Tooth Enamel Malformation in Cats

Enamel Hypoplasia/Hypocalcification in Cats

When tooth enamel -- the outer coating of the tooth -- is allowed to develop normally it has a smooth and white appearance. Abnormal environmental or physical conditions can interfere with the development of tooth enamel, causing it to take on a discolored, pitted or otherwise unusual appearance.

Bodily influences, like a fever over an extended period of time, may cause pitting and discolored enamel surfaces. Local influences, like injury (even from baby tooth extraction) over a short period of time can cause specific patterns or bands to appear on the developing teeth. These types of traumas can result in less than normal deposits of enamel, medically termed hypocalcification. The lack of sufficient enamel may cause the teeth to be more sensitive, with exposed dentin (which is normally hidden underneath the enamel), and occasionally fractures of severely compromised teeth. The teeth usually remain fully functional.

Symptoms and Types

• Irregular, pitted enamel tooth surface with discoloration of diseased enamel and potential exposure of underlying dentin (light brown appearance)
• Early or rapid accumulation of plaque and calculus on roughened tooth surface
• Possible gingivitis and/or accelerated periodontal/gum disease

Causes

• Injury during enamel formation on the teeth
• Fever, trauma (e.g., accidents, excessive force used during deciduous/baby tooth extraction)

Diagnosis

Discolored teeth may be found by your veterinarian during a routine physical exam, which normally includes a complete oral exam. Intraoral radiographs (X-rays) can then be taken by your veterinarian to determine if the roots of the teeth are still alive.

Treatment

Treatment of your cat's teeth will depend upon the extent of abnormalities and the equipment and materials that are available. Your veterinarian will try to create the smoothest surface possible on the cat's teeth. Prior to receiving any dental work, your pet will be given pre-operative antibiotics and oral pain medication. Your veterinarian will try to gently remove the diseased enamel by scrubbing the enamel with special dental instruments, while taking care not to remove too much enamel and/or dentin or to overheat the insides of the teeth.

If the insides of the teeth have become exposed as the result of the hypocalcification, they will be sealed with a bonding agent that is made to protect the inside of the tooth along with its surface. A strong fluoride treatment applied to the teeth can be used in tandem with the other treatments to decrease sensitivity and enhance the enamel’s strength. It must be applied to a dry tooth surface using a varnish or strong sodium fluoride paste. This treatment will be performed under medical guidance in-hospital.

Using fluoride on your pet at home without consulting a veterinarian is not advisable, since fluoride can be toxic, and can itself cause damage to the enamel if not applied properly.

Living and Management

If your cat has been diagnosed with hypocalcemia, your veterinarian will recommend regular professional dental cleaning, about once or twice a year, but possibly more depending on the condition of the teeth. Routine home-care, with a regular brushing program, will also need to be undertaken. If you are unfamiliar with tooth brushing for cats, ask your veterinarian to demonstrate the proper techniques for you.

Weekly application of stannous fluoride can be done at home, but caution is important. You will need to prevent your cat from having access to the fluoride, or from swallowing it (though a minute amount being swallowed cannot be helped), since stannous fluoride can be toxic in large doses. Excessively chewing on hard objects should also be discouraged.