Tooth Resorption (TR) lesions cause many problems in feline practice. Global surveys
over the last twenty years indicate that 25% of the general feline population and 75% of those with other dental disease have at least one TR. Extracting TR teeth is the only sustainable treatment and very difficult as the loss of normal landmarks makes root luxation often impossible. IN addition, TR lesions present as three distinct types (Type 1, Type 2 and Type 3) which can only be identified by dental radiographs. Treatment for the three types are not interchangeable. Type 1 lesions require standard surgical removal via flaps and removal of all root tissue. Type 2 lessons are already resorbing bone and to perform a Type 1 surgical extraction in these teeth is to damage a healing process already taking place. Type 3 lesions are a mixture of both.

Good instruments help here. Our preference for feline dentistry is to use the "EX5" series luxators. These are available from Kruuse and Dr. Shipp - see our Location & Links page. Also, do not be tempted by the "atomisation" option! Severe damage can, and does, occur to collateral structures without due care. Many cases of Feline Oral facial Pain syndrome arise initially from "tooth root atomisation" procedures. Most teeth have large sensory nerves (infraorbital or inferior alveolar( close to the apices of the roots. Atomisation procedures often go beyond the rot apex damaging the nerves. Out advice? Don't do it!

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Case of FCGS - mild to severe Case presenting with caudal stomatitis

Feline CGS makes up a large proportion of cats referred to us. Most cases improve dramatically with some form of medical or surgical treatment but a small proportion appear to resist all efforts. Much misinformation is available. Since plaque intolerance is the source of the problem, our efforts are directed at controlling it - along with other treatment regimens. A combination of elective extractions, strict hygiene, oral chlorhexidine, antibiotics and feline interferon therapy is our best regime. Anti-viral drugs, such as Interferon, hold much promise in our opinion. Case selection is vital as best results come from cats who have already had elective cheek teeth extraction and are feline calici virus positive.
We have a trial running with 32 cases since November 2007. A number of other practices in the UK, and France are working on similar lines. The success rate holds much promise in the management of such cases.

The most recently reported research by Hennet and others can be found at:
Journal of Feline Medicine & Surgery (2011), 13, 577-587. Comparative efficacy of a recombinant feline interferon omega in refractory cases of calicivirus positive cats with caudal stomatitis: a randomised, multi-centre, controlled, double blind study in 39 cats.

Typical case of FCGS Case radiograph showing retained roots

In addition we have been working with the University of Glasgow Dental and Veterinary Schools since April 2009 on a reasearch project to detemine the exact nature of antigen in the mouths of cats with this problem. The project uses aerobic and anaerobic culture in addition to culture independent methods (gene sequencing) to find agents hard to culture or novel species. A paper with preliminary results has been submitted to Veterinary Microbilogy and was published in 2011

Feline Epulis is a rare condition that can be asily confused with cases of FCGS. This is a benigh neoplasm of the periodontal tissues that support the teeth and surgery to remove the masses and associated teeth is generally curative. In some refractory cases radiation therapy may be helpful