Gingivitis and Stomatitis in Cats: Painful Mouths and Treatment

By Tailwisp Editorial TeamUpdated October 20, 20264 min read

A cat with a sore mouth often tells you very little. It may eat slower, drop kibble or become grumpy. By the time you notice bad breath and drooling, the problem may have been painful for months. Knowing the difference between simple gingivitis and severe stomatitis helps you get help early.

What is gingivitis?

Gingivitis is inflammation of the gums, appearing as a red line along the tooth edge. It results from plaque bacteria. At this stage it is reversible with a professional cleaning and good home care. If it is not treated, it can progress to periodontitis, with loss of the tissues that hold the tooth. See cat dental disease.

What is stomatitis?

Feline chronic gingivostomatitis, usually called stomatitis, is a severe inflammation of the gums and other oral tissues, including the back of the mouth. The immune system overreacts to plaque bacteria, and possibly to viruses such as calicivirus. The tissues become red, raw, swollen and may bleed. It is extremely painful, and is one of the more frustrating conditions in feline medicine.

Signs

• Bad breath.
• Drooling, sometimes with blood.
• Dropping food, or chewing on one side.
• Refusing hard food, or eating less.
• Pawing at the mouth.
• Yowling when eating or yawning.
• Weight loss and a rough coat.
• Reduced grooming.
• Irritability, hiding or aggression.
• Red, swollen gums, ulcers, and sores at the back of the mouth.

Risk factors

• Plaque and poor dental hygiene.
• Calicivirus, FIV and FeLV infection. See FeLV and FIV in cats and upper respiratory infections in cats.
• Crowded households, with higher disease exposure.
• Genetic factors, since some breeds and lines are affected more.
• Tooth resorption. See tooth resorption in cats.

Diagnosis

The vet examines the mouth, which may require sedation because it is painful. Bloodwork, tests for FIV, FeLV and calicivirus, dental X-rays and sometimes biopsies help find the cause and rule out cancer. See cancer in cats.

Treatment

1. Professional dental care. Cleaning under anesthesia, with X-rays. See cat dental cleaning: what to expect.
2. Pain relief, and anti-inflammatory medication, often essential.
3. Home care. Brushing, if tolerated, and oral antiseptic gels or rinses recommended by your vet. See how to brush a cat's teeth.
4. Antibiotics, in selected cases.
5. Immune-modulating drugs, such as steroids or cyclosporine, for some cats. Long-term steroids have side effects.
6. Extractions. For stomatitis, removal of all teeth behind the canines, or all teeth, is the most effective treatment. About two thirds of cats are cured or much improved afterward, and many more partly improved.
7. Newer options, such as laser therapy or stem cell treatment, are used in some centers, though evidence is still developing.

Cats without teeth

It may sound drastic, but cats without teeth are generally more comfortable and eat well. The pain was coming from the teeth and gums, so removing the source helps. Most cats manage canned food, and many eat dry food. They still groom, play and live normal lives.

Care after surgery

• Offer soft food and water.
• Give pain relief as directed.
• Keep your cat indoors and quiet.
• Watch for bleeding or swelling.
• Return for rechecks.

Prevention

• Regular dental checks and cleanings.
• Home brushing.
• Vaccinations. See cat vaccination schedule.
• Prompt care for mouth pain.

Day-to-day comfort

A cat with a painful mouth benefits from soft, warm, aromatic food. Offer several small meals, and use a wide, shallow dish. Pain relief prescribed by your vet is not optional, because cats that hurt will eat less and lose weight. Watch for dehydration and encourage water. See how to get a cat to drink more water. If your cat will not eat for more than a day, call the vet.

Cats with FIV or FeLV

Cats with FIV or FeLV are more prone to severe mouth disease, because their immune systems are weaker. Treatment follows the same principles, but outcomes can be less predictable. Keep up with checkups and dental care. See FeLV and FIV in cats.

Expectations and costs

Full-mouth extraction is a major procedure, with cost and recovery time, but many owners say it transformed their cat's life. Plan for follow-ups. If stomatitis continues after extraction, your vet may add medications or refer you to a dental specialist. Pet insurance may help. See cat pet insurance guide.

When to see a vet

See a vet if your cat has bad breath, red gums, drooling or difficulty eating. Use the US vet directory to find a clinic.

This article is general educational information, not veterinary advice. Every cat is different. If your cat is unwell, or you are unsure about a symptom, diet change or medication, contact your veterinarian.