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I am a big fan of dental hygiene for cats. Having had dental issues myself, I can assure you that it is no fun to have gingivitis and/or periodontal disease. And since cats are by nature stoic, they will not show any signs of pain until their teeth are severely infected and at that point they may end up losing the teeth.
Ideally, you would want to brush their teeth daily, but in the real world that's not going to happen. If you can do it once or twice a week, that will still do some good. Get a toothbrush/paste kit from your vet or at the pet store, or use a child's soft toothbrush. Let the cat sniff it and play with it for a while, then see if you can slip it into the cat's mouth. Go slowly - it may take several sessions with the brush before kitty is used to it. Then put a tiny dab of paste on the brush (be sure to use kitty toothpaste which is fish or chicken flavored and made to be swallowed without rinsing) and brush gently. Concentrate on the back teeth (the premolars and molars) as that is where most of the disease occurs.
If you can't do that (I can't get my own cats to hold still for that), ask your vet if he/she has any sort of dental gel. This is a product that is squirted in the mouth once a day (easier than brushing) and helps prevent the adherence of plaque to the teeth.
What I use on my own cats' teeth is an oral sealant. This is a product that has to be applied to clean teeth and produces a barrier to prevent plaque formation and bacterial growth. It comes in a little pot like lip gloss and is applied with your finger to the outer surfaces of the teeth. It is then spread via the cat's saliva.
Having said that, I must get on my soapbox about dental cleaning under anesthesia. All my clients are concerned about the risk of anesthetic. Remember that in most cases, your cat is more at risk from the dental disease itself than from the anesthesia. We did a full dental prophylaxis recently (including several extractions of rotten teeth and roots) on a frail 19-year-old cat who wasn't eating due to his oral pain. We called the owner a couple of days later and she was thrilled to report that on the very night of the dental cleaning he went straight to his food dish and chowed down as if he hadn't eaten in days (which indeed he hadn't). He is happy as can be and is gaining weight. I hear stories like that every day.
Any cat that will be having an anesthetic procedure in our hospital gets a full blood panel first to check kidneys, liver, blood count, and electrolytes to make sure it can handle the anesthetic. We use gas anesthesia, which is very safe as it is not accumulated in any amount in the internal organs and is quick to be expelled from the lungs. (Also, having an endotracheal tube in place prevents dislodged dental tartar from being thrown into the trachea.) All patients have an intravenous catheter in place to provide fluids (keeping blood pressure at acceptable levels and allowing us to administer any drugs that may be necessary). Anesthesia is monitored constantly by a doctor or a qualified technician throughout the procedure (in addition to visual inspection of the cat, we use a respiratory monitor and a pulse oximeter, which measures the amount of oxygen in the blood). The procedure involves ultrasonic scaling, polishing, fluoride treatment, and application of sealant. All teeth are probed for the presence of cavities and pockets of infection, and are extracted if necessary. We watch the cat closely until it is fully awake; then kitty is sent home with antibiotics and medication for pain. (We also demonstrate home dental hygiene and give the option of taking home toothbrush/paste, gel, or sealant.)
We have not had any problems so far with this protocol - I think that most veterinary hospitals that do a lot of dentistry use more or less the same procedure we do. While I agree that one should be very respectful of anesthesia, modern techniques are far safer than they used to be, and so the worry factor is much less these days. If your vet is familiar with your cat's medical history and follows the above precautions, I would not hesitate to follow his/her recommendation for a dental cleaning.
Sorry so wordy - I am quite passionate about dental health in cats (and dogs)! Hope this helps.
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