Cat Dental Care: An Interview with Veterinarian Sarah Brandon, DVM
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Dr. Sarah Brandon is a practicing Veterinarian and CEO of Canna Companion, where she oversees the research, development, and manufacturing of hemp pet supplements. Dr. Brandon also maintains a small feline only mobile practice in Washington state, focusing on a balanced, holistic approach for her patients which includes nutrition & herbal and essential oil supplementation. It is her belief that the best healthcare plans incorporate the specific needs of the household, rather than only the patient. During the past two decades, researching herbal therapies in clinical practice became her passion, and the experience and data gained was used to launch a line of supplements designed to support a balanced cannabis receptor system. Outside of her professional life, Dr. Brandon enjoys backpacking with her two rescued Belgian Malinois, playing fetch and laser tag with her three youngest cats, or curling up with a good book and one of four senior cats. Other hobbies include birdwatching, listening to Blues & Jazz, and making herbal teas from plants grown in her organic garden.
What is the best way to keep my cat’s teeth healthy and clean?
Cats and their humans everywhere are not going to like this answer … brushing their teeth daily really is the best way to ensure a healthy mouth.
The physical action removes plaque, while compounds within the toothpaste help reduce overall oral bacterial content; both helping to slow the progression of tartar buildup on enamel and under the gumline.
Here are written and visual (0:50) instructions regarding feline brushing, as well as flavored and unflavored toothpastes.
What if your cat will not allow brushing, no matter how slow you go?
Some of these guys will still allow physical removal of plaque with plain or treated (veterinary dental gel, toothpaste, etc.) cotton tipped applicators, while others will accept water additives. (Scroll to pages 2 & 3 for details.)
Second only to daily brushing in prevention of tartar build-up, daily raw chicken necks also provide physical removal of plaque while massaging the gums. It’s not just any raw bone which will do the trick here.
The combination of muscle, tendon & ligaments and bone with hollow core (spinal canal) allows for the most complete plaque removal from tooth tip to below the gumline.
The flip side? Brushing does nothing for feline oral resorptive lesions which start below the gumline and is the number one factor necessitating dental extractions.
If your cat isn’t into brushing, regular feeding of raw chicken necks can perform similar actions. Muscles, tendons & ligaments help massage gums, and when cats bite down, the vertebral column collapses.
Are dentals necessary? How do you know your vet is right about your cat needing a dental?
Yes, if a cat’s mouth meets certain criteria. I do not agree that cats should have their teeth cleaned yearly, though this is what most veterinary organizations (AAHA, AVMA, AVDC, etc.) recommend.
It is my preference to take their guidelines into consideration with every patient. For example, if I examine a 4 yr Ragdoll’s mouth and note zero gingivitis and ¼ tartar, I recommend daily brushing (if not already started) or 1 raw chicken neck/day (as part of their diet).
The same recommendation generally applies if there is zero tartar and generalized stage 1 periodontal disease (mild gingivitis). I like to recheck these cats in 6 months to make sure we’re on the right track.
If however, the patient has individual teeth with gingivitis or more advanced levels of diffuse tartar or gingivitis, then an anesthetic dental cleaning is warranted. (Non-anesthetic cleanings may work for some dogs; I’ve not found them helpful in cats.)
Patients with single lesions like this cat (source lbah.com) often have oral resorptive lesions which usually require extraction to prevent significant pain. There’s typically not much which can be done outside the above mentioned techniques to prevent these as we think they arise from a variety of causative factors: genetics, calici viral load, congenital oral bacterial population, GI flora health, and more.
From a Chinese medical philosophy, there can be a Kidney Yin deficiency or excess in Stomach Fire, and some patients respond well to appropriate herbal, dietary and acupuncture therapies.
Is brushing cat teeth effective?
Very! Just start slow, ideally during kittenhood (face handling, opening the mouth, gently rubbing the gums with your finger, letting them chew on plain toothbrushes), and work up to full brushing over a few years. Just make the experience positive and your cat is likely to accept the whole thing 🙂
Currently, there is a promo running on Facebook and Instagram about an additive you can add to your cat’s water to help keep their teeth clean – what do you think of that?
I’ve some products like this work; others not at all, even after confirming the client was following labeled directions. The variable response is likely multi-factorial. I can at least say these products are not harmful — at least I’ve never come across such a report and their ingredients are generally non-toxic.
They are saying it’s veterinarian approved – but is that something you can rely on?
You can rely on the fact that making this claim means the company must provide proof a veterinarian approves of their product for it labeled/intended use. Whether that veterinarian works for the company or the doctor just likes their product and is willing to say so, doesn’t matter.
I think it’s more important you find products and resources approved by your veterinarian and/or those approved by other veterinarians you trust.
What do you think of cat dental treats? And/or prescription food?
