Plus-Hex CLINICAL
On inspection of the oral cavity, gingival inflammation in the area where there is a missing tooth could indicate retained roots that have been resorbed [ 23 ]. This demonstrates the requirement for dental radiography if any abnormality is noted during an oral examination. Dental radiographs( Figure 2) [ 23 ] will provide a more complete picture of the condition of the periodontal tissues below the gingiva, allowing more informed treatment choices [ 1 ].
Feline chronic gingivostomatitis
Feline chronic gingivostomatitis( FCG) is a proliferative oral disease in cats typified by severe ulcerated lesions within the oral mucosa( Figure 3) [ 29, 30 ]. This condition is idiopathic, although multiple causative factors have been suggested, including retroviruses, periodontal disease and plaque hypersensitivity [ 29 ].
Figure 3. Feline chronic gingivostomatitis in a cat; the gingival tissues are severely inflamed and erythematous [ 30 ].
Figure 2. Dental radiography reveals the extent of tooth resorption [ 23 ].
Investigation into TR has focused on cats, owing to its high incidence in this species. However, the prevalence of resorptive lesions in dogs has been poorly researched and has been accepted as being rare [ 25 ].
TR causes multiple undesirable clinical signs, including dysphagia, ptyalism and anorexia stemming from considerable oral discomfort [ 21 ].
The two main recognised forms of TR are characterised by type 1 and type 2 lesions. Type 1 lesions are associated with the inflammation seen with periodontal disease [ 26 ]. A sustained inflammatory response initiated by plaque and bacterial accumulation is thought to encourage odontoclastic activity [ 27 ]. By contrast, type 2 lesions occur in clinically healthy teeth without the presence of periodontal disease, and their aetiology remains unknown [ 28 ].
Excessive dietary vitamin D and infections with viruses such as feline calicivirus and feline immunodeficiency virus have been hypothesised as causes of TR; however, these have not been proved within current published studies [ 27 ]. Although it is difficult to prevent TR when its underlying cause is not fully understood, regular dental care at home is encouraged to inhibit plaque accumulation, localised gingivitis and its associated odontoclastic activity.
Plaque intolerance is dominant in the progression of FCG; the immune system produces a disproportionate response to plaque, causing intense stomatitis and oral discomfort, contributing to weight loss and anorexia [ 31, 32 ].
FCG is a common, yet frustrating, condition to manage in clinical practice [ 33 ]. For successful management of FCG after partial extractions, compliance with daily toothbrushing and rinsing with chlorhexidine is argued to be essential for plaque deterrence; however, these methods are likely to worsen oral discomfort in sensitive gingival tissues and patient tolerance is understandably low [ 34 ].
Regular dental prophylaxis to adequately remove plaque deposits above and below the gingival margin is necessary if home plaque control is limited. The debilitating nature of FCG makes client education on feline dental disease important.
Methods of dental home care
Daily toothbrushing is considered the gold standard for plaque removal in companion animals [ 35 ]. Toothbrushing mechanically removes bacteria from the gingival sulcus, interrupting plaque build-up, but plaque rapidly re-establishes, necessitating a regular toothbrushing routine [ 36 ].
Harrison [ 5 ] considered the use of meat-flavoured toothpastes to encourage patient compliance. Two older studies in cats reported contrasting findings on toothbrushing efficacy [ 37, 38 ], and the limited significant
Volume 41( 2) • April 2026
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