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    When and why a cat’s teeth should be brushed

    It is essential to clean your cat’s teeth to maintain good oral health.

    Introduction

    Periodontal disease (PD) is a very common problem in cats. In fact, it has been estimated that 70% of cats over the age of 2 years already have a certain degree of PD and that prevalence increases with age.1-2 PD is an inflammatory disease caused by bacterial plaque and includes gingivitis and periodontitis.

    • Gingivitis is a reversible process if the bacterial plaque is removed, but if it is allowed to progress, it often leads to periodontitis.
    • Periodontitis is an irreversible process in which the progressive destruction of the periodontal ligament and alveolar bone will eventually result in tooth loss. In addition, periodontitis has been linked to other oral diseases, such as tooth resorption and feline chronic gingivostomatitis.3

    Moreover, feline PD has a negative impact on the cat’s quality of life and has been linked to the development of cardiorespiratory, liver and kidney diseases4, although the causal relationship between them is not fully understood. Consequently, there is clearly a need to implement measures that prevent or delay the development of PD.  

    Why should you brush your cat’s teeth?

    In both human dentistry and veterinary medicine, regular dental brushing is considered the standard procedure for maintaining adequate oral health.2

    There is no point in cleaning teeth and removing dental tartar and bacterial plaque unless it is followed by adequate home maintenance of oral hygiene. Following dental cleaning in patients with periodontitis, it has been shown that plaque reattaches to the surface of recently cleaned teeth in less than 24 hours and the periodontal pockets become re-infected within 2 weeks.5

    When and how to brush your cat’s teeth

    Considering most cats develop PD within the first 2 years of life, then the sooner owners start brushing their cat’s teeth, the greater the benefitsIf plaque is allowed to mineralise and subsequently develop into tartar, brushing alone will no longer remove it and so dental cleaning under general anaesthesia is required.

    As such, the general recommendation is to start brushing a cat’s teeth when 8–10 weeks old. This averts the potential scenario of an adult cat refusing to undergo an unfamiliar procedure that it may well find disagreeable at first.6

    Unless a cat’s teeth are brushed on a daily basis, and it must be done correctly, then home dental brushing loses a lot of its efficacy.1

    Cats must be allowed to become accustomed to brushing gradually. To this end:

    • Choose a quiet area of the house where the cat feels comfortable and away from other potential stimuli.
    • Start by inserting a finger in the animal’s mouth and then once the cat tolerates this, introduce the brush.
    • The use of tasty flavourings can facilitate the process.
    • It is important to be patient until the cat accepts the procedure willingly, otherwise it will prove impossible to brush its teeth on a regular basis.6
    • Although plaque can accumulate on all teeth, and while full brushing is clearly the ultimate aim, the most important target area is the external (labial) surface of the molars, premolars and canines.
    • With the cat’s mouth closed, lift the corner of the lips and insert the brush. Perform circular movements at 45° to the gingival margin, angling the brush to adapt to the teeth’s contours. Note that as cats have anisognathic jaws, the maxilla is easier to brush than the mandible.
    • Brushing should last for 30–60 seconds on each side of the mouth. In cats that will not tolerate brushing in a particular area, cotton swabs can be used instead but they are less effective.3,6
    • Use a special brush designed for cats, with a small head and soft or, at most, medium hardness bristles and, as with humans, it is important to replace brushes frequently.
    • Toothpastes containing fluoride, foaming agents or menthol should be avoided. Insofar as possible, always use a toothpaste formulated especially for cats. Toothpastes with chlorhexidine or zinc may have an additional antiplaque effect.3 
    • A dry diet helps increase protection against problems in the oral cavity; not only do cats like the crunchy texture of extruded kibble but chewing on the hard pieces also has an antitartar action that improves their dental health.

    Conclusions

    Despite the benefits of regular dental brushing on oral health, very few owners brush their cat’s teeth regularly. So, vets really need to stress the importance of brushing a pet cat’s teeth and the best time is when a newly acquired kitten is brought for its first visit. Either way, other alternatives (specific diets, dental treats, oral antiseptics) should be offered to help maintain oral health in the case of cats that do not tolerate brushing or owners who are inconsistent with daily brushing. 

    References
    1.     Ingham KE, Gorrel C, Blackburn JM, et al. (2002). The effect of toothbrushing on periodontal disease in cats. J Nutr. 2002; 132(6 Suppl 2):1740S-1S.
    2.     Buckley C, Colyer A, Skrzywanek M, et al. (2011). The impact of home-prepared diets and home oral hygiene on oral health in cats and dogs. Br J Nutr; 106 Suppl 1: S124-7.
    3.     Perry R, Tutt C. (2015). Periodontal disease in cats: back to basics--with an eye on the future. J Feline Med Surg; 17: 45-65.
    4.     Oskarsson K, Axelsson Puurtinen L, et al. (2021). Dental problems and prophylactic care in cats-knowledge and perceptions among Swedish cat owners and communication by veterinary care staff. Animals (Basel); 11: 2571.
    5.     Niemiec B, Gawor J, Nemec A, et al. (2020). World Small Animal Veterinary Association Global Dental Guidelines. J Small Anim Pract; 61: E36-E161.
    6.     Ray JD Jr, Eubanks DL. (2009). Dental homecare: teaching your clients to care for their pet's teeth. J Vet Dent. 2009; 26: 57-60.