Gingivitis in Cats

In periodontal disease, the structure supporting the teeth under the gumline is diseased by bacteria that has entered the gingiva, or gum pockets, and causes inflammation and bleeding. The inflammation can spread to other parts of the mouth causing discomfort and difficulty eating. Gingivitis can sometimes be associated with a condition called stomatitis (gingivostomatitis) in which lesions form on the gingiva and surrounding areas of the mouth. Also, sometimes during treatment for gingivitis an underlying systemic viral condition may be discovered.

Plaque build-up is the most common dental issue affecting cats. Without a proper cleaning, this buildup can lead to a gum disease called gingivitis. It is one of the earliest signs of periodontal disease and is reversible with proper care, but if left untreated could become severe and lead to more advanced stages of the disease.

The first symptom you may see in gingivitis is occasional bleeding or perhaps blood when your cat eats. Upon closer examination you may also notice:

• Redness and swelling in the gums
• Bad breath
• Visible plaque build-up
• Decreased appetite
• Inflammation of the oral mucosa
• Irritability
• Discomfort

When you see these symptoms, it is time to call your veterinarian and schedule a thorough dental cleaning before the condition becomes more serious.

The accumulation of plaque and its accompanying bacteria are the primary cause of gingivitis. Other circumstances that may make your cat sensitive to the development of gingivitis are:

• Mouth chemistry
• Breed disposition especially if pure-breed
• Bartonella bacteria
• Low-fiber diet
• Feline leukemia virus
• Feline immunosuppressive virus
• Diabetes

Your veterinarian will perform a routine, general physical examination as well as an examination of the mouth after asking you a series of questions concerning your cat’s dental care and health history. A separate appointment may be needed for a more thorough dental examination. 

During this second examination, your veterinarian will first anesthetize your cat, take dental x-rays, draw blood to evaluate your cat’s systemic condition and blood cell count, and check for the severity of symptoms like depth of gum pockets and amount of plaque and tartar build-up. 

If lesions are found, that would indicate a condition called stomatitis. Stomatitis is poorly understood, but the prevailing thought is that it is caused by either bacterial or viral infections, or from a hypersensitivity to oral antigens. In addition to the symptoms of gingivitis, your cat may experience difficulty swallowing, drooling, fatigue, and weakness. Your veterinarian may also find loose or missing teeth during the examination. Tests for underlying systemic diseases such as feline leukemia, feline immunodeficiency virus (FIV), and feline calicivirus (FCV) will be conducted to determine a possible cause for the lesions. A biopsy will also be taken to test for the possibility of cancer.

Usually, diagnosis will be immediately followed by surgical treatment within the same visit.

Treatment for gingivitis is fairly simple. There are four steps to a thorough dental cleaning.

• Removing Build-up: Your cat’s teeth will be scaled to remove the plaque and tartar buildup both above and below the gumline. 
• Polishing: The teeth will be polished to remove any remaining plaque and to create a smooth surface to prevent plaque from reforming. 
• Rinsing: An oral rinsing with a special solution will flush any remaining buildup between the teeth and remove bacteria. 
• Probing: Additional examination of the mouth will be conducted to assess any additional issues.

If your veterinarian finds any additional oral issues or underlying conditions in your cat, the next steps for treatment will be discussed with you. The treatments may or may not be surgical. Often, extractions are necessary, due to bone loss, fractures that are exposing the pulp canal, root abscesses, and resorption. If stomatitis is found, often all of the teeth must be removed (full mouth extraction) to relieve pain and aid in general recovery from the underlying condition. 

For any remaining teeth, a sealant may be applied to prevent future buildup of plaque and tartar.

Some cats do not respond well to treatment even after a full mouth extraction. The reason is unknown, but it is suspected that there are enough persistent bacteria in the mouth to keep the mouth inflamed and irritated. Your veterinarian will prescribe pain medication, anti-inflammatories, and antibiotics to help control the disease. If your cat continues to not respond to treatment, additional testing will be necessary.

If a diagnosis of a systemic virus such as feline leukemia, feline immunodeficiency virus, or feline calicivirus is confirmed, medications to treat it will also be prescribed.

Assuming your cat does not have stomatitis, you will most likely not need a follow-up appointment unless symptoms reappear. If this occurs, call your veterinarian right away. A more in-depth examination may be necessary to rule out any other underlying conditions. Otherwise, you should expect to have your cat’s teeth cleaned at least once every year by your veterinarian. More frequent cleanings may be necessary depending on the severity of your cat’s condition.

Regular brushing of your cat’s teeth is the best way to prevent gingivitis both initially and again in the future. Your cat’s teeth should be brushed at least three times a week. An antibacterial rinse may also be suggested. Your veterinarian will instruct you how to brush, and what tools and toothpaste to use. Do not use toothpaste made for humans.

You should consider changing your cat’s food to one that has higher plant fibers that helps to prevent plaque build-up. As your cat eats, the fibers scrape against the teeth and acts as a natural plaque remover. Ask your veterinarian for a recommendation. Certain dental chews and treats may also be helpful.

Regular cleanings at home, routine examinations by your veterinarian, and a proper diet are essential for good oral health for your cat.