As you know, I am not a fan of dental diets. They simply do not work in the overall population as cats do not chew their food. In addition, the kibble-based nutritional component is the opposite of what cats need: water-heavy and animal-protein based. (Yes, there are exceptions; I speak to the 99% of the cat world.)
This applies to dental treats as well. CET is a good brand and for those cats who will gnaw on whole pieces, it does appear to lessen tartar build-up. I know a few cats whose regular (every 24-48 hr) freeze dried treats large enough to encourage gnawing, seem helpful in reducing plaque formation. This is likely physical removal of bacteria more than anything else.
Are there other ways to keep your cats teeth clean without brushing?
See question 1 & links. Yes, there are several ways.
Are there certain health conditions where dental health is more important than others – like a cat with diabetes vs. one that doesn’t have it?
Not in my opinion. Dental health is important in any cat.
Are certain diseased states more prone to encouraging dental issues?
Yes, if those diseased states are unregulated. Using diabetes as our example: if the patient is unregulated and excess glucose is available for oral bacteria to multiply, then there is an increased risk for periodontal disease.
Similarly, cats taking immunosuppressive drugs are prone to dental infections. If the diseased state is regulated, e.g. glucose remains 80-120 mg/dL at home on insulin therapy & appropriate diet, then there should not be an increase in oral bacterial load.
Reader questions:
Suzanne Getson: my female ended up having some teeth extracted, including her upper canines, because of dental disease. I was told there’s no way to know if she will continue to have issues and no known measures for prevention of future issues…I would be interested to know if this is true?
Maybe … it’s true there’s no way to know if she will develop ORLs in the future, though statistically speaking she will. However is it not true there are no preventative measures. Keeping plaque build-up to a min via brushing, raw chicken necks, water additives, etc. will help keep the oral cavity healthier overall, reducing inflammatory lesions like ORLS — in some cats. In other cats, addressing Yin/Yang imbalances helps correct the underlying issue, or at least slow down the development of future ORLs.
Krista Burre: Thank you for this opportunity. Are there any safe and effective cat toothpastes or brushless gels (not a drinking water additive) that actually dissolve tartar and or treats ginvivitis like so many claim and people even show photos of before and afters because I have tried so many that claim this and I think they’re lying because I have found nothing that actually removes the tartar or prevents new tartar build up after a vet teeth cleaning. Also I would like to know just how safe or unsafe the preservative sodium benzoate is for cats. It’s in almost every cat and dog toothpaste I have found. Thank you so much!”
Question 1 has two options for toothpaste, though I think it’s more likely the abrasive action of brushing is more important than the specific ingredients.
It is the consistency of brushing which seems to make the most difference to tartar development. Gingivitis also responds to plaque removal, though its development has a larger range of causative factors, like ORLs.
Sodium benzoate is indeed toxic to cats, particularly in the presence of vitamin C, where it can turn into benzene, a known carcinogen. The FDA set limits on sodium benzoate use as a preservative in pet foods/products to 0.1%, in part based on old studies showing 0-0.25% did not cause negative effects in small feline test populations.
Would I use/recommend dental products containing this preservative?
Yes, and subjectively it’s not caused any problems. Do my cats receive products containing this ingredient? No. I try to avoid any additives whenever possible and stick with chicken necks and other similar treats for tartar control.
I must confess to not brushing their teeth; 2 dogs/day I can handle but adding 7 cats to that list is too much for me. The dogs use a human product (Auromere) which lacks preservatives … and makes my cat gag at the smell 🙂 It’s very minty and too strong for their palate.
Anne Grove – I would like more information on stomatitis; cause and treatment. Is extraction the only permanent solution?
Feline gingivostomatitis complex is debilitating and often does require full mouth extractions as the teeth literally start to fall out of inflamed/loose gums. We don’t know exactly what causes it, though many with this condition have significant calici-viral loads and alterations in their overall immune system functions.
From an Eastern perspective, cats with this condition are generally Yin deficiency which affects Kidneys (oversees skeletal system including dentition) & Lungs (oversees immune system).
There are exceptions to this whereby cats can have excess Fire (Yang) and this causes the inflamed gum tissues; a licensed TCVM doctor can determine which condition is more prevalent/patient.
Some patients with milder forms and early intervention may respond well to dietary changes, herbal blends, and acupuncture which nourish Yin.
Other patients respond well to therapies which support a healthy immune system … pre & probiotics, essential oils, immunomodulating herbs (Western, Eastern, mixed), mushrooms (proteoglycans are fantastic for the immune system).
Antibiotics and immune suppressing drugs rarely work, though they are often part of the initial therapy in an attempt to avoid surgery.
Sadly, surgery is often required simply for pain relief and quality of life. Oral discomfort in these cats often prohibits oral therapies of any kind, and even affects appetite & drinking patterns.
