, especially with more advanced lesions. Your cat may show their discomfort by having a hard time chewing hard food or treats and may resort to swallowing their kibble whole to avoid the pain. They may suddenly begin to prefer canned food as well. Other signs include behavior changes such as hiding more, becoming less playful, or shying away from handling.
What causes resorptive lesions in cats?
Unfortunately, vet professionals do not fully understand the cause of tooth resorption in cats or why only certain cats develop the condition, but there does seem to be a link to periodontal disease, highlighting the need for regular dental checkups during your cat’s wellness exam.
How do you treat a cat’s tooth resorption?
The course of the resorptive lesions in cats treatment depends on the severity of the lesions. The goal is always to remove as much of the affected tooth as possible, and it is possible that one or more teeth will need to be extracted.
How can I prevent tooth resorption in cats?
Regular dental checkups and professional dental cleanings (when recommended by your vet) are the first line of defense against tooth resorption in cats.