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Foster Diary: The Curious Case of Sir Buttons’ Teeth

Lesson Learned: Always check a cat’s teeth to monitor dental disease. If you see any sort of inflammation, plaque, or tartar along the gumline, see your vet immediately – your cat could be in pain.

gray and white cat
Sir Buttons and I had a special bond even though I didn’t foster him for very long.

Sir Buttons
3-5 year old domestic shorthair
Gray and white tuxedo
Supposedly growly and mean – actually a love bug
Gums extremely red along gumline, with lots of deposits of some sort along gumline of most teeth
Plan: Dental surgery to resolve inflammation and any other issues

My foster Sir Buttons had a host of dental issues leading to 9 extractions (that’s a lot). When I read the post-surgical notes, I was shocked to learn about all of his issues. I’ll breakdown what was going on in his mouth, covering dental disease and individual tooth conditions so if your cat gets a dental, you can understand what happened.

First, let’s look at the post-op notes.

Reading Dental Surgery Notes

The documentation I received after Sir Buttons’ surgery showed the overall status of three different dental diseases above a diagram of the feline mouth, with 15 teeth on the top and 15 teeth on the bottom. Then, the status of each tooth was explained using certain initials, with a key explaining the initials under it.

Diagram of feline mouth and teeth
These post-op notes detail the extent of Sir Buttons’ dental disease, along with the condition of his teeth.

Next, we’ll look at the three dental diseases, then the teeth conditions.

Dental Disease

Gingivitis

Sir Buttons: 2/4

gray and white cat laying on floor
Sir Buttons had the most charming white mustache.

Gingivitis is when a build-up of plaque attracts bacteria and causes red, swollen, and painful gums.

Stomatitis

Sir Buttons: 0/4

Stomatitis is severe inflammation of the gums and mouth. There are two types. The first is inflammation around the teeth. The second, which is harder to treat, is in the back of the mouth where the upper and lower gums meet.

Calculus

Sir Buttons: 3/4

Calculus is when plaque absorbs minerals from the gums and saliva and hardens. The rough surface attracts more bacteria.

Teeth Conditions

Next, we’ll look at the conditions on the surgical summary, along with how many of Sir Buttons’ teeth were affected. Remember, that one tooth can have multiple issues.

Gray and white cat in woman's lap
Sir Buttons loved to curl up in my lap.

S = Stable

Sir Buttons = 20 Teeth

Pop the champagne: Stable teeth are in good shape and do not need to come out.

M = Missing

Sir Buttons = 1 Tooth

You can put it on a milk carton if you want, but you’re never going to find it.

Fx = Fractured

Sir Buttons = 1 Tooth

A fractured tooth is a chipped tooth. Most fractured teeth should come out to prevent the possibility of bacteria getting into the tooth, traveling through the pulp and into the root.

Ed = Enamel Defect

Sir Buttons = 6 Teeth

A lot of things can cause defects in the enamel (covering) of the tooth. Most often, an enamel defect means the enamel is thin in certain areas, discolored, or spotted. Sometimes, the tooth needs to be removed, but other times, the tooth can stay.

cat mouth
Sir Buttons had an enamel defect on that top tooth that wasn’t stable, resulting in an extration.

E = Extracted

Sir Buttons = 9 Teeth

There’s good news and bad news. The bad news is, the tooth was problematic. The good news is, the cat will not suffer anymore.

Bad teeth need to come out. Painful teeth diminish their quality of life, and some of these cats experience 24/7 pain, along with eating being borderline torturous.

Also, if your vet recommends full mouth extractions, I know the gut reaction is nooooooo … but I ask you to entertain the idea, and even, get a second opinion if that will help. A full mouth extraction likely means your cat is in constant pain or will be very soon.

Red gums in cat mouth
When I looked in Sir Buttons’ mouth, I noticed so much redness around the gumline, and realized he was likely in some pain.

G = Gingival Recession aka Recessing Gums

Sir Buttons = 2 Teeth

Gingival recession means the gum line has receded and is higher up on the tooth than it should be. If the recession is severe, the tooth will be extracted. I’m not sure how they measure it, but I imagine it’s based on whether the root is exposed or close to being exposed.

O = Osseous Recession

Sir Buttons = 6 Teeth (All on the bottom)

Two cats in cat tree
Shy foster Bucky and Sir Buttons bonded and used to cat nap together in the cat tree’s hut.

Let me be clear – this condition is hard to find information on. Based on what I read about osseous surgery for humans, I believe this is when certain parts of the gumline along a tooth recess (not the entire gumline). If those spots continue to recess, big pockets will develop. Why is this an issue? Pockets = Bacteria. The bacteria can actually damage the bone of the tooth.

