We receive a lot of calls and emails regarding treatment of feline patients with stomatitis. Everyone wants to know what new drug is out there that will treat them without surgery… we wish there was one. However, at this time, nothing compares to the clinical improvement we see after extraction of teeth. This difficult discussion with clients becomes easier with experience and after seeing the remarkable improvement in quality of life for stomatitis patients after surgical extractions. Extraction of every tooth is not always necessary. In fact, for the majority of cats with stomatitis, extraction of the premolars and molars will allow the oral cavity to heal. Below are photos of a patient with stomatitis (confirmed with histopathology) compared with 1 year post premolar and molar extractions.
How do you determine the best course of action for a patient with stomatitis?
What procedure should be performed on 100% of stomatitis patients undergoing surgery?
Full mouth dental radiography is absolutely essential before and after extractions. We all know how brittle diseased feline teeth can be and if root fragments are retained, they lead to continued inflammation and can harbor bacteria. In our practice, less than 20% of patients with extractions of their premolars and molars have continued clinical disease requiring extraction of the canines and incisors. However, the patients who do not initially require full mouth extractions are carefully selected by evaluating their dental radiographs and oral exam. Patients with moderate to severe gingivitis or periodontal disease of the canines and incisors should have those teeth extracted during the initial procedure. With proper patient selection, careful surgical technique, pre- and post-op dental radiographs and regular follow-up, it is possible to dramatically improve your stomatitis patient’s quality of life.