Understanding Gingivitis and Its Symptoms in Cats

1. Introduction

Gingivitis is a common dental condition that affects many cats. It is marked by inflammation of the gums, causing redness, swelling, and bleeding. Gingivitis can be caused by a variety of factors, including poor oral hygiene, which allows plaque and tartar to build up on the teeth, leading to inflammation. Other possible causes of gingivitis in cats include viral or bacterial infections, immune system disorders, hormonal changes, certain medications, and underlying health issues, such as diabetes or kidney disease. Gingivitis is often mild at first but can progress to more severe forms of periodontal disease if left untreated.

Gingivitis has several different clinical forms, including acute necrotizing ulcerative gingivitis, chronic gingivitis with lymphocytic-plasmacytic infiltrate, juvenile gingivitis, cementifying fibroma, gingival epulids, neoplasia, gingival hyperplasia caused by calcium channel blockers, regional stomatitis, and Orofacial pain syndrome. Untreated gingivitis can lead to periodontal disease, which can cause the loss of teeth, infection of the jaw bone, and other health problems.

Fortunately, gingivitis in cats can be diagnosed and treated with proper care. Regular dental check-ups and cleaning can help prevent gingivitis and other dental problems. There are also special diets and dental treats available that can help support your cat's dental health. Additionally, you can help support your cat's dental health at home by brushing their teeth regularly and providing them with dental toys and treats. If you suspect that your cat may have gingivitis, it is important to take them to the veterinarian for an examination and possible treatment. Early detection and treatment can help prevent further complications and ensure the long-term health of your pet.

2. Causes of Gingivitis in Cats

Gingivitis, a common feline inflammatory oral disease, occurs when the immune system overreacts to specific bacteria in the plaque formed on the teeth and gums. It is essential to differentiate between gingivitis and periodontitis, as the latter is uncommon in cats. Even though gingivitis is often milder and more reversible, it can lead to tooth loss without proper treatment.

Plaque, a colorless accumulation of bacteria, sugars, and proteins, forms on teeth and under the gum line. When plaque is not removed, it hardens into tartar, leading to gingivitis. Regardless of gingivitis severity, plaque must always be removed. To prevent gingivitis, cats should have their teeth brushed regularly. Other products, such as dental treats or food, may be recommended, but a toothbrush and toothpaste designed for cats are preferable.

Additional factors may contribute to gingivitis, such as traumatic oral lesions, calculus buildup, feline stomatitis, immunodeficiencies, systemic diseases, nutritional deficiencies, and genetic predisposition. Nevertheless, a thorough examination and professional cleaning are always necessary. Plaque is the main factor, while others act as promoting agents.

3. Symptoms of Gingivitis in Cats

Gingivitis is a common dental condition in cats due to the accumulation of plaque and tartar. Recognizing the symptoms is crucial for early intervention and treatment. This section will explain the visible signs and behavioral changes that may indicate gingivitis in cats.

3.1. Visible Signs

One of the most obvious signs of gingivitis in cats is the presence of red or inflamed gums. This can be seen when the cat’s mouth is opened and examined from the side. Instead of a healthy light pink color, the gums appear dark red and swollen. In more advanced cases, white or yellowish materials can be seen on the gum line. This is called calculus, which is a hard mineralized substance. Tartar builds up in one location over time due to improper dental care.

Another visible sign is a change in the appearance of the teeth. The teeth may appear discolored with brown or green areas blooming on the enamel surface, or a cat with excessive gingivitis can even lose teeth. One of the most severe implications of untreated dental disease is dental fractures. Crown abscesses at the base of teeth can cause chronic pain and continue to break the tooth. Some crowns of the teeth may even be completely missing.

3.2. Behavioral Changes

In addition to visible signs, some behavioral changes may also indicate gingivitis in cats. Excessive drooling or salivation can be a sign that something is wrong in the cat’s mouth. Sometimes the saliva may even be foamy or have a different color. This can be a response to pain, discomfort, or difficulty swallowing. With a sore mouth, a cat may stop eating its regular dry food and prefer to eat only wet food. A dry food diet will require more chewing and can be painful for a cat with dental disease. In severe cases, cats will stop eating altogether. Any sudden changes in eating habits should prompt a trip to the vet.

Visible Signs

There are a number of visual signs that can flag possible pet dental problems. Cat owners should examine their pets' teeth and gums regularly for visible signs such as redness and swelling. The cat's breath can be a good indicator of dental health. Pet breath with a strong, foul odor can indicate infection. A brownish tartar buildup can be seen covering teeth. These deposits are bacterial colonies that live and thrive in the mouth, feeding on foods and making acid and toxins. Poorly brushed teeth can ultimately devolve into painful gum disease.

