What are gingivitis and stomatitis?
Gingivitis is a medical term that refers to inflammation of the gingiva (gums). Gingivitis is the earliest and only reversible stage of periodontal disease (disease of the support structures surrounding the teeth).
Stomatitis refers to a more generalized inflammation of the mucous membranes within the mouth and may involve the gums, tongue, inner surfaces of the lips, and/or the floor and roof of the mouth. In some cases, it can even extend down the throat.
What causes gingivitis and stomatitis?
Gingivitis may be caused by a bacterial infection from plaque bacteria on the teeth and is usually associated with poor oral hygiene. When bacteria contact the gingiva, and possibly even enter the pocket between the gum and the tooth (known as the gingival sulcus), they may cause an inflammatory reaction. If gingivitis is left untreated, bacterial infection can progress to tooth supporting structures and eventually result in tooth loss (periodontal disease).
The cause of stomatitis is unknown. It may be caused by a hyperimmune response of the oral tissues to bacterial plaque (an overreaction by the immune system). Other immune system triggers and certain viral infections that affect the immune system, such as feline immunodeficiency virus and feline leukemia virus, may also play a role.
What are the clinical signs of gingivitis and stomatitis?
Gingivitis is inflammation (redness and swelling) along the gumline where the gum contacts the tooth. Typically, the cat will also have bad breath (halitosis). When the teeth are brushed, the inflamed gums will often bleed.
"Often it will be too painful for the cat to self-groom, causing the haircoat to appear unkempt."
Stomatitis is a more severe form of oral inflammation than gingivitis, involving more than just the gingiva. Stomatitis is often very painful, causing a decreased appetite or difficulty eating. Weight loss may occur. Often it will be too painful for the cat to self-groom, causing the haircoat to appear unkempt.
How are these conditions diagnosed?
Diagnosis is primarily based on medical history and clinical signs. Blood and urine tests are often recommended to look for any underlying systemic disease that could also result in inflamed gums or oral tissues. Dental X-rays are taken to determine if there is any damage to the tooth roots and other supporting structures.
How are gingivitis and stomatitis treated?
The first step is a complete oral health evaluation and removal of plaque and tartar under general anesthesia. The deposits of plaque and tartar are removed with ultrasonic scaling followed by polishing of the tooth surfaces. It is important to clean the tissues beneath the gumline carefully to remove any accumulated plaque or tartar. After the cleaning, the gingivitis can subside. Some cats need this done regularly to maintain their oral health.
The treatment of stomatitis involves treating the underlying cause of the problem, if one can be identified. Most often, no specific cause is determined. Affected cats will require frequent dental cleanings with extractions as well as home treatment, including tooth brushing and the use of chlorhexidine rinses or gels to manage the disease. Pain medications, broad-spectrum antibiotics, and/or anti-inflammatory medications may be prescribed. Extraction of some or all teeth is often recommended as this is proven to have the greatest effect on stomatitis; however, some (refractory) cases won’t fully resolve after extraction and still need medical management as described above.
What is the prognosis for gingivitis and stomatitis?
The prognosis for gingivitis is excellent, provided you follow your veterinarian's instructions. Your cat will benefit tremendously from a professional oral assessment and teeth cleaning under anesthesia, followed by a consistent homecare routine.
"Routine dental evaluation and treatment by your veterinarian will keep your cat’s mouth healthy and comfortable."
The prognosis for stomatitis varies depending on the individual cat and needs to be addressed on a case-by-case basis. If tooth removal is needed, cats still do very well. Routine dental evaluation and treatment by your veterinarian will keep your cat’s mouth healthy and comfortable.