FORL stands for feline odontoclastic resorptive lesions and is a very painful dental disease in cats. Almost every second cat is affected from the age of five. Even for veterinarians, FORL can only be detected with the naked eye in its final stages. X-rays of the teeth provide clarity.
FORL is also known as resorptive lesions (RL) or tooth resorption (TR). It is not the same as tooth decay, which does not occur in cats. In FORL, the body's own cells break down the dentin (the hard substance of the tooth), destroying the teeth. These so-called odontoclasts are responsible for breaking down the roots of milk teeth in young cats, thereby enabling tooth replacement. For reasons that are still unclear, the odontoclasts are reactivated in adult cats with FORL. The immune system is thought to play a role in this process. The process usually begins at the roots of the teeth, less commonly at the necks of the teeth. Deep holes develop. Only in the final stage is the crown of the tooth affected. At this point, the changes are visible to the naked eye as small holes or reddened, inflamed gums. However, the affected cat has been suffering from severe toothache for a long time, as the nerves in the tooth remain intact.
FORL is divided into three types:
The exact cause is still unknown. Since the body's own cells attack the teeth, FORL is classified as an autoimmune disease. There are indications that reduced calcium intake through food may be a contributing factor. The risk of developing FORL increases with age. Almost half of all cats are affected by the age of five.
FORL can only be detected with the naked eye in its final stages. At this point, you will see holes in the tooth crowns and broken teeth at the neck of the tooth. FORL types 1 and 3 are also accompanied by gum inflammation and growths.
FORL is usually overlooked in its early stages. Cats are masters at hiding pain. They suffer unnoticed and continue to eat normally in some cases. However, if you notice any changes in their eating habits, you should take this seriously. Pain can also manifest itself in an increased need for rest, urine marking, or behavioral changes.
The most common symptoms of FORL are:
If you suspect your cat has FORL, take it to your vet immediately. After a general examination, the mouth will be examined thoroughly. The teeth and gums will be probed with a probe to find painful areas, holes, dissolved tooth roots, or loose teeth. Depending on how cooperative your cat is, these examinations can be carried out with or without sedation or anesthesia.
X-rays provide a clear diagnosis. Only these images allow the part of the teeth that lies under the gums to be assessed. Several images are taken under anesthesia for this purpose.
Further decay of the tooth substance cannot be prevented or repaired. Therefore, all teeth affected by FORL must be completely removed. This is done under general anesthesia, ideally immediately after the X-ray diagnosis. Follow-up X-rays ensure that no tooth remnants remain in the jaw. These would otherwise lead to inflammation. The resulting gaps in the teeth are then covered with gum tissue and sutured. The sutures are self-dissolving and do not need to be removed. Your cat will be given painkillers and antibiotics while the wound is healing. They will be able to eat again just one day after the operation, starting with wet food. However, some cats enjoy eating their dry food again after a short time. Even without teeth, cats can chew this with their jaws.
FORL is incurable and will continue to progress. However, if you have affected teeth removed at an early stage, your cat's life expectancy will be just as high as that of healthy cats.
FORL cannot be predicted or prevented. On average, every second cat is affected during its lifetime. Therefore, take your cat for regular health checks at the vet. Dental X-rays should also be taken, especially from the age of five. This allows FORL to be detected as early as possible. If you have your cat's teeth cleaned at the vet's, the tooth necks can also be assessed and X-rays taken while your cat is under anesthesia.
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