Helping a Cat with a Broken Tooth

Sissy is a friendly, engaging, robust 17 pound cat who lives in Johnson City, TN. She was adopted by her family as a rescue, and she serves as an excellent example of the many wonderful, loving cats that can be adopted. Sissy’s mom brought her in to Animal Hospital of North Asheville last week for an appointment for a dental evaluation and tooth cleaning, and her case points out some important characteristics of cats.

Sissy arrived at our hospital for dental care by Dr. David Thompson due to findings during her annual comprehensive physical exam. On physical exam, Dr. Earley had found a broken tooth, which is a painful dental problem, as well as tartar and gingivitis. Blood tests performed at the time of her annual exam identified that she was healthy with no known risk factors for anesthesia.

As you can see in the picture taken after Sissy was under general anesthesia, the lower right canine tooth (even in cats it is called a canine tooth) is fractured near the tip. A tooth fracture in a dog or cat can be complicated or uncomplicated. In an uncomplicated fracture, the fracture is shallow so that the dentin (just below the enamel) is exposed but the fracture does not enter the root canal or pulp cavity. In people, we know that this type of fracture causes sensitivity of the tooth and there is an increased risk of deep tooth infection. There is a simple treatment for these shallow fractures that eliminates discomfort and risk of infection.

Sissy, unfortunately, had a complicated fracture, meaning the root canal/pulp cavity is exposed. One characteristic of cats is that they seldom have uncomplicated fractures of their teeth. In cats, the pulp cavities are very close to the surface of each tooth so it is rare that a fracture does not enter the root canal.  Another characteristic of cats is that they seldom show any outward signs of oral discomfort. Experts theorize that in nature, showing pain or weakness encourages predators to attack and also signals other animals to take advantage of the situation by taking food from or ostracizing the affected animal. People describe the initial pain of a complicated fractured tooth as initially extreme and after a day or two as a dull throbbing pain which lasts for days, months or years until corrected. Even though Sissy’s family is extremely attentive, Sissy showed no obvious sign of pain. Sissy’s family had two choices to eliminate her pain: Have Sissy undergo a root canal or extract the tooth. Most families opt, as Sissy’s did, to extract the tooth.

Because cats have longer, thinner, more delicate roots than people do, every extraction in a cat requires a lengthy, careful, precise surgical procedure. After Sissy was under general anesthesia, an x-ray of the tooth and root was performed to confirm that the tooth did indeed need to be extracted and to eliminate any surprises during surgery such as a broken root.  You can see there is a dark halo around the root tip (see the dots outlining it). This is where bacteria entered the tooth at the fracture site, traveled to the root tip and began destroying the bone in that area. The dark halo is termed a periapical abscess.  The halo indicates that infection has been present for a year or longer. Sissy must have been in pain for a long time, yet Sissy’s very attentive and loving mom had no way to know.

Important Points:

  1. Every fractured tooth is uncomfortable and requires treatment.
  2. We cannot assume our pet will indicate oral discomfort or even oral pain.  Even tartar is uncomfortable.
  3. A study performed at the University of Pennsylvania indicated that 10% of dogs have at least one fractured tooth during their lifetime.  There is not a fracture study in cats but 70 % have periodontal disease by 3 years of age.  Oral disease is common even in young cats and dogs.

Once the gas anesthesia was turned off, Sissy was awake yet sleepy in Dr. Thompson’s arms within minutes. Pain during dental surgery is prevented with nerve blocks, which numb the surgery site so general anesthesia can be kept light for safety, and a soothing narcotic, which is given before the procedure and sent home to maintain comfort during healing.

Sissy went home that same day, comfortable and relaxed and free of pain.

Comments

The dental services for cats are outstanding. We have moved back to California after 9 great years in Asheville. We were fortunate to have found our way to AHNA for the care of our multi-cat household while we lived there. We had many teeth cleanings and some broken and absessed teeth treated during that time. The care overseen by Dr. Thompson was topnotch! And as usual the staff was extremely kind and caring. All of our cats are rescues and became inside cats only, once they started living with us. It is really important to have annual exams and have their teeth checked because as an owner you can be completely clueless to serious dental problems. No one wants their beloved cats to be in pain.

There are many things we miss about Asheville and AHNA is at the top of the list.

Best regards to Dr.Thompson and staff for your excellent veterinary care.

Vicki & Steve Vlasich

Thank you so much for your kind words, Vicki! Can we use your comment in the Testimonial section of our website?

Thanks again!

Thank you for this information. I have little indoor/outdoor kitty Stella (she was a rescue) who was injured just last week. She has a broken top canine tooth and the vet recommended removing it. I was thinking that maybe we were rushing this and I should give her some time to see how she did--she is starting to eat again. Her fracture is higher up on the tooth that Sissy had. After reading this article, I can go ahead with Stella's surgery and feel confident that it's the right thing to do. Thanks for that peace of mind.

Hello, my 8-year-old male cat's canine tooth was discovered to have broken almost half-way up. The doctor thought the root wasn't exposed, so nothing further was recommended. No x-ray was done. Now I am wondering if more treatment is needed. My cat is definitely an alpha male and has always been a "nipper," i.e. he nips people when he gets excited and purring when affectionate and when he's hungry he'll bite any part of your body he can get ahold of. But now I'm wondering if this nipping and biting is due to being uncomfortable, too?

Pages