Ask a vet 24/7: Dental Dilemma - Black Spots on Cats' Teeth

Have you ever gotten home after a vet visit and realized you forget to ask them something important about the discharge instructions or home care? Of course, this scenario typically happens after the vet hospital is closed and lines of communication are severed.

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Whoopi & Onslo Have Black Spots on Their Teeth

Question: “Both of my 2 year old felines have small black spots on both of their upper canines. The rest of their teeth are spotless & perfect. The spots are located towards the inside and up high, but are located below the gum. We are unsure how long its been there, we just noticed a couple of days ago. Both cats eat Taste of the Wild Canyon River dry food. They get dairy products as treats on a limited basis, such as tiny bits of cheddar cheese and skim milk. Whoopi (all black female) gets more of the dairy products than Onslo (grey male). What can these spots be?”

cat-teeth

Answer:

I was able to gather some good information that I believe should help you going forward.

There are a few things this could be. The lesions are a little unusual in that they are bilateral, and both cats have them. I was unable to confirm if this could have a genetic cause but it does not rule it out. There are a few rare congenital conditions which can cause unusual tooth development but they tend to result in deformed crowns on all of the teeth, very thin tooth walls, unusually short roots etc. The prognosis for these teeth is that they will wear faster than expected at the sites where the enamel is deficient, and/or are more susceptible to fracture. You will need to watch for pulp exposure and changes in tooth color suggesting pulpitis or infection. In order to determine the cause of these dark lesions, it will be necessary to have a vet visit either with a veterinary dentist or a veterinarian who is very knowledgeable about dentistry and has the ability to take dental x-rays. A veterinary dentist would probably be your best bet but there are certainly some general practitioners who have lots of experience in dentistry that may be capable as well. You can use this link to find a veterinary dentist if you choose to go this route.

Regardless of where you choose, the veterinarian will need to do the following at the appointment: detailed examination that will include visual, tactile (with a dental probe) and radiographic examination of each affected tooth.

I do want to give you a bit of a background in tooth anatomy and composure so the rest of the answer will make more sense. Teeth are composed of four main tissues. The crown (the visible part of the tooth) is covered by a thin veneer of enamel and the root (the part of the tooth within the gum line that we can't see) is covered by a thin layer of cementum. Under the enamel and cementum is dentin and inside the dentin is a chamber filled with soft tissues known collectively as the dental pulp. The chamber within the crown is called the pulp chamber and within the root it is called the root canal.

The pulp is a highly organized collection of tissues that includes blood vessels, nerves, lymphatic channels, undifferentiated cells and highly specialized cells (it gets a forty-page chapter in some veterinary dentistry textbooks). The pulp can become diseased in a number of ways, but they all boil down to inflammation (usually due to infection) or necrosis from lack of blood (usually due to trauma).

This brings us back to the dark spots. Most likely these dark spots are either 1) crown fracture or wear with pulp exposure or near pulp exposure, 2) chip fracture or wear with tertiary dentin, or 3) discoloration.

Regardless of the specific course the lesion takes, all cause pain to some degree and all are associated with a chronic infection that the body cannot possibly clear. The source of the infection is the bacteria inside the tooth and there is no longer any way for the body to reach in there to clean up the mess. Antibiotics may offer short-term symptomatic relief, but they have no effect on the source of the infection.

Something else I have considered was if the two cats were exposed to something as kittens, such as a virus, that could have affected the development of their enamel. The pattern is so striking on both the left and right sides, as well as the two cats themselves, I can't help but wonder. Of course, this is difficult to know since it is usually impossible to know what they were exposed to early in their lives.

The bottom line is that when the pulp has been exposed, there is no doubt as to what will happen. The pulp will gradually die and become non-painful for a while before inflammation will develop, which is when the lesions will become painful to some degree. Consequently, with pulp exposure, resolving on its own is not possible. In all the cases, treatment would either be endodontic treatment (typically a root canal by a veterinary dentist) or extraction. Many primary vets can do extractions. Canine teeth are typically the most challenging to extract so you do want to choose your veterinarian wisely, which really goes without saying. Root canals may often be priced similarly to extractions and the recovery is usually superior so that is why I would suggest seeking out a board-certified veterinary dentist if you have that option.

I know I have left you with several different causes of these mysterious dark spots and lots of technical information, but I wanted to go ahead and do my best to explain it to you so you can understand how it can be multiple things. I wish you and your cats the best option moving forward and that no surgical measures are needed.

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