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Feline Odontoclastic Resorptive lesions or FORL is becoming an important dental disease in
the cat, It is a one of the main reasons for tooth loss, gingivitis, and chronic oral pain in
the cat.
FORL causes excavation lesions in the roots and main body of the tooth resulting in complete
resolution of the root or fracture of the crown of the tooth.
FORL is graded in stages depending on the extent of the disease. In milder stages, only small
enamel and dentin defects are noted. But as the defect deepens and widens, pathologic fracture
of the tooth usually occurs.
Most veterinary dentists believe that even the smallest of FORL lesions result in pain. If we
think of ourselves with a large cavity or fractured tooth, we can understand the cat's
hesitation to drink cold water or eat harder foods. In fact, one of the earliest clinical
signs is the owners' realization that their cat will no longer eat dry, hard foods.
In our practice, we see many cases of lower urinary tract disease in the cat. Is it possible
that, in addition to feeding drier sources of foods, that the cat's mouth is sensitive to
cold so that it shies away from water? In many cats with lower urinary tract disease, we can
identify small to large defects in the neck of many teeth.
FORL, as a disease, is quite poorly understood. We did not see this disease thirty years ago.
Research into the disease shows that there is an attraction of bone-resorbing cells called
osteoclasts. Osteoclasts are responsible for bone remodeling and their benefit goes on
throughout one's lifetime. When osteoclasts are ordered to break done enamel and dentin in
the tooth, the destructive FORL lesion is produced. Some researchers are looking at the levels
of Vitamin D in our pet's food, reasoning that bone resorption could take place in the
presence of excessive Vitamin D. We have learned that the oxygen levels in the affected gum
tissue surrounding the FORL lesion is lowered, but what is causing lowered oxygen tension in
these areas of gingiva?
Ultimately, and unfortunately, the only real treatment for the significantly affected tooth
is to extract it. Even the smallest lesion generally progresses to tooth loss. Dental
radiography is an important imaging modality to fully appreciate the affects on the tooth
roots in affected cats.
Although we still highly recommend professional cleaning of the teeth, the process of simply
cleaning the teeth does not stop or alter the progression of FORL in the cat. We appear to
have a long way to go in stopping this feline ailment.
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