Gingivitis and Stomatitis in Dogs

By Courtney Barnes, BSc, DVM; Lorraine Hiscox DVM FAVD Dip. AVDC; Jan Bellows, DVM, Dipl. AVDC, ABVP

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.

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 enter the pocket between the gum and 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, but it may be caused by a hyperimmune response of the gum tissues to bacterial biofilm (an overreaction by the immune system).

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 dog 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 dog to self-groom, causing the haircoat to appear unkempt."

Stomatitis is a more severe form of oral inflammation than gingivitis and usually involves more tissues than just the gingiva, including the tongue, lips, and other soft tissues inside the mouth. Stomatitis is often very painful, causing a decreased appetite or difficulty eating. Weight loss may occur. Often it will be too painful for the dog 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 tooth structures.

How are gingivitis and stomatitis treated?

The first step is a complete oral health assessment under general anesthesia, combined with a thorough cleaning of the teeth. 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. Many dogs 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. Regardless, a detailed assessment under general anesthesia, combined with a thorough teeth cleaning and polishing, is also appropriate. Afterwards, a detailed homecare program specific to your pet should be instituted and anti-inflammatories and antibiotics may also be prescribed. In severe or rapidly recurring cases, removal of some or all teeth may be necessary to provide your dog with a pain-free mouth.

What is the prognosis for gingivitis and stomatitis?

The prognosis for gingivitis is excellent, provided you follow your veterinarian's instructions. Your dog will benefit tremendously from a professional oral assessment, treatment, and teeth cleaning under anesthesia, followed by a consistent oral homecare routine.

"Routine dental evaluation and treatment by your veterinarian will keep your dog’s mouth healthy and comfortable."

The prognosis for stomatitis varies depending on the specific situation, but if tooth removal is needed, dogs still do very well. Routine dental evaluation and treatment by your veterinarian will keep your dog’s mouth healthy and comfortable.

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