Pet Health Community

Hi Dr Draper,

People seem to be shy in sharing about teeth care. It has become a major issue for my kitty who is just 1.5 yrs old and a month ago had 3 teeth extracted. I got her at just over 5 months old and she has always had some gingivitis. The first vet thought it was related to teething and wasn't concerned about it ... though I asked her to do a thorough check when my kitty was under anesthesia for her spay surgery at 7 months. The vet felt it was okay.

That vet left the practice and the new vet noted her continuing gingivitis at her 1 yr check-up but didn't feel anything needed to be done. Finally, another new vet who saw her in Dec (when taking her for her 1 yr Rabies booster) said that she needed a dental ... and I agreed. At the time she didn't expect to have to do any extractions but ended up taking out three teeth.

I want to try to get her used to having her teeth brushed. I have tried to follow the suggestions from the 4 week training method used on the Cornell Univ Feline Health Center website video on "Brushing Your Cat's Teeth":
http://partnersah.vet.cornell.edu/pet/fhc/brushing_teeth

My problem has been that my kitty LOVES the chicken flavor toothpaste and thinks it is candy ... so she wants to lick and chew the toothbrush and won't let me brush her teeth. I'm still working on it.

At the time of her dental, I asked my vet to get the needed swabs to do the IDEXX URI PCR test. She has no URI symptoms at all, but I heard a talk by Dr Richard Ford of NCSU on Feline Herpes/Calici in which he commented that Calici can be a factor in Gingivitis. As I anticipated, my kitty is negative for Herpes, Calici, Bordatella, Chlamydophila ... BUT she is positive for Mycoplasma. She has no symptoms and while Mycoplasma can cause URI symptoms, I can't find anything linking it to gingivitis. Are you aware of any connection?

My vet suggested I could try some Nolvadent. Are you familiar with it? She had to order it and just got it in, so I haven't yet picked it up. I read on a website that it isn't supposed to be used concurrently with other toothpastes or products. Which would you feel is better to use ... toothpaste (I got from my vet, "Enzadent" Enzymatic Toothpaste by Vet Solutions) ... or, the Nolvadent?

My vet was recommending Hills T/D diet. However, my kitty is also prone to cystitis and doesn't drink enough (has hard dry pellet feces) and I feel that she really needs the added moisture of canned food. So, I'm continuing to feed canned food but do give her 3-4 of the very large size pieces of T/D each day. I don't know if that helps or not, but probably can't hurt.

Do you feel that in some cats, gingivitis is mostly a genetic problem? I'm worried about her losing her teeth ... though a vet I correspond with in Michigan thinks extracting all teeth can be beneficial. But I want to do what I can to help her keep her teeth. At the moment, it looks like her mouth has healed well after the dental/extractions. I want to do what I can to prevent it from recurring. I'm very concerned that she is so young and already has had teeth extracted.

Stephanie in Montreal

Stephanie...Happy New Year! Great to hear from you again.

I've not heard of or had a case of Mycoplasma (a red blood cell parasite previously referred to as Hemobartonellosis) being linked to gingivitis. I have, however, experienced cases where young cats with autoimmune disorders have experienced gingivitis- particularly a condition called plasmocytic gingivitis (also lymphocytic-plasmocytic gingivitis). These cats do respond well to antibiotics and cortisones (like prednisone), but many times it is recommended that they have all teeth extracted since there is some thought that a part of the problem is the gingiva's allergic reaction to plaque on the teeth. I'd discuss a possible gingival biopsy with your vet if not already considered.

Another note- there has also been some possible correlation to chronic gingivitis and feline aids (FIV). So, if your kitty has not been tested for that, that's something to consider as well.

As far as diet- controlling the cystitis is very important- but your vet knows best what to recommend for your kitty. As far as toothpaste vs Nolvadent, really whatever works best for your kitty. There is no wrong answer there, in my opinion.

Thanks again!

Hi Dr Draper,

Thanks for the reply.

My kitty was tested for FeLV/FIV at 16 weeks and was negative. I can have her retested but she is an only cat and very healthy other than the gingivitis episode, so I really don't think FIV is a factor and my vet didn't consider/mention it.

I've been trying to learn and sort out Mycoplasma which is a bit confusing for me. I just finished listening to a talk on Mycoplasma by Dr Julie Veir of Colorado State Univ (given at the CVC in Kansas City last August). From what I can understand, there are many types of Mycoplasmas ... of which one is Mycoplasma haemofelis (formerly Hemobartonella felis). It is one that attaches itself to red blood cells and results in the body destroying the red blood cells in order to kill the Mycoplasma Haemofelis ... causing anemia. But my kitty has no signs of anemia and I don't think she has that form of Mycoplasma.

While Dr Veir spent most of her talk on Mycoplasma Haemofelis, towards the end she talked about the upper respiratory form of Mycoplasma, which I think is a separate form of Mycoplasma. There has been some debate on whether it is a primary cause of URI or simply a secondary infection. I think they feel now that in some cats it can be a primary cause of URI ... but she was suggesting the typical URI symptoms of sneezing and sinusitis. She didn't make any mention of Mycoplasma being a cause of gingivitis.

