Gingivitis
Gingivitis is a condition in which the gums around the teeth become inflamed (red, swollen, and painful). This inflammation is usually the result of a process that begins with the buildup of plaque, a film that harbors bacteria, on the teeth. In cats with good oral health, the bacteria that live in this film are believed to be beneficial, and the plaque that harbors them accumulates above the line where the base of the teeth meets the gums (gingiva).
If not regularly removed, plaque migrates deeper toward where the gingiva meets the base of the tooth. Eventually, plaque will migrate below this point to the subgingival region, where a cat’s immune system may mount a response to these bacteria, resulting in the inflammation that we refer to as gingivitis. Some researchers believe that the onset of gingivitis may be caused by a shift in the populations of bacteria in plaque from normal, healthy species, to disease-causing species. Tooth crowding and insufficient oral health care may contribute to plaque accumulation.
When plaque becomes hardened by absorbing minerals from both the saliva and from the gingiva itself, it is referred to as calculus or tartar. Calculus provides a rough surface that disease-causing species of bacteria can attach to. It is not the calculus itself that promotes an inflammatory response, but rather the bacteria that attach to the calculus.
Disease-causing bacteria that accumulate on and below the gums produce substances that damage the cells that form a barrier between the gums and the teeth. This allows the bacteria access to the connective tissue below the teeth where the cat’s immune system will probably react by making the gums inflamed and painful. If the cat’s immune response to these disease-causing bacteria is strong, he or she will develop gingivitis, but it is also possible the cat’s immune system will tolerate the bacteria without any detrimental effects on either.
Gingivitis may also be brought on by a number of infectious or systemic diseases, including feline leukemia virus, feline immunodeficiency virus, feline calicivirus, severe kidney disease, diabetes mellitus, and autoimmune disease. When caused by one of these systemic diseases, gingivitis may be accompanied by inflammation or sores in other parts of the pink mucous lining of the mouth, a condition known as stomatitis.
Clinical Signs/Diagnosis
Gingivitis is characterized by swelling, redness, discomfort, and, in severe cases, bleeding where the gums and the teeth meet (the gingival margin). Depending upon the severity of the gingivitis, cats may be hesitant to eat, may turn their heads unusually while eating, may stop eating, drool, or develop bad breath (halitosis). In some cases, cats with gingivitis will show a preference for soft foods.
Prevention and Treatment
The best way to prevent gingivitis in cats is to regularly remove plaque build-up by tooth brushing (see Figure 1). It is important to use only tooth gel or toothpaste designed specifically for cats, as human products can be toxic to cats. While some cats require gradual introduction before they will allow regular tooth brushing, most cats can eventually be trained to accept this preventive measure. If a cat has severe gingivitis, tooth brushing can be quite painful, so consult with a veterinarian before considering brushing the teeth of a cat with gingivitis.
Luckily for cats who have already developed gingivitis, the condition is usually reversible. The recommended treatment will depend upon how severe your cat’s case is and on the underlying cause, and may involve cleaning your cat’s teeth at home, giving him or her antibiotics (either taken as a pill or as an oral rinse), scaling of inflammation-inducing plaque from the teeth (which usually requires anesthesia), the use of immunosuppressive drugs, and in extreme cases, the removing of teeth that may serve as sources of inflammation. There is little or no evidence that treating gingivitis with antibiotics alone is effective.
In cases of feline gingivitis that are due to systemic or infectious underlying diseases, it is important to address the primary disease in order to manage the gingivitis.
