Franklin Vets Blog

What dental x-rays & diagnostic tests tell us

August 27, 2019

Katie is one of our senior cats who came to see us a year ago for dental work as she had very inflamed gums around some teeth that were causing pain.

Being an older cat, we wanted to make sure Katie was healthy for an anaesthetic. We ran a battery of blood and urine tests in the clinic on the morning of admission.

Katie the cat's chemistry results

Chemistry results

Katie the cat's haematology results

Haematology results

Katie the cat's urine test results

Urine test results

The machines we now have available in the clinic give us an extremely accurate picture of the state of an animal’s health, all within minutes. In this case, there was some suggestion of possible early kidney disease and evidence of some physiological stress. (the kidney issue was rechecked at a later date and found to be normal).

Katie was then anaesthetised using a careful drug cocktail that was as safe as possible considering her age. Full mouth x-rays were taken to look at all the remaining teeth (she already had a few missing!).

X-ray showing hole at gum level

X-ray showing hole at gum level

The x-rays showed that the right lower canine was present, but had a hole in it at the level of the gum. This is a condition called Feline Odontoclastic Resorptive Lesion (FORL) and is a common cause of dental pain in cats. As usual in medicine, there are many different forms of this condition. Katie had an actively resorbing area on the tooth itself, which would have been painful, but the entire root had been replaced with bone. This process is called replacement resorption, and may in fact be part of a healing process for a damaged tooth. In essence, the body recognises the tooth root as bone, and the root does not respond to bone filling in the tooth socket. In time, the root is completely replaced with bone.

All very interesting, but of what value is this to Katie?

Resorptive lesions are very common in cats, affecting more than half of cats in one Australian study, with each cat having about 3 teeth affected. And many of the lesions are not visible with the eye, they need x-ray exam to detect.

So every dental case should have a set of full mouth x-rays performed. And if you find one lesion, look for more. Katie had a second one further back in the mouth.

The other benefit of diagnosis is that in this case, there is no need to dig out the root, which can be traumatic, painful, and somewhat risky in an older cat’s mandible (jaw bone). Over 80% of the strength of the mandible at the front of the mouth comes from the canine teeth, so removing them can result in a jaw fracture. In Katie’s case, given the root had turned to bone, the tooth could simply be cut off at the gum level and the gum sutured over the top. Very easy dental surgery, and no risk of a mandibular fracture.

So there we have it. Another interesting story from the medical files, and illustrating the benefits of blood testing, full mouth x-rays, and careful attention to detail for all our patients.

Paul Eason BVM&S MANZCVS (Surgery; Emergency and Critical Care Medicine)