Aggressive Periodontitis (AP). This condition can start at 6-8 months of age. Another name for this condition is juvenile gingivitis, which may resolve with time and topical management. If this doesn’t resolve, it can progress to AP, which is rapid extension of gingival inflammation to the periodontal tissues with/without tooth resorption. The main difference between this and FCGS is that the inflammation does NOT extend beyond the mucogingival junction (see photo on left). Diagnosis is made based on history, clinical findings, dental radiography and can be confirmed by biopsy. This disease may progress to FCGS, therefore requires long-term follow up.
Feline Chronic Gingivostomatitis (FCGS) is characterised by severe inflammation that extends beyond the gingiva to the mucosa, particularly towards the back of the mouth (see photo to the right). This is a multifactorial disease, the exact cause is unknown, but it is generally thought of as an inappropriate immune response to plaque bacteria. (i.e. an ‘allergic reaction’ to their own plaque), which can be worsened by viral infection (Calicivirus, Feline Immunodeficiency Virus, Feline Leukaemia Virus). Because teeth harbour plaque, they act as a constant presence to trigger this response, which is why the recommended first-line treatment is full mouth extractions. Medical management without tooth extractions is often unrewarding long-term.
Unfortunately, because these conditions have no definitive cause, there is no way to effectively prevent them from happening.
Managing Aggressive Periodontitis and/or Feline Chronic Gingivostomatitis:
- The first line treatment for both conditions require a general anaesthetic and a thorough oral assessment which
includes probing, charting, scaling and dental x-rays. - blood test will also be taken to check for underlying viral infections.
- Surgery: For AP, selective or full mouth extractions dependant on the case.
- Surgery: For FCGS, full mouth extractions. This initially is just the cheek teeth only (the canines and incisors left where possible).
- It is extremely important that these cases have all root tissue removed, as anything left behind will continue to cause inflammation. This can be very difficult in some cases, so we use pre- and post-extraction x-rays to confirm all roots have been successfully removed.
- Medications: Pre- and post-operative pain management. Anti-inflammatories +/- additional pain relief. Post-operative antibiotics.
- Follow-up checks to assess the long-term response to treatment.
- Further dental treatment may be needed in the future if not all the teeth have been removed.
It can take up to 4 months to see a full resolution. Some aggressive cas