Juvenile Gingivitis

"Young Cats

Some young cats will have significant eruption 

gingivitis as the primary teeth are exfoliating and the 

adult teeth are erupting. In some cases this is 

associated with what appears to be gingival 

hyperplasia, but I suspect that it is actually inadequate 

apoptosis (programmed cell death). As the adult teeth 

erupt, soft tissue over the crowns must die, opening a 

hole through which the teeth  can erupt. As the teeth 

are erupting, the gingiva is very loosely attached to 

the tooth so that the tooth can erupt. Until the tooth 

has erupted completely and the gingiva has died back 

to an appropriate height, there will be excess gingiva 

and deeper-than-normal  probing depths around the 

tooth. These false pockets can be plaque-traps and 

triggers for gingivitis.

See these papers for more about false pockets and 

inflammation around under-erupted teeth  -

gingival_hyperplasia.pdf and pericoronitis.pdf.

If you are seeing gingivitis as the primary teeth  are 

exfoliating and adult teeth are erupting, do not panic. 

This may all be transient and resolve spontaneously 

once all the primaries are gone, the adults are all in 

fully  and the gingiva has adjusted to proper height 

and contour and has attached properly to the tooth.

If the gingivitis persists after the teeth are fully 

erupted (say beyond seven months of age) and 

especially if there appears to be excess gingival tissue 

around the teeth then it is time for a COHAT. Whole 

mouth radiographs are required to evaluate bone and 

root structure and to look for developmental 

abnormalities below the gum line. Excess gingiva 

should be carefully contoured away, being sure to 

leave an appropriate amount of gingiva  around each 

tooth. Teeth with significant bone loss or deep true 

pockets (not just false pockets) should be removed. 

Remaining teeth are then scaled and polished above 

and below the gum line.

I hear you thinking, but these brand new teeth have no 

tartar so why clean them? Tartar is not the problem. 

Plaque, particularly subgingival plaque, is the issue 

and it is invisible to the naked eye and hiding below 

the gum line. So yes, you do need to do an oral 

hygiene procedure to get back to a clean oral 

environment. How quickly does plaque accumulate? 

Well, if you brush your teeth before going to bed, 

they are clean and smooth. When you wake up in the 

morning, your teeth are wearing fuzzy little sweaters 

of plaque that formed overnight as you slept. That is 

how long it takes.

Following this COHAT, the owner must institute a 

program of daily plaque control (dental home care). 

Plaque retardant diets are indicated but many are not 

appropriate for growing kittens as they are adult 

formulations. I strongly recommend products that 

have the VOHC seal of acceptance for plaque control 

(way more important than tartar control) and you can 

find a list of these products on the VOHC website. 

However, these diets are not intended to support the 

growth and development of a young cat. Therefore, 

feeding a growth diet in combination with the plaqueretardant diet until a year of age would seem 

appropriate.The mainstay of daily plaque control is tooth brushing 

and this should be started as soon as the mouth has 

healed from any COHAT-related surgery. It is not 

nearly enough to just give your client a tooth brush 

and tell them to get at it. They need detailed 

instructions on how to go about training their cat how 

to enjoy having its teeth brushed daily. I have some 

guidelines on my website (dentalcare.html) and there 

are some helpful videos such as this  - Cornell 

brushing video - on the internet. Every clinic should 

have a training program that they can outline in detail 

for their clients. Without this crucial knowledge, I can 

guarantee that every home care program you 

recommend will fail.

A third strategy is to incorporate a legitimate wateradditive to the cat’s life. At time of writing, the only 

such product with VOHC acceptance is the dog 

version of healthymouth™. There is a feline version 

which is very similar to the dog recipe. It is quite 

acceptable to give the dog recipe to  cats and vice 

versa. For more about this product, have a look at this 

from the August, 2010 edition of The CUSP  -

HealthyMouth.pdf. 

If the owners can institute an effective plaque control 

program after your appropriate treatment, then some 

of these juvenile cases will settle down to have 

relatively normal feline dental health. They should 

still have annual COHATs to look for and manage 

any issues and to try to stay ahead of dental disease.

For cats/owners who will not/cannot institute an 

effective plaque control program, the problem is 

likely to persist and escalate and so warn them early 

that whole-mouth extraction may not be far off."