What You Can Do for a Cat with Misalignment of Teeth (Malocclusion)

By Malcolm Weir, DVM, MSc, MPH; Jan Bellows, DVM, Dipl. AVDC, ABVP

Cats can have malocclusion (misalignment of the teeth) much like people. Cats, like people, develop teeth after birth and misalignment may begin as the teeth come in or it may occur later in life, due to injury.

When a tooth is out of place but does not interfere with other teeth, rub against or penetrate the gum tissue, or affect how your cat eats, it is a functional bite. Repairing a functional bite for cosmetic purposes is not necessary and is considered unethical.

When a tooth is out of place and it interferes with other teeth, rubs against or penetrates the gum tissue, or affects your cat's ability to eat, it is a non-functional bite. In this case, action must be taken to create a functional bite. Three treatment options exist: extraction to provide space, crown reduction and restoration, and tooth movement.

When is extraction preferred?

Extraction of the offending teeth is usually the treatment of choice and usually results in immediate relief.

Extraction of the canine or fang teeth can be challenging, as the roots of these teeth are very long. In some cases, a referral to a veterinary dental specialist may be recommended. Your veterinarian can recommend a dental specialist in your area.

Why not just make space rather than extract?

Removal of the damaged gum tissue where the misaligned tooth contacts the gums can result in a pain-free functional bite. Unfortunately, the benefit can be short-lived if the gum tissue grows back.

This procedure involves laser ablation (removal) of the inflamed gum line affected by a malpositioned tooth, thereby creating a functional bite.

What is crown reduction and restoration?

Crown reduction is the process of reducing the length of a tooth (often the canine) to resolve the problem of tooth penetration into the opposing gum. This is an advanced dental procedure, preserving the vitality of the tooth through either vital pulp therapy or root canal therapy.

Vital pulp therapy involves the removal of a layer of pulp in the tooth and placing a medicated dressing over the newly exposed pulp to allow healing. Root canal therapy involves the removal of pulp in a tooth, cleaning and sterilizing the pulp canal, and finally filling the canal with material to prevent infection.

Restoration is a process that follows crown reduction, in which a barrier of light-cured dental composite is placed over the area. A metallic crown can be placed for added protection.

What’s involved with tooth movement?

Moving poorly positioned teeth to functional positions can be challenging. Teeth are moved either surgically or through the use of inclined planes (appliances that are adhered to the teeth), orthodontic buttons (or brackets, like those used in people), and elastics.

Orthodontic movement is an advanced dental procedure that should only be performed by someone with an advanced understanding of dental anatomy, physiology, and orthodontic principles. See the handout “Orthodontics (Moving Teeth) in Cats” for more information. Your veterinarian can help you find a board-certified veterinary dentist in your area, or you can go to www.avdc.org.

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