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Good oral care is essential to a cat's overall health. Without it, bacteria multiplies in a cat's mouth to form tooth plaque. Over time, plaque triggers gingivitis and eventually periodontal disease, a painful condition that can have serious impacts on a cat's behavior.

The best defense against dental problems is preventing them from starting in the first place with daily at home oral care. For this guide to the best dental products for cats, we consulted three veterinarians, one of them a board certified veterinary dentist, and tested 19 toothpastes, toothbrushes, water additives, and dental treats. We also looked to the Veterinary Oral Health Council (VOHC), an organization that governs and certifies pet dental products, and the dental care guidelines established by the American Animal Hospital Association (AAHA). You can read more about our methodology at the end of this guide.

Pros: VOHC-accepted, can be used on a toothbrush or spread by finger, contains minerals to boost tooth enamel, human-grade, free of BPAs and parabens

Cons: A little messier than some other toothpastes

Daily use of a feline toothpaste or gel is a cat's best defense against periodontal disease. Even when just smeared on a pet's teeth and gums with the finger, a veterinary-approved toothpaste can be beneficial. "It works not as well as teeth brushing, but it works better than not doing it at all," said veterinarian Andrea Moore, medical director at VCA Pinnacle Animal Hospital in San Jose, California.

Petsmile Professional Toothpaste is one of only two that are VOHC-accepted for the prevention of plaque. Its active ingredient, a proprietary formula called Calprox, has been proven to inhibit the buildup of plaque and tartar and gently dissolves the bacteria-rich biofilm that naturally forms on the surface of the teeth.

Petsmile Toothpaste is hypoallergenic and contains calcium, magnesium , and phosphates, minerals that help to boost the strength of tooth enamel. It also contains potassium hydroxide, which neutralizes acidity to prevent tooth decay, and germ-fighting cetylpyridinium chloride. The formula is human-grade and free of BPAs, silica, sulfates, and parabens.

Petsmile Toothpaste is sold in two flavors: London broil and rotisserie chicken. My cats clearly preferred the London broil flavor — they opted not to taste the chicken flavor.

Petsmile was a little more watery and messy than some of the other brands we tested, but it held tight to both a finger and toothbrush. It was also one of the two most expensive toothpastes we considered, but because it's one of only two confirmed by VOHC to be efficacious, it's worth the extra cost. The 4.5 ounce tube holds a six-month supply.

Pros: Easy to maneuver while brushing, small, angled head and soft bristles for reaching back teeth

One of the challenges with brushing a cat's teeth is the size of their mouth. "Their lips are really tight, so it's hard to get a regular toothbrush that's square or rectangular back into their mouth," said Moore. Finger toothbrushes (a plastic cap with a ridged "brush" that slips over the finger) are also hard to use with cats.

Instead, the best toothbrush for a cat is small with a rounded head and bristles, according to Moore. She recommends the Virbac C.E.T. Toothbrush. "It's angled so you can get to the back part of the cat's mouth," she explained. 

Out of the three toothbrushes I tested, I found that the Virbac C.E.T. was indeed the easiest toothbrush to use on my cats' teeth. While the Virbac brush had roughly the same size head as the others (approximately 0.5 inches by 0.25 inches), at 6.25 inches in length, it was the shortest of those I considered. That shorter handle made the toothbrush easier and less awkward to maneuver, while still keeping my fingers safely away from my cats' teeth.

The dainty Virbac C.E.T. Toothbrush is made with soft nylon bristles and comes in assorted colors, though you can't select your color preference when purchasing.

Pros: VOHC-accepted; shown to reduce plaque by more than 85% in clinical trials; contains ingredients with antimicrobial, antioxidant, and anti-bacterial properties and omega 3-rich salmon oil

Cons: Some cats may avoid drinking the additive due to taste

Although daily brushing works best to promote a healthy feline mouth, some cats will never be fully comfortable with it. For these finicky felines, water additives combined with a targeted diet that reduces plaque and tartar is second best, according to board certified veterinary behaviorist Wailani Sung at the San Francisco SPCA in California.