Kathy Bayliss – Swain: I have 2 cats that had to have extractions this year. I only do hard kibble & dental chews, no treats. What else should I be doing? Brushing their teeth was traumatic for all of us.
Extractions are often due to oral resorptive lesions rather than tartar build-up. This means you may not be able to prevent future issues. However, now is the time to try since they’ve just had their teeth cleaned.
If they will eat a raw food diet, or canned food plus daily raw chicken necks (they can split one or each have their own), that’s ideal. Alternative are listed above as well as in some of the links.
Joel Schmid: My cat refuses to hold still when I try to brush his teeth. What products are available that WORK that will clean a cats teeth without human intervention?
Those which work for most cats are brushing (off the table unless you can get him used to it) and eating raw chicken necks (1/2-1/day). Everything else is hit/miss in my opinion.
I’ve had some patients who do very well on CET chews while others have no change in dental state. A few have responded to various water additives; most have not. I think you’re time is best spent getting him used to either brushing or raw necks, even if that takes daily training sessions for a year.
If nothing else, your cat will enjoy your attempts and the extra attention — just remember to keep it positive, even if you have to skip a day because you or he isn’t feeling it!
My cat has been accustomed to having his teeth brush and does not fuss much. What toothpastes if any are safe to use on the little finger brushes I use to clean his teeth ?
There’s a lot which are safe, though I usually reach for CET (flavored)
or an unflavored one like OxyFresh.
If the ingredients are the same as on these labels (or very similar), then you’re probably okay. Products which come from your veterinarian’s office are often good choices as are those with VOHC seals.
Judy Sheppard: Here is my question: – Is PetSmile professional cat toothpaste safe to use?
Yes, products with a VOHC seal are generally safe to use.
Jamie Lynn: Yes- thank you for doing this interview! I have a brand of toothpaste (PetSmile) that claims you only need to rub it on the teeth- no brushing required. Is this effective?
I have doubts . . .Brushing with toothpaste/gel is preferred as you achieve physical removal of current plaque as well as paying down a layer of enamel protection, reducing adherence oral bacteria.
Will this product work on its own?
Better than not doing anything for sure though it’s unlikely to be as effective as brushing too.
Larry Howard: My question is. Does feeding hard food to kittens promote healthy teeth as they grow into adulthood?Verses feeding wet food?
No. Feeding kibble at any stage will not help teeth as they do not chew their food. Starting kittens out on raw food (commercial ground cat food products) and letting them gnaw on toys, sisal, cat grasses, and the occasional raw chicken neck (supervised, toss when they lose interest), mimics their natural behaviors if in the wild.
They will also chew on feathers which are okay to let domestic cats do, but supervise them as a few have gone feather-crazy and eaten huge chunks of feathers rather than gnaw on them.
Get them used to handling their mouths as well, and let them (supervised) chew on plain toothbrushes. This gets them used to future needs (full brushing) once their teeth have fully erupted.
Loc Hoang: Does the Vibrac CET Oral dental chews work?
Sometimes … the cat has to gnaw 1 large treat to receive benefits of outer coating (antimicrobial) and inner core (abrasive). If they will do that daily, the product does seem to help for most patients.
Simone Vrij: It would be very interesting to growing group to know how her experience is, looking at cats teeth that are kibble fed or raw fed. It was this very observation which led me to first research raw food in cats!
In my first 3-4 years of feline only practice, I noticed my patients on kibble did not have less tartar than those eating (any) non-kibble diet. Upon further investigation, patients eating raw food subjectively had healthier mouths than those who ate either canned or kibble.
There were outliers whereby canned food was their main diet and they received 3-4 pieces/day of a prescription kibble dental diet who had lovely teeth. And then if she noticed a difference between raw fed as in bones with meat on it or when ground raw meat was offered daily?
Yes, as time has gone on, I’ve done this very experiment in my own home — as well as subjective assessment of feline patients. Those raw diets with whole bone (e.g. ground meat mixture + ½-1 chicken neck/day) > those with ground bone > no bone (egg shells & kelp are used for similar nutritional needs), provided the best overall oral health.
Tartar was noticeably reduced, reversed in some cases based on examinations by same & different doctors, and gingivitis scores were lower. There was no change in ORL development and possibly slightly fewer gingivostomatitis complex cats (too little data for full assessment of the latter).
Note: the ground bone diets sometimes got stuck in between teeth … uncomfortable but correctable with a flick of the thumb. I prefer ground diets & chicken necks for most cats.
Would she see benefits in any of those?
See above.
From what age is the difference (if there is) noticeable?
Adult to senior cats (4 yrs and older).
Once cats have teeth issues and then start with raw meat (meat on bones/NRV/Barf or ground raw) is there a difference to be expected after a while?
I noticed a difference within 6 months for most, followed by a second group (usually senior cats) at 12-18 months. I did not check anyone prior to 6 months.
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