Dental Extraction For Cats

A dental extraction (exodontia) is a medical procedure in which the veterinarian removes a damaged or diseased tooth or in some cases, multiple teeth. Diseased teeth cause considerable pain and impact on a cat’s quality of life. Cats do well after dental extractions and even those who have had all teeth removed (due to stomatitis), are still able to eat well.

Indications

• Loose tooth and bone loss due to advanced gum disease
• Retained baby tooth
• Crowding of teeth
• Broken tooth with exposed pulp
• Stomatitis
• Feline odontic resorptive lesions (FORL)

Symptoms of dental disorders

• Red margins along the gumline
• Reluctance to eat, especially hard food
• Drooling
• Bad breath
• Visible tartar on the teeth
• Pawing at the mouth

Diagnostic workup

Dental x-rays: These will give the veterinarian a picture of what is happening underneath the gumline and evaluate the roots and bone.

Baseline tests: Complete blood count, biochemical profile and urinalysis which will provide information on the overall health of the cat as well as evaluate liver and kidney function which is vital before the cat goes under anesthesia.

Pre-surgery guidelines

Because all dental procedures in cats require a general anesthetic, it will be necessary to fast the cat overnight. If the cat does accidentally eat, let your veterinarian know, in most cases, they will re-schedule surgery to avoid the risks associated with aspiration of the stomach contents in a cat who has eaten in the previous 12 hours.

Most surgeries will admit the cat in the morning; the veterinarian will run through the procedure with you and provide the opportunity to ask any questions.

Dental extraction procedure

The veterinarian will examine the cat before surgery and place a catheter to administer fluids, antibiotics, and pre-emptive painkillers.

Several extraction methods will depend on the type of tooth and root (single roots in the incisors vs. multiple roots in the premolars and the molars).

Dental extraction can be crown, simple (closed) or surgical.

Simple (closed/intra-alveolar) extraction:

• A simple extraction is most commonly for incisors and uses a tool called an elevator or luxator to cuts the gingival attachment around the circumference of the tooth.
• The veterinarian applies forceps to move the tooth back and forth to break the periodontal ligament; careful force is then applied to remove the tooth.
• Diseased tissue is debrided (removed) and bony edges smoothed.
• The area is rinsed and in some cases sutured.

Surgical (open/trans-alveolar) extraction:

For large teeth, with multiple roots, the surgical method will be used to avoid a root fracture.

• The veterinarian makes surgical flaps over the tooth root to access the underlying bone.
• The bone overlying the tooth is removed using a burr, and if the tooth has multiple roots, it will be sectioned, by cutting it into several smaller pieces with a high-speed bit.
• An elevator or luxator to cuts the gingival attachment around the circumference of the tooth.
• Forceps extract the tooth once it is loose enough.
• Diseased tissue is debrided (removed) and bony edges smoothed.
• The veterinarian rinses and sutures the surgery site to close it.

Crown amputation:

This procedure may be used in cats with FORL in which the crown is removed to the level of the gum. Over time, the gum tissue will cover the underlying area.

The veterinarian will perform x-rays after surgery to confirm extraction of the entire tooth and roots.

In most cases, the cat can go home the same or the following day. The veterinarian will go through post-surgery care at the time of discharge and will schedule a follow-up appointment seven days post-surgery to check the cat’s progress.

Complications

• Retailed roots or root tips: This highlights why post-surgery x-rays are essential. In some cases, it will not be possible to remove the entire root, in which case the veterinarian will periodically monitor the cat for complications.
• Dry socket (alveolar osteitis): A blood clot should form after surgery which protects the underlying bone and nerves, in some cases the clot dislodges or dissolves, and exposes the underlying tissue.
• Wound breakdown: Rupture of the wound along the suture line.
• Oronasal fistula: A communication between the oral cavity and the respiratory tract which can occur secondary to surgical extraction of a maxillary canine tooth

Signs to watch for include coughing, bleeding, infections, bad breath and signs of pain.

Home care

It takes between 10-14 days for the gum to heal after a dental extraction.

General anesthesia will cause the cat to be somewhat groggy on the first, and he may be reluctant to eat on the first night.

Dental surgery is painful, and in most cases, the veterinarian will prescribe painkillers as well as antibiotics, administer as per instructions.

Sutures will dissolve in 2-4 weeks.

Feed a soft diet for several days while the mouth heals to avoid trapping food in the open sockets, damaging stitches and avoiding the discomfort of dry food in a sore mouth. If the cat refuses a change in diet, offer dry, but pre-moisten it first. If the cat has not eaten after 24 hours, speak to your veterinarian.

Keep the cat inside during recovery and minimise activity.

Do not brush your cat’s teeth for two weeks post-surgery.

Prevention

Prevention is always better than cure, especially when it comes to dental care. Start when the cat is young.

• Schedule annual health checks, during the exam, the veterinarian will check the cat’s mouth and teeth for signs of disease. Gingivitis is early gum disease, and at this stage, it is possible to reverse.
• Clean the cat’s teeth once a day with a pet toothbrush and toothpaste (never use human toothpaste).
• Feed raw chicken necks, wings of chunks of steak which help to clean the teeth.
• See your veterinarian if you notice bad breath, drooling, red and inflamed gums, especially along the gum line, or a kitten with two teeth (usually the canines) in the same spot.

How much does a dental extraction cost?

The cost will depend on the number of teeth and the complexity of surgery but expect to pay between $300 and $1,500 which will include anesthesia, drugs, surgery, hospital care and post-surgery painkillers and antibiotics which will go home with the cat.