Pet::Essential Healthymouth Water Additive is the only VOHC-accepted option for cats. The formula includes papain, which is an enzyme extracted from papaya fruit; antioxidant and anti-microbial cinnamon; cleansing chlorophyll, and antibacterial pomegranate. Two clinical trials conducted in 2010 indicated that this dental additive reduced plaque by more than 85% when mixed with fresh water daily.

Pet::Essential Healthymouth Water Additive comes in more than two dozen flavors. My cats taste-tested the tuna, chicken, and salmon varieties. One had a clear preference for the salmon. The other cat wouldn't drink from any of the bowls containing the additives, even mixed at a lower concentration than the recommended one teaspoon per liter. Avoidance due to taste is the biggest potential problem with this water additive because it can put a cat at risk of dehydration. When adding a water additive to your cat's routine, monitor them closely to ensure that they're drinking enough throughout the day.

This product is the most expensive of the water additives we considered, but the compact jug packs a lot of punch and will last three to four months. The larger 16-ounce jug contains twice the volume for just $16 more.

Pros: VOHC-accepted to reduce tartar, available in four flavors and sizes

Cons: Must feed 16 treats daily to be effective for a 10-pound cat

Dental treats have an important place in the promotion of good cat dental health. Like any treat, they're designed to taste great, and with cats, that's half the battle.

There are a number of brands that sell dental treats, but the only way to ensure the one you're purchasing is effective is if it is VOHC-accepted. "Anything with a VOHC seal is going to have teeth behind it, with that treat shown scientifically to reduce plaque, tartar, or both," said veterinarian Christopher Snyder, clinical associate professor of AVDC oral and maxillofacial surgery at University of Wisconsin-Madison School of Veterinary Medicine. With that in mind, we selected Feline Greenies Dental Treats, one of the first feline products to earn a VOHC seal, as the best dental treat for cats.

Feline Greenies have been shown to reduce tartar. They contain vitamins and minerals like calcium carbonate and zinc oxide and have a crunchy texture that helps scrub teeth and gums as a cat eats. Greenies can be given to cats who are 1 year or older. For greatest efficacy, the company recommends feeding a 10-pound cat eight treats twice a day. Although each treat is only 2 calories, they add up to around 15% of the calories a 10-pound cat requires in a day. To prevent them from gaining weight, you'll have to reduce the amount of cat food you feed them daily.

Feline Greenies are sold in four flavors — chicken, salmon, tuna, and catnip — and my cats love them all. They're also available in four package sizes: 2.1-ounce bag, 4.6-ounce bag, 9.75-ounce tub, or 21-ounce tub.

Feline Greenies Dental Treats, available at Chewy and Petco, starting at $2.34

Pet::Essential Healthymouth Cat Topical Gel: Healthymouth's topical gel is the only cat toothpaste with a VOHC seal besides our top pick. The brand recommends applying the gel with the included cotton-tipped applicators instead of a toothbrush, but I struggled to get the goopy formula out of the jar and onto the swabs. My cats were wholly unimpressed by the smell of the gel and refused to taste it. It's also notable that this is the most expensive toothpaste we tested, almost three times the price of our top choice, Petsmile.

Vetoquinol Care Enzadent Enzymatic Toothpaste: Of all the toothpastes we tested, my cats liked the taste of this poultry-flavored formula most. I liked that it was stickier and a little less runny than some other formulas — plus the price is nice. But while Vetoquinol contains bacteria-fighting enzymes and has been audited by the National Animal Supplement Council, it has not undergone the voluntary VOHC seal of acceptance review process to confirm its efficacy at preventing plaque buildup.

Zymox Oratene Brushless Enzymatic Oral Care Dental Gel: My cats liked the flavor of this dental gel and its enzymes should help prevent the buildup of bacteria and remove plaque. The manufacturer also advertises that their formula is extra-gentle, protecting mouth tissue against dryness — though I was unable to confirm this in my own testing. The product, however, has not undergone the process to earn a VOHC seal.

Virbac C.E.T. Enzymatic Toothpaste: The poultry-flavored Virbac C.E.T. toothpaste was a hit with my cats and the price is right. However, as Snyder told us, without a VOHC seal, there's no way to know for sure.

Oxyfresh Pet Toothpaste: I love that this toothpaste is cruelty-free, but with no scent or flavor, my cats showed zero interest in it. It is also not VOHC-accepted.

