Feline Alveolar (Expansile) Osteitis

Malcolm Weir, DVM, MSc, MPH; Robin Downing, DVM, DAAPM, DACVSMR, CVPP, CRPP

What is alveolar osteitis?

Alveolar osteitis, also called expansile osteitis, is a relatively common condition in which the bone forming a cat’s tooth socket becomes inflamed and abnormal new bone forms. This creates a hard swelling that pushes outward toward the lip and also pushes the tooth out of the socket. It is associated with periodontal disease and most often develops around an upper or lower canine tooth, although other teeth can be affected.

How can alveolar osteitis affect a cat?

Alveolar osteitis is painful and can interfere with grooming and eating. If the affected tooth falls out rather than being extracted, an oronasal fistula can form (an opening between the mouth and nose). This opening allows bacteria from the mouth to enter the nasal cavity, resulting in inflammation, nasal discharge, and nasal or sinus infections.

How is alveolar osteitis treated?

If this disorder is detected early, it may be possible to treat it through periodontal therapy (dental cleaning and scaling), without extracting the tooth. A flap of gum may need to be lifted away from the abnormal bone to allow its removal. The gum is then replaced and sutured into place to promote healing. Unfortunately, many affected cats have advanced periodontal disease, and the teeth appear longer than normal because they have moved out of the tooth socket. In these cases, the affected teeth will be extracted.

What is the outlook for cats with alveolar osteitis?

Once the affected teeth are extracted and the gum tissue is repaired, cats generally do exceptionally well and enjoy a normal quality of life and life expectancy.

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