By Dr. Becker
Strange as it may seem, teeth grinding, also called bruxism, is a relatively common condition in cats. Common — but definitely not normal.
If you’ve ever heard or watched a kitty grind her teeth, you know instinctively something is wrong. The grinding can at times sound more like chattering or clicking. Sometimes the grinding is noticeable because the cat moves her jaw side to side, which is different from the up-and-down motion she uses to chew food.
In humans, teeth grinding is often a tic, bad habit or something that occurs unconsciously during sleep. However, in cats, it’s almost always a symptom of a more serious problem, and a sign your furry family member is in pain.
Reasons for Teeth Grinding in Cats
There are several reasons your cat might grind his teeth, but by far the most common cause is pain — sometimes excruciating pain — due to a problem such as abnormal alignment of the teeth, which can create temporal mandibular joint (TMJ) pain, a tooth fracture, inflammatory gum disease, mouth ulcers, tooth resorption, stomatitis, a disorder of the TMJ, or oral cancer.
• Abnormal tooth alignment, also called malocclusion, is seen most often in Persians and other brachycephalic breeds with flat faces, as well as some Siamese due to their long, pointy faces.
In addition, some cats tend to grow abnormally long fangs, a condition called extrusion, which can cause grinding. Abnormal dentition can result in a shift in how the jaw joint articulates, resulting in TMJ pain and grinding.
Like humans, cats can also develop a TMJ problem that can cause teeth grinding. The TMJ is the hinge (joint) in your cat’s jaw where the temporal and mandible bones meet. There are two joints, one on each side of the face, and they work in concert with each other.
Any problem with the TMJ makes opening and/or closing the mouth painful. It will also be difficult for your cat to move his mouth normally and chew.
• Tooth fractures in cats are usually the result of trauma. The tips of the upper canine teeth are most often fractured, which can happen if kitty bites down on something hard, or jumps from a high surface and hits his head as he lands.
• Inflammatory gum disease, also called gingivitis or periodontal disease, is epidemic in the U.S., affecting about 70 percent of cats over the age of 3, and increasing 20 percent each year of a pet's life.
Inflammatory gum disease affects some or all of a tooth's deep supporting structures. The condition usually starts with inflammation of a single tooth.
Left untreated, the disease progresses to an irreversible stage marked by significant amounts of calculus below the gum line, severe inflammation, gum recession, loose and missing teeth, pus and bleeding from the gums, and significant bone loss.
• Mouth ulcers are open sores typically found on a cat’s gums and/or tongue. They are a sign or symptom of an underlying condition, such as calicivirus, uremic poisoning (end stage kidney disease), pemphigus complex, feline herpes, systemic lupus erythematosus (SLE), ingestion of toxins, or an electrical or thermal burn.
• Tooth resorption is the most common feline oral disease, affecting between 30 and 40 percent of healthy adult cats, and from 60 to 80 percent of kitties who visit a veterinarian for treatment of dental disease. Persians and Siamese cats may be more prone to the condition than other breeds.
Tooth resorption is the gradual destruction of a tooth or teeth caused by cells called odontoclasts. The process usually starts on the outside of a tooth at the gum line, and is most common in premolars in the lower jaw, but can occur in any tooth.
• Feline stomatitis is a serious, chronic and very painful disease thought to be autoimmune in nature. In affected cats, the immune system seems to overreact to dental plaque around the teeth, triggering inflammation in the tissues of the mouth.
The problem also occurs on the back of the throat at the oral pharynx, and even underlying bone in the mouth can become inflamed or infected. Stomatitis inflammation appears externally in the mouth as angry, red, swollen tissue.
• There are several types of oral cancer that occur in cats, but squamous cell carcinoma is the most common. It is typically middle-aged and senior cats that develop oral cancer, but squamous cell tumors have been seen in young kitties as well.
Secondhand smoke has been linked to squamous cell carcinoma in cats. Kitties are particularly vulnerable to the carcinogens in tobacco smoke because daily grooming exposes delicate oral tissues to hazardous amounts of cancer-causing substances.
Cats living with more than one smoker and those exposed to environmental tobacco smoke for longer than five years have especially high rates of squamous cell tumors.
Other Conditions That Can Cause Teeth Grinding
A cat who is dehydrated will sometimes grind her teeth. Dehydration can increase stomach acid, resulting in acid reflux.
Like humans, a cat in this situation will often swallow repeatedly to clear the acid, and this can lead to tooth grinding or gnashing. Severe dehydration is a medical emergency in kitties, and points to an underlying disorder that needs to be identified and addressed.
Other painful diseases that can trigger teeth grinding in cats include inflammatory bowel disease (IBD), gastrointestinal (GI) ulcers, pancreatitis, kidney failure and cancer. Low potassium levels, brain tumors, neuropathy and behavioral disorders are other possible causes of feline teeth grinding.
Getting Help for a Tooth-Grinding Kitty
If you know or suspect your cat is grinding his teeth, it’s important to make an appointment with your veterinarian right away. Remember — these cats are almost always in significant pain. Also, the sooner you get a diagnosis, the sooner you and your veterinarian can start helping your pet feel better.
The majority of oral diseases that cause bruxism can be diagnosed during an examination of your pet’s mouth. Rarely, X-rays, an MRI or a CT scan may also be needed to identify the cause. To identify conditions occurring outside the mouth, blood tests or other diagnostics may be required.
Since tooth grinding means your cat is in pain, any treatment plan must involve effective pain management along with resolving the underlying cause.
If your cat is found to have no oral issues and bloodwork and urinalysis are normal, I recommend finding a qualified animal chiropractor to evaluate the functionality and health of your cat’s TMJ joints. Many cats I have seen for teeth grinding have jaw joint issues that improve with chiropractic care.
Tips for Keeping Your Cat’s Mouth Healthy
• Practice dental home care. Learn how to brush kitty’s teeth and do it consistently (daily if your pet is older or at least several times a week for younger pets). Watch my video on how to brush a cat's teeth for the first time.
• Feed a balanced, species-appropriate diet. As your pet chews the bones in a raw diet, they help to scrape away tartar and plaque on her teeth. The cartilage, ligaments and tendons in the raw meat act as a natural dental floss.
• Schedule regular oral exams with your veterinarian, and professional cleanings under anesthesia as required.