Sentry Petrodex Veterinary Strength Malt Toothpaste Dental Care Kit: Although the consistency of this toothpaste was just right for brushing, its ingredient list does not include any of the enzymes found in many of the other formulas we tested and it has not undergone the process for VOHC acceptance. The flavor was also a miss for my cats, who refused to taste it. I did like the toothbrush sold with this kit, which appears to be identical to our top pick, Virbac's C.E.T. Toothbrush.

Petsmile Professional Pet Toothbrush: The angle of this dual-sided toothbrush was helpful in brushing hard-to-reach back teeth and I like the grippy material on the handle. However, at 8.5 inches in length, the Petsmile toothbrush was awkward to hold and hard to maneuver. It also costs nearly three times that of the other toothbrushes we tested.

Vetoquinol Enzadent Dual-Ended Toothbrush: Like the Petsmile toothbrush, the Vetoquinol Enzadent is dual-ended and long, approximately 8.5 inches. Unlike the Petsmile, it is not angled to more easily reach the back teeth, making it just as awkward to use and less effective overall.

Zymox Oratene Water Additive: This enzymatic water additive is tasteless and odorless and my cats drank it readily. However, as Snyder told us, looking at ingredients alone doesn't necessarily indicate that the formula is effective at promoting dental health. The thing that best confirms that is a VOHC seal, which Zymox Oratene doesn't have.

Oxyfresh Water Additive: My cats drank up this cruelty-free, tasteless, odorless concentrate without noticing anything amiss in their water bowl. During the weeks that I added Oxyfresh to the water, I swear my cats' breath did seem to smell marginally better. However, Oxyfresh does not contain enzymes. Its primary ingredient, which the brand calls "oxygene," is made from sodium chlorite, a chemical water disinfectant, which the FDA approved in 2004 as a nontoxic antimicrobial agent for drinking water. 

Zesty Paws Breath Freshening Water (out of stock online): This water additive contains digestion-supporting ingredients like aloe vera, bromelain, and papain, but my cats were turned off by its strong spearmint scent and flavor. 

Royal Canin Veterinary Diet Dental Dry Food: Moore sometimes recommends feeding VOHC-accepted dental kibble like Royal Canin's as supplemental dental treats, but there is no good resource to inform pet parents how many pieces they require to reap the benefits. So while my cats liked the taste of this kibble and ate it as quickly as the other dental treats, that uncertainty combined with a high price tag were a large part of what kept this product and Hill's Prescription Diet t/d out of the top spot. A second issue with this kibble popped up after my senior cat had a few teeth removed. While he was able to eat the large, round kibble without trouble with a full set of teeth, post dental surgery he regularly got the kibble stuck between his lip and gums and struggled to get it out.

Hill's Prescription Diet t/d Dental Care Food: Like Royal Canin's dental diet, my cats liked the taste of this VOHC-accepted kibble. But also like Royal Canin's dental diet, it is pricey, there is no good resource that confirms how many should be fed daily, and the large, hard pieces were challenging for my cat to eat after having a few teeth removed.

Purina DentaLife Daily Oral Care Cat Treats: My cats liked the taste of the chicken-flavored DentaLife treats and the ingredient list is remarkably similar to that of Feline Greenies. Like Greenies, DentaLife treats are VOHC-accepted to remove tartar and are sold at a similar price point, but they only come in only two flavors and three package sizes. The large, round shape of the treats may make it difficult for cats missing a few teeth to eat.

Virbac Intellident: My cats liked Virbac's Intellident and I was pleased to find that only three treats are recommended daily, compared to the 16 recommended by Greenies. But while Virbac has conducted an in house study of its product's efficacy, it has not been VOHC-accepted.

It's worth noting that neither of the vets I spoke to for this guide recommended dental toys for cats and the VOHC does not include the category in their accepted dental products. Cats typically don't chew on their toys and generally use only their canine teeth when hunting and playing. It's unlikely these toys would impact common problem areas in the back of a cat's mouth. For these reasons, we have not included this category.