I was just raising the question because my kitty tested positive for Mycoplasma ... which is listed on the IDEXX report as "Mycoplasma felis" (not as Mycoplasma haemofelis).

I haven't seen any other signs of illness in my kitty that might suggest an autoimmune problem, and her gums look pretty good at the moment. Maybe I am panicking too quickly. But if her gingivitis returns, I agree that a gingival biopsy would be a good idea to help see what we are dealing with. I'm hesitant to start giving her steroids and antibiotics without good cause to avoid other side effects or causing antibiotic resistance strains of bacteria.

I've been working with using the toothpaste ... which my kitty thinks is really "tongue-paste". She loves it and thinks it is a special treat. I think I am getting better at getting it on her teeth and gums. It is nice that she likes the procedure since she loves the toothpaste. She thinks of it as dessert. I wonder how many calories there are in the toothpaste! :-)

Thanks again for sharing your expertise. I'm trying my best to be a good pet owner and give my kitty the best care I can. I've already decided to keep her on a schedule of wellness check-ups every six months. I have a good veterinary scale and weigh her daily to watch her weight (my vet put her at a BCS of 5 to 5.5 on the 9 point scale) and also to catch any weight loss that could be an early indication of illness. Any other suggestions for someone who wants to be a good pet owner are welcome.

Happy New Year to you, too!

Stephanie in Montreal

I make an effort to... both of my dogs really don't mind it. I use a flavored paste. It doesn't really give the desired 'clean and fresh' smell I'd prefer - but makes it more pallatable for them. I have a Weimaraner that needs some coaxing but our German Shorthaired Pointer LOVES getting her teeth brushed... she also LOVES baths! That's fine by me! Makes my job easier!! :)

my kitties would bite the heck out of me and put up one big stink if i tried brushing their teeth (well at least the older one would) the younger would try to get away and not like it one bit. she would hide from me for days after. they get regular vet wellness checkups and i've asked about having their teeth cleaned and so far, they've looked good.

kathykatt: there are some dental treats for dogs AND cats that contain a dental-tartar fighting ingredient/antiseptic- chlorhexidine... maybe those would work for your kitties?

We have 3 dogs (miniature Dachshunds) and 3 cats. We spent in excess of $800 in 2010, on dental cleaning and extractions on the 3 dogs. That did it for us! We now brush the teeth of all 6 animals with Biotene oral gel every single night as a "bedtime" ritual. Yes, it took weeks to get them use to this practice (and a couple still aren't quite there!!), but it has certainly helped keep down the plaque buildup. We use human toothbrushes on the dogs (which get changed out on the 1st day of each month to new ones), and a "finger brush" on the cats. The line in the story above is correct: something's better than nothing, and in our case, $800 dental bills ... and that's just for the 3 dogs!!

I try to brush Abby's (3-year old Airedale) teeth at least once per week. This is not an easy task as she tries to avoid my getting the toothbrush very far back into her mouth.

I am also trying a product called Suzies Tartar Liquid which is added to Abby's water dish. It's supposed to change the pH of her mouth and soften the tartar which is supposed to loosen and be removed when eating hard foods.

I'd like to know if anyone has any positive or negative results with this treatment.

My dog had terrible breath and tartar on teeth, however could not get them cleaned due to a seizure condition. When she had blood work the liver enzyme was elevated in the thousands. I feel the bacteria effected her liver. If the liver is effected where the liver enzymes are abnormally high, would it have to show an elevation in the WBC count? I thought she should have had an antibiotic, but the vet said her white count was normal. Now I read your dog can have an infection in the liver without elevating the WBC. And I also read the abnormal liver count could be causing the seizures. Please give me your opinion Dr. Will.

My 8 year old Boxer was prescribed Antirobe, 1 pill x5 days monthly for the last year. It did work, the tartar is gone and she does not have bad breath. Gracie just went for her rabies/checkup and the Vet recommended taking med every other month. Thanks

My problem is, I have no time to be brushing my dogs teeth every time she eats. I have tried brushing them at least once in awhile but it is very difficult, she doesn't cooperate and her gums bleed. Tiny is an 8 year old bossy toy poodle. I have been putting this liquid in her drinking water which I guess helps a little but you can see some tartar on her teeth.

Great, Gracie. Antirobe is an antibiotic which is great for gingivitis (gum inflammation/infection). It doesn't do much for dental tartar, but certainly getting infection under control can help with bad breath. Keep up the good work!

kanded: the liquid is a good additive, and is certainly better than nothing. Remember...there are tartar and plaque fighting enzymes in most pet toothpastes, so the important thing is to get it on the teeth- if you can do that and not necessarily try to "brush" them, that will help a lot. You can simply use a piece of gauze or soft cloth to gently apply the paste to the teeth...see if that helps. Keep up the good work!

Great! An ounce of prevention is worth a pound of cure, as they say! The brushing is certainly going to save you money in the long run. Great job!