Brook A. Niemiec, DVM
Feline oral inflammatory diseases are a fairly common occurrence. They can also be very
frustrating to treat. Many practitioners are aware of stomatitis, however there is an emerging
condition called juvenile periodontitis which is often mistaken for stomatitis. This newsletter
will explain this condition and how to differentiate from stomatitis. Finally, treatment will be
Juvenile periodontitis appears as significant gingival inflammation, often with gingival
enlargement. (Figure 1) This begins soon after eruption of the permanent teeth (9-12 months of
age). Bleeding during mastication and on oral exam are common findings. It is generally a non-
painful condition for the patient, and halitosis is a common complaint. If left untreated, it
typically proceeds quickly to marked periodontal disease, which may result in early exfoliation
of the teeth. This is generally the worst in around the mandibular first molars. (Figure 2)
Figure 1: Significant gingival inflammation and overgrowth on the maxillary left of a young cat
Figure 2: Dental radiograph of a mandibular left of a young cat with significant alveolar bone loss already
affecting the first molar (yellow arrow).
This disease is commonly mistaken for caudal stomatitis. The distinguishing clinical sign is the
lack of caudal inflammation in this disease process. (Figure 3) In addition, patients with caudal
stomatitis tend to be painful. Finally, it is rare for cats under 2 to develop stomatitis. (Figure 4)
As the patient matures, susceptibility appears to subside at approximately two years of age,
which is the same type of pattern followed in the human disease. Ergo, if this process is treated
Early (9 months of age) and frequent (q 6-9 months) dental prophylaxis (even if only minimal
plaque is present) along with strict homecare is critical to decrease inflammation. Ideally,
homecare consists of daily brushing, as it is the gold standard of plaque control. Other homecare
alternatives include chlorhexadine rinses as well as plaque control diets and treats. In cases
where gingival hyperplasia is present, early gingivectomy is recommended to remove
psuedopockets, decrease inflammation, and facilitate plaque control (both professional and
homecare). Dental radiographs should be performed to evaluate the quality of the alveolar bone
and also for early tooth resorption. Extraction of any significantly diseased teeth is warranted to
decrease the degree of inflammation.
painful and halitosis is a common sign.
Caudal stomatitis is painful and generally seen in older cats.
The key clinical sign that differentiates these two conditions is the lack of caudal
during and immediately after eruption of the permanent dentition.
Treatment and management of this problem includes early (and regular) professional