P = Periodontal Pockets

Sir Buttons = 0 Teeth

This is when osseous recession leads to deep pockets around the tooth where bacteria can get in and have a party.

gross cat teeth
These teeth were in bad shape. The one near the back of the mouth had furcation, an enamel defect, and gingival recession. It was extracted.

Fu = Furcation

Sir Buttons = 1 Tooth

Furcation is bone loss where the roots meet the trunk of the tooth (basically where the roots fork from the tooth). Again, the issue is bacteria get in that space and cause havoc.

R = Resorptive Lesions

Sir Buttons = 0 Teeth

Basically, the tooth eats itself (ewww) from the outside in. Dentin, the layer under the enamel, is absorbed back into the tooth. If it continues, the inside or pulp will eventually be exposed. Lesions can exist on the crown or on the root, but the crown lesions are very painful and require treatment.

The are two types of resorptive lesions:

  • Type 1 – Destruction of the visible area of the tooth (crown), but the root looks normal on the radiographs.
  • Type 2 – On radiographs, the root appears to disintegrate and can’t really be distinguished from the bone.

Ca = Crown Amputation

gray and white cat with gold eyes
Sir Buttons had beautiful goldish yellow eyes.

Sir Buttons = 0 Teeth

An alternative to a complete extraction is crown amputation. When a tooth shows Type 2 resorptive lesions (described above) and, the surgeon may decide to leave the roots behind. After a flap is made along the gumline, the crown (head) of the tooth is removed to the bone. The surgeon smooths out the bone and remaining tooth, then uses sutures to surgically close the flap.

L = Mobile

Sir Buttons = 0 Teeth

Very simply, a mobile tooth is a loose tooth.

gray and white cat
Sir Buttons’ ears were sort of like airplanes. No matter what type of mood he was in, they were always positioned in a funny way, out from his giant head.

Sr = Stable Root Fragment

Sir Buttons = 0 Teeth

A stable root fragment is a when a tooth is fractured during extraction, leaving some part of of the root behind. Sometimes, the benefits of leaving the root outweigh the benefits of continually trying to remove it. The r00t is left behind and considered stable if these three factors exist:

  1. Fragment is small, no more than 3-4mm long.
  2. Root is deeply, not slightly, embedded into the jawbone
  3. No infection present.

Rf = Root Fragment

Sir Buttons = 0 Teeth

cat hugging woman
After being returned for hiding and growling, I feel like Sir Buttons really opened up to me after he knew he was loved and safe.

If the above conditions don’t exist and: 1) A root fragment isn’t stable or 2) Pre-surgery radiographs show the root fragment has moved (displaced) to another location, the cat will likely need to see a dentistry vet. These types of fragments are typically beyond the expertise of a general practice vet, and require more specialization.

Se = Supraeruption

Sir Buttons = 0 Teeth

The easiest way to explain supraeruption is with an example. For instance, say a tooth is missing on the bottom jaw and the tooth on the upper jaw then drops down even further into the open space below it. That’s supraeruption.

Post-Op

Lastly, let’s review what happens after surgery. If your cat has extracted teeth, you’ll be sent home with antibiotics and pain meds. They must eat wet food for two weeks to prevent the dissolvable stitches from tearing out.

gray and white cat hugging woman
Grabbed some hugs the day before Sir Buttons went to his forever home.

While he slept a lot the day of his surgery, Sir Buttons was a total champ and completely back to normal the following day. He found his forever home shortly after that, and I have to say, I still miss him. He was a very special boy and would literally hug me like a baby, and is sweetness and loving energy has a permanent place in my heart.

Did you know some cats can be born without eyelids? Take a look at my article on eyelid agenisis.

Sources

To learn more about these conditions, I highly suggest visiting some of the sources below. Although some are about human dental disease, the actual explanations are still applicable and very useful.

Cornell University, College of Veterinary Medicine, Feline Dental Disease.

MSPCA Angell, Dr. Kate O’Hara, DVM, Feline Stomatitis.

AAHA.org, 2019 AAHA Dental Care Guidelines for Dogs and Cats.

U.S. Department of Health and Human Services, National Institute for Diabetes and Digestive and Kidney Issues, Dental Enamel Defects and Celiac Disease.

East Valley Periodontics, Osseous Surgery.

VCA Hospitals, Lorraine Hiscox DVM FAVD Dip. AVDC; Jan Bellows, DVM, Dipl. AVDC, ABVP, Tooth Resorption in Cats.

Dear Doctor, Dr. Laureen Langer, What Are Furcations?

Vetstream, Periodontal Pockets.

Frank J M Verstraete, Milinda J Lommer, DVM Dipl Avdc, Boaz Arzi, Oral and Maxillofacial Surgery in Dogs and Cats – E-Book.

NYC Dentist, Dr. Jeffrey Dorfman, Supraeruption.

Dog Beach Vet, Crown Amputation.

By LizsKittyBootCamp

I foster cats and kittens, specializing in behavioral cases.

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