Sometimes the breakdown of gums can be seen where gums recede from a tooth, exposing the root. Missing teeth can indicate dental disease and infection. The cat's fur coat may appear dirty, unkempt, and lose its shine. The pet may cry or yowl when touched on the face and head. Fonds of food and treats may be pushed around the dish and not be eaten. A sudden withdrawal and skittishness can occur around play with string and sticks. Aggression when petting the face and head as usual is noticed after it has been fine is often a sign of pain. In and out of the cat litter box with frequent attempts can indicate urinary tract problems.

3.2. Behavioral Changes

Just as with humans, dental health is a crucial component of overall health in cats. When a cat's teeth develop plaque and tartar buildup, swelling and inflammation of the oral tissues can occur. This condition is known as gingivitis, which can lead to periodontitis and loss of teeth. Signs that a cat might have gingivitis can be broken down into two sub-categories - visible signs and behavioral changes.

The inflammation typically starts around the gums where plaque and tartar accumulate, but with time it spreads to the surrounding tissues and forms pockets of infection. Although plaque buildup is a component of this disease, some cats will remain resistant to gingivitis despite significant plaque and tartar accumulation. There are many documented cases of cats developing gingivitis without an obvious reason, even those who follow a proper dental routine. Regardless of the reason for the development of this disease, there are some common behavioral changes that are indicative of gingivitis.

One of the most severe consequences of gum disease is that it can affect the cat's willingness to eat or drink. If the cat's gums are sore or swollen, it may be hesitant to bite down on kibble. Even chewing on soft food can cause discomfort if the molars are affected. Fresh water can also cause soreness if the inflammation spreads to the tissues in the back of the mouth or throat. To cope with the discomfort, even otherwise healthy eaters may stop using their food and water bowls. Instead, they may eat dry food, drink from a running sink, or try to nibble on treats.

Cats with gingivitis can also experience foul-smelling breath due to the buildup of bacteria in the mouth and the formation of cysts on the gums. These bacteria secrete byproducts which can sometimes be absorbed into the bloodstream, resulting in kidney damage or other health issues. The composition of the oral bacteria may also shift with age and diet. In some cats, the composition might predispose the oral environment to gingivitis. Another behavioral change that can accompany periodontal disease is changes in grooming habits. Cats may display swollen cheeks or discharge around the mouth, and subsequently, neglect grooming around these areas.

4. Diagnosis and Treatment of Gingivitis in Cats

Gingivitis can be diagnosed during a routine veterinary examination. Generally, if a cat looks healthy, the veterinarian examines the mouth for signs of gingivitis, which include redness or swelling along the gum line, calculus on teeth, bad breath, and an elevation in the third eyelid near the corner of the eye. Gingivitis is often graded from a level of 0 (normal) to level 3 (persistent gingivitis), with indications that there is a risk of permanent damage at levels 1 or 2. With a level 3 rating, diseased teeth need to be extracted. In normal cats, there may be occasional tartar, familiar breath, and no swelling or redness along the gum line.

A more thorough examination often requires anesthesia. Once the cat is sedated, its mouth is examined further. Gingivitis can affect just a few teeth or the entire mouth. X-rays may also be taken. Following the thorough examination, treatment will be planned. Most likely it will include a professional dental cleaning, dental extractions, and/or instructions for dental care at home, including brushing teeth and using dental treats and rinses. The treatment plan will depend on the kind and severity of the gingivitis. With a degree of gingivitis, professional dental cleaning is often needed to remove the tartar build-up that causes inflammation. The cleaning includes scaling the teeth above and below the gum line and polishing them. Intermediate cleaning may include extractions of teeth that are loose due to severe loss of bone around those teeth.

After a cleaning, many cats require dental care at home which could include brushing teeth daily or 2-3 times weekly. There are special toothbrushes designed for cats and toothpaste that come in a variety of flavors such as poultry or fish that are designed to be safe to swallow. Some dry dental cat food and treats are designed to help reduce tartar before it becomes a problem. Regular dental cleanings are also encouraged, often once a year for cats who are at risk or showing early signs of gingivitis. Cats that develop more serious forms of gingivitis may need to have their mouth checked and cleaned more regularly to minimize discomfort and pain.

4.1. Veterinary Examination

If a cat is exhibiting symptoms of gingivitis, it is important to schedule a veterinary examination. A veterinarian can provide a thorough examination of the cat's mouth, teeth, and gums. Because most cases of gingivitis are caused by bacteria in the mouth, dental examination is the main part of diagnosing gingivitis.

Unfortunately, dental disease is difficult for cats to deal with without a veterinarian's help. Cats also tend to hide or mask signs of pain and discomfort until the situation is serious. Therefore, it is recommended to have a veterinarian examine a cat's mouth before it develops oral disease symptoms.

What to Expect During the Examination

- Medical History: Prior to the appointment, the cat owner will usually be asked about the cat's medical history and dental health history. They will be asked why they suspect gingivitis and what symptoms they have observed. Any medication the cat is taking and changes in behavior will also be discussed.