Instead of allowing observations about my cat's teeth to dictate the selections, I looked at the factors I could evaluate: whether my cats appeared to enjoy or at least tolerate the product, how easy the product was to use, and the product's ingredients and their known efficacy. Most importantly, I looked to see if the product had a VOHC seal of acceptance confirming its efficacy at controlling plaque and tartar.

I conducted the following tests on each of the 19 products included in this guide. Manufacturers provided Insider Reviews with editorial samples, with the exception of Virbac C.E.T. Toothpaste, Sentry Petrodex Dental Care Kit, Hill's Prescription Diet t/d, and Feline Greenies.

Cat-approval test: My two cats taste-tested all of the toothpastes, water additives, and dental treats. In a first trial, the cats were presented with each product individually. Those they willingly tasted or ate were then presented simultaneously to see which toothpaste, water additive, or treat drew their interest first. For this update, I presented the new products alongside our original top picks.

Ease of use test: I used each product as directed by the manufacturer to determine whether any were more challenging to use than their competitors. With toothpastes and gels, I looked at water content, stickiness, and adherence to finger or toothbrush. With toothbrushes, I considered how easy it was to maneuver in the mouth while brushing my cat's teeth. With dental treats, I considered the number of treats recommended and whether my cats had any trouble eating them due to size, shape, or texture. This test did not apply to water additives, each of simply needs to be diluted with fresh water.

Ingredients and known efficacy: I analyzed the ingredients list of each of the cat dental products and noted those typically considered beneficial for dental care. I also kept an eye out for ingredients that may be considered harmful to cats. However, I did not make any decisions based on ingredient lists alone, something Snyder recommends against.

VOHC seal of acceptance: Snyder explained the challenges of identifying a good cat dental product based on ingredients and marketing claims alone, so in this update, products with a VOHC seal of acceptance scored higher. The Veterinary Oral Health Council (VOHC) is a division of the American Veterinary Dental College that conducts third-party assessments of pet dental products. Products that earn the VOHC's seal of acceptance meet current criteria for effectively controlling plaque and tartar.

Just because a cat dental product has not been VOHC-accepted doesn't necessarily mean it is not an efficacious product. Getting a VOHC seal of acceptance is voluntary and, according to Snyder, not every company can afford to conduct the studies the VOHC requires. Nevertheless, it is currently the best tool consumers have for identifying whether a toothpaste, water additive, or dental treat has been scientifically proven to perform as advertised.

Here are the most common dental products for cats and how they work:

Toothpaste or gel: Toothpaste or gel is the most important product in the feline oral health arsenal. When applied daily by toothbrush or spread on the teeth and gums by finger, toothpastes and gels can help prevent the buildup of biofilm and plaque that leads to periodontal disease.

Water additive: Water additives are highly concentrated solutions that contain plaque-fighting ingredients. When diluted with water, these formulas help minimize bacteria every time your cat takes a drink. Some can also be used as a food topper. Water additives are a good option for cats who resist toothbrushing.

Dental sprays and rinses: While there is one VOHC-accepted dental spray for cats, we have not included sprays or rinses in this guide based on Moore's observation that they can be a real challenge to use with cats.

Dental wipes: Moore believes a high-quality dental wipe could be effective at promoting good feline oral health. There is one product that is VOHC-accepted, Pet::Essential Healthymouth's Anti-Plaque Daily Topical Wipes, though it is not currently available for purchase. Because the other cat-safe dental wipes on the market are not enzymatic like the toothpastes and gels we tested, we did not include this category.

Dental toys: None of our experts recommended dental toys for use with cats and the VOHC does not include the category in their accepted dental products. Because cats typically don't chew on their toys and generally use only their canine teeth when hunting and playing, it's unlikely these toys would impact common problem areas in the back of a cat's mouth. For these reasons, we have not included this category.

Dental treats: Delicious dental treats are a useful tool for maintaining a cat's oral health, according to Snyder and Moore. For dental treats to have an impact, they must be fed daily in the amount recommended by the manufacturer. They are also more effective when used in combination with daily toothbrushing and/or a daily dental water additive.

Dental diet: Pet food brands like Hill's Science Diet and Royal Canin sell veterinary-formulated cat kibble that target oral bacteria and clean the surface of a cat's teeth while they eat. Because these diets must be prescribed by a veterinarian, we have not included this category.

