Feline tooth resorption in cats

Feline tooth resorption, also called FORLS, is a progressive and painful dental problem in cats. It affects between 20 and 75% of adult cats and represents a major ‘hidden‘ health concern.

After periodontal disease, feline tooth resorption is the second most common dental problem affecting cats in the UK. FORLS can affect all ages of cats. It results in broken or missing teeth and swollen, inflamed gums. The condition can be intensely painful, although cats usually hide this. For this reason, FORLS in cats is usually very advanced when diagnosed.

Overview

What is feline tooth resorption in cats?

What happens in feline tooth resorption?

Some of the body’s own cells start to attack the tooth, eating it away from the inside.
The destruction starts with the roots and continues up to the crown.
The gum around the tooth becomes angry and inflamed.
Parts of the hard enamel on the crown start to break off.
The resulting ‘holes’ fill up with angry, inflamed tissue.
Eventually the crown (visible part of the tooth) breaks off.
The remaining root may eventually be resorbed.
If your cat has unexplained missing or broken teeth, they may well have feline tooth resorption.

feline tooth resorption in cats — Swollen and inflamed gums and possible tooth resorption.

Facts about FORLS:

11% of cats seen by vets have feline tooth resorption. Many more cats have the disease and don’t see a vet.
Anywhere between 20 and 75% of adult UK cats have feline tooth resorption. It’s a major hidden problem in cats.
We don’t know for certain what causes feline tooth resorption. Sometimes it follows inflammation of the tissues surrounding the tooth (periodontitis). But it’s likely that multiple factors are involved.
Feral cats rarely get feline tooth resorption. This suggests that lifestyle and diet play a significant role in the disease.
The teeth most commonly affected are the first lower cheek teeth and premolars.

Symptoms

Symptoms of feline tooth resorption in cats

Symptoms of dental problems will relate to pain, difficulty biting or chewing food and decay. However, some cats don’t show symptoms of pain. Cats are prey animals; they don’t want to look like victims, so they hide pain well and ‘suffer in silence’. Many pet parents report that their cats have much happier and friendlier personalities after dental surgery.

Warning signs of FORLS include:

Dropping food, eating on one side of the mouth
Eating soft food and leaving kibble
Dribbling saliva, bleeding from the mouth
Halitosis (smelly breath)
Rubbing or pawing at mouth
Losing weight
Reduced grooming and unkempt coat
Becoming quiet, less sociable, and more withdrawn

shutterstock 1219722472 min — Drooling and an unkempt coat can be signs of dental disease.

Risk

What are the risks of feline resorptive lesions in cats?

Higher risk cats

Various life stage, breed and health factors affect your cat’s risk of having FORLS. These include:

Increasing age
Eating a poor diet
Poor dental hygiene – not having teeth brushed or cleaned regularly
Being a purebred cat – Siamese and Persians

Complications of feline tooth resorption

Feline tooth resorption triggers inflammation and a progressive decay process, as well as the active tooth destruction. Untreated dental disease can lead to other serious and life-threatening illnesses when bacteria from the infected mouth spread throughout the body:

Chest infections and bronchopneumonia
Septicaemia
Kidney disease
Damaged heart valves and muscle (bacterial endocarditis)

Diagnosis

Diagnosis of feline tooth resorption in cats

It’s impossible to fully assess your cat’s mouth when they are awake. So your vet will advise a general anaesthetic. This allows careful examination of teeth and gums while your cat’s asleep.

Physical check: only damage above the surface is visible. Physical checking alone is nearly two and a half times less likely to pick up FORLS than x-rays. Most stages of the disease affect the tooth root so x-rays are essential.

Dental x-rays: reveal root destruction and resorption into bone.

shutterstock 2478157729 min — Dental x-rays of a cat.

Vet treatment

The treatment for feline tooth resorption in cats

Treatment options include:

Removing teeth with defects due to resorption.
Removing tooth roots where the crown is missing and gum is inflamed.
Removing just the remaining top part of the tooth.

Filling damaged teeth is not an option with feline tooth resorption because the condition is progressive. When the tooth root is eaten away and what’s left fuses with the jawbone, it’s impossible to remove. In these circumstances, vets remove the damaged top of the tooth and ensure the gum is smooth. The process will be followed with a full clean-up and polish of the remaining teeth.

Home treatment

Home care for feline tooth resorption

If your cat has dental problems, including FORLS, they should see their vet for a full examination. Your vet will be able to advise on treatment that is safe and in your cat’s best interests.

If your cat is showing symptoms of mouth pain:

Call your vet for the next available appointment.
Feed smaller, more frequent meals of soft food.
Encourage your cat to drink as much as possible, even if they refuse food.

Prevention

Reducing the risk of feline tooth resorption

The risks of FORLS in later life can be reduced if you start cleaning your cat’s teeth while they’re still a kitten.

What you’ll need:

Cat toothpaste: there are some specifically designed toothpastes to help break down plaque.
Toothbrush, finger brush or microfibre cloth.
Patience and perseverance.
Special dental diets: Hills Science Plan Oral Health for cats, Hills t/d, Purina Dental Health. Always check the feeding instructions or ask your vet for advice.

Feline tooth resorption is expensive to treat. Often, cats will require repeated operations to keep their mouths comfortable. But keeping your cat’s mouth healthy and clean through a healthy diet and regular cleaning will give them the best chance of maintaining a healthy mouth.

When to worry