What is a FORL?

What is a FORL?

Well, you guessed it, it has something to do with your cat's teeth.  

Feline Odontoclastic Resorptive Lesions (FORL)

What are Feline Odontoclastic Resorptive Lesions?

Dental health is a very important aspect of general health in both our canine and feline patients.  Cats are particularly susceptible to painful dental disease known as a “feline odontoclastic resorptive lesion” (FORL), previously known as caries, cervical neck lesions, or root resorptions.  This condition is an inflammatory disease whereby the tooth resorbs and eventually breaks.  Studies have shown that more than half of all cats over the age of three will have at least one tooth affected by resorption.

The cause of FORL’s is not completely understood, but the involvement of odontoclasts, cells normally responsible for absorbing deciduous (baby) teeth, is seen at a microscopic level.  It is likely that these cells are triggered by an autoimmune response, meaning the tooth is most likely being destroyed by the cat’s own immune system.

FORL’s can be very painful as the protective outer layer of the tooth, the enamel, is worn away, exposing the sensitive dentin and pulp.

How do I know if my cat has a resorptive lesion?

During your cat’s physical exam, the doctor will closely examine the mouth, looking for obvious signs of resorption, often found along the edge of the tooth at the gumline, as well as evidence of pain or sensitivity.  Pain may manifest as jaw trembling, drooling, bleeding, or a decreased appetite. Cats, however, do not often show outward signs of oral pain.  A complete examination and oral evaluation require anesthesia, assessing the mouth with a probe similarly to a human dentist, cleaning both above and below the gumline, and radiographs (x-rays) of the entire mouth. According to the American Veterinary Dental College, intraoral radiographs are the required to properly evaluate this condition.

How do you treat my cat’s resorptive lesion?

All of the information above combined allows for development of an accurate, complete treatment plan.  Because teeth suffering from resorptive lesions are being destroyed by the cat’s own immune system, continued breakdown is inevitable and the only treatment available is extraction of the affected tooth. 

During extractions, our standard of care involves a multimodal approach to pain management including nerve blocks during the procedure, pain medication before and after the procedure, and pain medication to go home.  Further, teeth are extracted surgically, a post extraction x-ray is taken to ensure the complete removal of the tooth, and the gums are closed with absorbable suture material.

Written by:  Stephanie Kotas, DVM