What is gingivitis or stomatitis?
Gingivitis is a medical term that refers to inflammation of the gums. Gingivitis is the earliest phase of periodontal disease.
"Stomatitis refers to a more generalized inflammation of the mucous membranes within the mouth."
Stomatitis refers to a more generalized inflammation of the mucous membranes within the mouth, and may involve the gingivae, tongue, inner surfaces of the lips, and/or the floor and roof of the mouth.
What causes gingivitis or stomatitis?
Gingivitis is most commonly caused by bacterial infection in the mouth and is associated with poor oral hygiene. On the surface of the teeth, these bacteria create plaque, which becomes tartar and eventually becomes calculus, the hard, mineralized deposit that covers the teeth. When bacteria enter into the small pocket between the gums and teeth known as the gingival sulcus, they cause an inflammatory reaction. Left untreated, bacterial infection of the gingival sulcus can progress to periodontitis and tooth loss.
Stomatitis may be caused by a local infectious or inflammatory process or may be a secondary condition. Some of the causes of stomatitis include:
- Anatomic abnormalities such as overcrowding of teeth or abnormal location of the lip frenulum
- Metabolic disorders
- Uremia and high blood ammonia levels often associated with kidney failure
- Vasculitis associated with diabetes mellitus
- Hypoparathyroidism causing enlarged tongue and lips
- Immune mediated disease (Pemphigus foliaceus or vulgaris, Bullous pemphigoid or Lupus erythematosus
- Drug reactions
- Bacterial infection secondary to existing oral lesions
- Irritation of soft tissues from calculus
- Fungal infections
- Calicivirus or herpesvirus infection
- Feline leprosy (mycobacterium)
- Systemic or blood-borne infections
- Foreign bodies
- Electric cord shock
- Chemical burns
- Chemical irritants
- Snake bite
- Trauma to the face or mouth
- Toxic plants
- Chemotherapy or radiation therapy
What are the clinical signs of gingivitis or stomatitis?
The most common clinical signs and abnormalities associated with gingivitis include a thin red line along the margin of the gums, swollen gum margins, bad breath, and plaque and calculus. If the teeth are brushed, the inflamed gums will often bleed.
"Stomatitis is extremely painful."
Stomatitis is generally a more severe form of inflammation than gingivitis and involves the tongue, lips and other soft tissues in and around the mouth as well as the gingivae. Stomatitis is extremely painful, and many cats will have a decreased appetite due to the pain. In severe cases, there may be swelling around the eyes or the facial tissues around the mouth.
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. Oral radiographs are often taken to determine if there is any damage to the tooth roots and supporting structures. Cultures and biopsy samples may be taken in severe or suspicious cases.
How is gingivitis or stomatitis treated?
A dental prophylaxis (teeth cleaning) is the first step in treatment for gingivitis. The deposits of calculus are removed, the tooth surfaces are scaled (cleaned) with dental instruments, and finally the tooth surfaces are polished. It is important to clean the tissues beneath the gum line carefully to remove any accumulated plaque or calculus. Antibiotics, oral rinses containing chlorhexidine and other home care treatments, including regular tooth brushing may be recommended, based on your cat's needs. Home care is directed at reducing the plaque accumulation that leads to gingivitis.
"Many cats will require broad-spectrum antibiotics, chlorhexidine rinses or gels and anti-inflammatory medications."
The treatment of stomatitis involves treating the underlying cause of the problem. Many cats will require broad-spectrum antibiotics, chlorhexidine rinses or gels and anti-inflammatory medications. The specific cause and the severity of the condition will determine your cat's treatment.
What is the prognosis for gingivitis or stomatitis?
The prognosis for uncomplicated gingivitis is excellent provided you follow your veterinarian's instructions. Most cats will benefit tremendously from a dental cleaning and polishing followed with routine home oral care. The prognosis for stomatitis is determined by the underlying cause. Most cases of stomatitis respond well to medical treatment. Your veterinarian will provide you with a more specific prognosis based on your cat's diagnosis.