- Oral Examination: The veterinarian will examine the cat's mouth using a tool called an otoscope. An otoscope has a light and camera attached to help look deeper in the mouth. With the cat in a comfortable position, the veterinarian will look at the gums, teeth, tongue, and under the tongue. During this examination, the veterinarian will likely check for broken teeth, tumors, swelling of the gums, or other oral irritations.

If gingivitis is suspected, it is likely the veterinarian will recommend a dental cleaning, also called dental prophylaxis. The dental cleaning is the most efficient way to diagnose, assess, and remedy dental disease. In-depth examination and cleaning cannot be performed by veterinary staff without special equipment. The cleaning must be done while the cat is under anesthesia.

- Blood Tests: Before anesthesia is administered, the veterinarian will likely recommend blood tests to ensure the anesthesia is safe. A pre-anesthetic blood test checks the cat's liver and kidney function through a simple blood draw. As blood is processed, it may take 30-60 minutes. During this time, the veterinarian may discuss the results of the oral examination with the cat owner.

- Dental Cleaning: The dental cleaning is done while the cat is under anesthesia. Once the cat is sedated, a veterinary technician attaches a tube called an endotracheal tube to the cat's windpipe to keep the cat’s airway clear and to help deliver oxygen and anesthetic. A technician will then place the cat on a dental bed that will keep the cat in a comfortable position during the whole procedure.

Most of the dental cleaning is performed by a veterinary technician. A veterinarian will usually come around to check the cat’s teeth and gums beforehand. The technician will use an ultrasonic scaler to remove tartar on the teeth. Scalers come in a variety of shapes and sizes to access all parts of the teeth and gumline, including hard-to-reach back teeth. After the cat’s teeth are cleaned, the technician will check for gingivitis and periodontal disease. This assessment includes probing gums to check the depth of pockets surrounding each tooth. An inflamed pocket indicates gingivitis, while deep pockets indicate periodontal disease. A veterinarian usually performs this assessment and determines any necessary extractions.

4.2. Dental Cleaning and Care

Gingivitis is an inflammation of the gums and is the earliest stage of periodontal disease. It can be reversible with proper brushing and dental cleanings, however, if ignored, it can progress to periodontal disease involving the bone loss around the teeth which is not reversible. Good dental care is vital for the long-term health of your pet!

Cat's teeth should be examined at least once a year at a veterinary visit. Some cats need dental cleanings every year while others may not require dental cleaning until several years when gingivitis evolves into periodontal disease. Periodontal disease is common in cats over 3 years old. Dental cleanings are done at the veterinary clinic under general anesthesia so that the veterinarian can clean and examine the teeth and gums properly.

Home dental care is very important and should consist of daily brushing of the teeth with pet toothpaste and a pet toothbrush. Cat's teeth are very fragile and need to be brushed gently in a circular motion while focusing on the line where the gums meet the teeth. If brushing is not possible, dental treats, hard kibble, or dental sprays can be used to help control tartar buildup, although brushing is the most effective. Never use human toothpaste for your cat. They typically swallow toothpaste instead of spitting it out like humans do, and many toothpastes with fluoride or xylitol are toxic to pets.

Early dental disease is hard to detect and often goes unnoticed. In more advanced cases, a cat may drool, have bad breath, lose weight, be sensitive around the mouth area, or have difficulty eating or picking up food. Cats may also yowl or cry while eating. Always consult a veterinarian if you suspect dental disease, as they can inform you of the best preventive or treatment options available.

5. Preventive Measures for Gingivitis in Cats

Regular dental cleaning:

Regular vet check-ups:

Balanced diet:

Fresh water source:

By taking these preventive measures, cat owners can help ensure that their furry friends maintain good dental health and avoid the discomfort and pain associated with gingivitis. (Caney)(Olsén et al.2021)(Tatlıağız & Akyazı, 2023)(Enlund et al., 2022)(Sordo et al.2020)

References:

Caney, S. M. A., . Urinary health: how water and 'water supplements' can help in the management of feline lower urinary tract disease. vet-center.eu. vet-center.eu

Olsén, L., Brissman, A., Wiman, S., Eriksson, F., Kaj, C. and Brunius Enlund, K., 2021. Improved oral health and adaptation to treatment in dogs using manual or ultrasonic toothbrush or textile of nylon or microfiber for active dental home care. Animals, 11(9), p.2481. mdpi.com

Tatlıağız, Z. & Akyazı, İ, 2023. Investigation of the effect of water temperature on water consumption of cats. Journal of Istanbul Veterinary Sciences. dergipark.org.tr

Enlund, K. B., Pettersson, A., & Eldh, A. C., 2022. Dog owners' ideas and strategies regarding dental health in their dogs-Thematic analysis of free text survey responses. Frontiers in Veterinary Science. frontiersin.org

Sordo, L., Breheny, C., Halls, V., Cotter, A., Tørnqvist-Johnsen, C., Caney, S.M. and Gunn-Moore, D.A., 2020. Prevalence of disease and age-related behavioural changes in cats: past and present. Veterinary sciences, 7(3), p.85. mdpi.com