Feline Alveolar (Expansile) Osteitis

By 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 that results from chronic periodontal disease in cats. It can occur around the upper or lower canine teeth. The gum tissue adjacent to the tooth becomes red and swollen. The bone of the tooth socket also becomes inflamed, and abnormal new bone is formed, causing a hard swelling that can be seen pushing outwards toward the lip. The new bone pushes the tooth out of the socket.

How can alveolar osteitis affect a cat?

Alveolar osteitis is painful and can interfere with grooming and eating. If the affected tooth is lost and not extracted, an oronasal fistula can form (an opening between the mouth and nose). This communication between the bacteria-laden oral cavity and the nasal cavity results 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 the disease without tooth extraction by performing thorough periodontal therapy (dental cleaning and scaling). 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 hasten healing.

"If this disorder is detected early, it may be possible to treat the disease without tooth extraction by performing thorough periodontal therapy."

Unfortunately, many affected cats have advanced periodontal disease, and the teeth appear longer than normal due to their migration out of the tooth socket. In these cases, the tooth will be extracted.

What is the outlook for cats with alveolar osteitis?

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

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