With the help of the veterinary experts we consulted for this guide, we provide answers to some of the most frequently asked questions about cat dental health below.

Moore recommends brushing your cat's teeth daily and, if possible, introducing them to the practice while they are still young. "It's important to start as a kitten because kittens are more accepting," she explained. Moore recommends using an enzymatic toothpaste. If your cat won't tolerate a toothbrush, try smearing the paste or gel on their teeth and gum line with your finger.

According to Snyder, the typical cat should have their first professional cleaning at 1 to 2 years of age. "It should ideally be a quick procedure," he said. "We're just getting in there, cleaning things up and looking for early warning signs." After the first cleaning, they should return to the vet annually for the procedure.

Snyder told us that anesthesia-free dental cleaning has not been shown to be as effective or safe as anesthetized veterinary dental cleaning. There are several major problems with the practice. Anesthesia-free cleanings are not typically performed by veterinary professionals and target only the exposed crown of the tooth, not the section beneath the gum line where problems usually develop. Because a cat remains awake during the procedure, x-rays cannot be taken and an anesthetized cat runs the risk of choking on loosened plaque or calculus. , There is also a risk of accidentally cutting the gums with the sharp instruments that are used, Snyder also told us that cats who have distressing anesthesia-free cleanings may be less likely to tolerate toothbrushing in the future.

Cats don't develop cavities, but they can develop holes at or below the gumline associated with resorptive lesions, a painful condition that erodes the tooth. Some types of tooth resorption have been linked to periodontal disease, but Snyder explained that vets don't have a good understanding of how the condition is triggered and why some cats suffer from it more than others. For more on tooth resorption in cats, read the next slide on common dental problems.

There is no consensus among veterinarians about whether a diet made up primarily of wet food has a more negative impact on a cat's dental health than a dry food diet. While cats who chew their kibble may successfully break up some plaque, many cats actually swallow their kibble whole the same way they do wet food. "If you ask 10 veterinary dentists [which diet is better], you'll get four different answers," Snyder said.

 "It's important to remember that cats, especially, are really good at masking their discomfort and sometimes it can be difficult to cue up on changes," explained Snyder. A cat who is experiencing tooth pain may avoid eating or drinking. Snyder advises pet owners to observe whether their cat is choosing wet over dry food or eating more slowly than usual. "Sometimes they'll cock their head to one side so food is preferentially chewed on one side," he said.

Sung noted that a cat's behavior may also change if their teeth are bothering them. A cat who is suddenly more irritable, hiding more frequently, or less affectionate then usual may be experiencing dental pain.

Although there are relatively few common dental problems that affect cats, those that do can be extremely painful, especially if left untreated.

Periodontal disease: Periodontal disease starts with gum inflammation, also known as gingivitis. Gingivitis occurs when plaque, a biofilm containing thousands of bacteria, builds up on the surface of the teeth. When plaque is not regularly broken down with at home dental care, a cat's immune system will mount a defense against the bacteria, causing the gums to become red, swollen, and painful. Over time, plaque mineralizes to form tartar or calculus which, in turn, attracts more plaque. Eventually, the gingivitis progresses to periodontitis, an irreversible condition that weakens the tissue attaching the teeth to the gums and causes teeth to loosen or to fall out.

Stomatitis: "Stomatitis is somewhat poorly understood, but it's more of a global inflammation that extends to different areas of the mouth," explained Snyder. Mucous membranes, the back of the mouth, the lips, and the tongue can all be affected by stomatitis. The pain caused by the condition may cause a cat to eat or groom less often.

Tooth resorption: In tooth resorption, dentin, which is the hard tissue beneath the tooth enamel, begins to erode. Over time, the lesion that forms in the dentin can spread to other parts of the tooth, causing it to be painfully destroyed. Veterinary dentists aren't entirely sure what causes feline tooth resorption, but they do know it's been going on for thousands of years. There's even evidence of the condition in mummified cats uncovered in ancient Egypt, according to Snyder. Cats experiencing tooth resorption require either full extraction of the tooth or amputation of the tooth's visible crown.

