Feline Gingivitis: Vital Answers From a Veterinarian About Periodontal Disease in Cats
I recently had the pleasure of interviewing Dr. Martha Smith-Blackmore on an important pet health issue: feline gingivitis. Dr. Smith is Director of Veterinary Medical Services at the Animal Rescue League of Boston, and she is passionate about animal welfare. She shares how gingivitis affects cats as well as her recommendations for treatment and prevention options.
Donna Cosmato (DC): What is feline gingivitis?
Dr. Smith: Gingivitis is a general term that refers to inflammation of the gum, so feline gingivitis refers to a mild periodontal inflammation where the gums may be a little bit red and sore.
It is usually a reaction to dental tarter, and you can see a visible yellow/brown buildup of hard material on the teeth.
Gingivitis only tells the story on the surface but it can be an indicator of more serious dental disease happening below the gum line.
DC: What is the difference between feline gingivitis and feline gingivostomatitis?
Dr. Smith: Stomatitis, which is also known as plasmacytic/lymphocytic gingivitis or saucitis, is a very painful inflammatory condition that happens in cats.
The gums are flaming, angry red, and while it has not been entirely determined, it is thought to be an immune overreaction to the presence of the plaque on the teeth, bacteria in the plaque, or even the cat’s own dentine, which is the hard material of which teeth are made.
You can tell a cat has the more advanced type of gingivitis (gingivostomatitis) because they hang their mouth open as it hurts to close it; they drool, and their drool is a stream of creamy whitish drool rather than clear, healthy-looking saliva.
There will be a lot of pus in the drool and it smells foul.
DC: Isn’t it unusual for a cat to have bad breath?
Dr. Smith: Yes, it is. If you go up to a cat and stick your nose right in the mouth, you might not find the breath to be too pleasant, but it should not make you recoil. When cats have the gingivostomatitis, it really stinks because their mouths are literally rotting.
It is a horrific condition. These poor cats do not want to eat and may only lick a little broth. They don't want to do any chewing.
DC: What are the contributing factors?
Dr. Smith: The contributing factor to the gingivostomatitis is the cat’s immune system overreacting to the plaque.
On the other hand, you can have a cat with healthy looking gums but with just one spot that looks like a little spot of gingivitis. That is an indication of feline odontoclastic resorptive lesions (FORLs). Those are like cavities that happen at the gum line.
DC: What observable symptoms would alert owners that their pet is suffering from feline gingivitis?
Dr. Smith: This would be an indication of a FORL: If your cat lets you touch it, and you put your finger on that little red spot, your cat would “chatter.” In other words, the jaw would jerk – like the reaction humans have when they have a chill.
It is a painful condition as well. Therefore, if after reading this article, your readers look in their cat’s mouth and they see a bright spot in the gum line where it meets the tooth, that may be the indication the cat has a painful cavity. I’d recommend that they take their cat to their veterinarian for treatment.
DC: Are there cat populations that are at higher risk?
Dr. Smith: There is a higher incidence of gingivostomatitis among cats with feline leukemia or FIV (feline immunodeficiency virus) positive cats. Cats that had calici viral infections and as a result experienced severe upper respiratory infections at the beginning of their lives may be at higher risk of stomatitis later in life.
DC: What about senior cats?
Dr. Smith: If a cat has lived a healthy long life, it is less likely stomatitis will erupt towards the end of their lives. However, a veterinarian should evaluate any change in a cat’s mouth as it ages.
One of the cancers we see all too often in cats is squamous cell carcinoma of the mouth, and they do not chew tobacco! It tends to be aggressive cancer and the chance of the cat responding to surgical treatment is better if it is detected and treated early.
DC: How is feline gingivitis diagnosed?
Dr. Smith: Feline gingivitis is a diagnosis made by observation and similarly for the stomatitis. However, stomatitis tends to extend beyond the jaw line. Gingivitis is typically a thin line on the gum line, while stomatitis is an inflammation of the whole mouth. (The stoma is the mouth.)
When you open the cat’s mouth and look down the back of its throat, there is a huge proliferation of this angry, red inflamed tissue at the back corner of the mouth or where the upper jaw meets. Stomatitis is spread out through the mouth rather than limited to the gum line where the gums meet the teeth.
DC: What are the treatments options for cats with gingivitis?