Broken teeth: When a cat falls or hits its head, a tooth fracture can occur, particularly in the long canine teeth. Breaking can expose the dentin beneath the enamel which is highly sensitive to heat, cold, and pressure. It can also expose the tooth's pulp, the connective tissue at its center. When this occurs, the tooth fills with bacteria, leading to an infection that causes pain in the mouth and other parts of the body.

Introducing a cat to toothbrushing takes time and patience, particularly if the cat is an adult versus a more malleable and tolerant kitten. 

Begin by placing "a small amount of either the flavored toothpaste or canned food onto a small pet toothbrush [and] allow the cat to sniff and lick the food off of it," said Sung. Some cats may prefer that you use your finger to start, instead of a brush. Pick a time of day when your cat is relaxed and position them so that their back is to you. Your cat will feel more comfortable if they are not restrained.

After a few days, begin to introduce lifting your cat's lips to better expose their teeth. Gently push back their top lip with your fingers, then release and reward them with a treat. Repeat this until your cat is comfortable with you opening their mouth.

Next, return to the toothpaste and toothbrush (or your finger). Squeeze out some paste, open your cat's mouth, and attempt to move your finger or brush a tiny bit along the front teeth and gums between licks. If your cat attempts to escape, you've likely pushed them too far too fast. If your cat accepts the touch of the brush or your finger, Sung said that in subsequent sessions you can gradually try to move further along toward the cheek teeth where most of the dental plaque and tartar builds up.

Keep your dental sessions to a quick 10 seconds to start, slowly building up their length over time until you are able to brush or smear all of the teeth with toothpaste.

Andrea Moore, DVM, medical director, VCA Pinnacle Animal Hospital, San Jose, California

Moore earned a bachelor's in animal science from California State University at Fresno and a veterinary degree from University of California at Davis School of Veterinary Medicine. As medical director of Pinnacle Animal Hospital, Moore specializes in soft tissue surgery and internal medicine and serves as a mentor for new veterinarians, technicians, and interns. We interviewed Moore via phone on March 23, 2020. Pinnacle Animal Hospital was not owned by VCA Inc., a division of Mars Petcare, at the time of our interview.

Christopher Snyder, DVM, clinical associate professor and founding fellow, AVDC oral and maxillofacial surgery, University of Wisconsin-Madison School of Veterinary Medicine, Madison, Wisconsin

Snyder earned a veterinary degree at The Ohio State University College of Veterinary Medicine in 2004, then completed a residency in veterinary dentistry and oral surgery at the University of Wisconsin-Madison School of Veterinary Medicine. He became a diplomate of the American Veterinary Dental College in 2009. Snyder's clinical interests include maxillofacial trauma, reconstruction, and surgery. We interviewed Snyder via phone on January 28, 2021.

Wailani Sung, director of behavior and welfare programs, San Francisco SPCA, San Francisco, California

Wailani Sung completed a master's degree and doctorate in psychology with a special interest in animal behavior from the University of Georgia. She then went on to earn a doctorate in veterinary medicine from the University of Georgia College of Veterinary Medicine. One of less than 100 board-certified veterinary behaviorists in the United States, Sung works with pets with behavioral challenges through the San Francisco SPCA's Behavior Specialty Service and writes about animal behavior for Vetstreet, PetMD, and Healthy Pet magazine. We interviewed Sung via email on March 30, 2020.

We consulted the following online sources in March 2021:

American Animal Hospital Association, 2019 AAHA Dental Care Guidelines for Cats and Dogs

Bellows, Jan. "Fractured Teeth in Cats," VCA

Bellows, Jan. "The Ultimate Guide to Veterinary Dental Home Care," DVM 360

Healthymouth. Feline Anti-Plaque Water Additive Clinical Trial Background

Hiscox, Lorraine and Bellows, Jan. "Dental Disease in Cats," VCA

Hiscox, Lorraine and Bellows, Jan. "Gingivitis and Stomatitis in Cats," VCA

Hiscox, Lorraine and Bellows, Jan. "Tooth Resorption in Cats," VCA

Jarvis B., et al. "Effectiveness of Palatable Dental Bites Developed for Cats to Prevent Plaque and Calculus Accumulation," EC Dental Science, 19.8 (2020): 204-210.

Veterinary Oral Health Council, VOHC-accepted Products for Cats

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