Dr. Smith: You can prevent gingivitis or slow its progression through daily teeth brushing at home. Of course, it is best if you start as early as possible and preferably when the cat is a kitten and more receptive to accepting the brushing as a positive thing.
You can teach old cats new tricks, however, and I recommend starting with a visit to your veterinarian for an assessment of the cat’s oral health. The vet may recommend a professional dental cleaning to get the mouth to get the mouth to a clean starting point and then introduce the tooth brushing from there.
DC: What tips do you have for owners who need to introduce their cats to a brushing regime?
Dr. Smith: The way I like to start tooth brushing is just to use a gauze square moistened with warm water and wrapped around my finger.
Gently rub the outside surfaces of the teeth with the finger. Try to make it like a grooming session where the cat is petted on the sides of the face and then gently insert your finger and do a little bit of rubbing. Work your way up from that and add some chicken flavored dentifrice, which you can get from your veterinarian.
Eventually, you should get to the point of being able to brush the teeth. Don’t worry about the inner surfaces of the teeth; just concentrate on the outer surface and especially the upper teeth. That’s where we see the majority of the disease.
How to Brush Your Cat's Teeth
DC: What is the prognosis for these cats?
Dr. Smith: It depends. Feline gingivostomatitis is a very challenging condition to treat. Many treatments may be tried before getting the condition under control.
Some cats require professional dental cleanings two or three times a year. Some unfortunate cats don’t respond at all to treatment, and the only way they can be comfortable is to perform a full mouth extraction. Of course, this is a treatment option of last resort. Even so, cats that have had this procedure generally do very well.
For other causes of gingivitis, underlining triggers must be resolved. Therefore, if there were a FORL, then the gingivitis is not going to go away until the FORL is treated. For most cats, that would mean extraction of the tooth. In cases of simple feline gingivitis related to an unclean mouth, the prognosis is excellent when the mouth is cleansed and kept clean.
DC: What role does nutrition play in preventing this disease?
Dr. Smith: I don’t know if it is really known. There was a time when it was thought a dry kibble was preferable to wet food because the dry kibble would supposedly have a mechanical action to chip away at the tartar and help to polish the teeth and keep them clean and smooth.
However, the pendulum reversed and now wet food is thought to be preferred for cats’ oral health. With dry kibble, in order to make the kibble form of the food, there has to be a higher carbohydrate to protein ratio.
All those carbohydrates dissolved in the saliva supports bacterial growth so dry food could actually make periodontal disease worse. The current thinking is the higher protein content of wet food may make for a healthier cat mouth. My recommendation is if you own a cat that allows you to brush its teeth daily, feed it a wet diet with a high protein level.
I do recommend a Hills science diet product called t/d, which is a puffed kibble coated with something delicious. Cats will take it as a treat, in fact. That has been proven to have a good dentifrice action, so if you own a cat that will not allow you to brush its teeth; you may want to supplement the diet with the t/d so they are eating a snack that helps to keep the teeth clean.
DC: What else do cat owners need to know about feline gingivitis?
Dr. Smith: I’m a big believer in the power of omega fatty acids to help with all kinds of inflammation and health issues, whether it is arthritis or periodontal disease. There is no harm in supplementing a cat’s diet with a little fish oil.
You can get fish oil from any nutrition store or at your local drugstore, and I recommend owners give their cats’ one capsule daily. Just pop a hole in the capsule and squeeze the oil out on the food. I can’t say fish oil will make the periodontal disease go away or prevent it, but it cannot do any harm and it might do some good. It is important not to use more than one capsule per day because the increased oil content in the diet could lead to loose stools.
Just Like You, Your Cat Needs Regular Dental Checkups
A signature trait of the feline species is their propensity to hide or disguise their pain. As predators, they do not want to expose a potential weakness to their enemies.
However, dental issues such as feline gingivitis, when left untreated, can lead to other health problems or may even endanger your pet’s life. According to the American Veterinary Dental Society about 75% of cats over 5 years of age are in need of dental care.1
Following Dr. Smith’s advice about obtaining an oral health evaluation from your veterinarian and taking your cat for regular dental checkups is the best way to protect your pet.
Phone interview with Dr. Martha Smith-Blackmore, 01/24/2012
1 – Undisclosed author, “Feline Dentistry,” Veterinary Dental Center, http://veterinarydentalcenter.com/feline.htm