Gingivitis in dogs and catswhat gum inflammation looks like and how it is treated

What is gingivitis

Gingivitis is inflammation of the gingiva — the soft tissue that fits snugly around the neck of each tooth. It is triggered by plaque, a bacterial film that forms on the teeth every day. Plaque bacteria at the gum margin irritate the tissue, which responds with inflammation: the gums turn red, swell and start to bleed. Some of the plaque mineralises into tartar (calculus), and its rough surface holds even more plaque.

Under the AVDC classification (American Veterinary Dental College), gingivitis without attachment loss is the first stage of periodontal disease, PD1. The key words are “without attachment loss”: the periodontal ligament and the bone around the root are not yet damaged. That is why gingivitis is reversible and periodontitis is not.

When owners say “my dog's gums are inflamed”, they most often mean gingivitis. But red gums occur with other diseases too, especially in cats, so the diagnosis is made after an examination.

The gums are part of the mouth’s protective barrier: they fit tightly around the neck of the tooth and keep bacteria away from the root. I explain what happens when this barrier breaks in How a dog’s and cat’s mouth works.

What gingivitis looks like in a dog or cat

Healthy gums are pink (in many dogs partly pigmented and dark), with a thin, firm edge that hugs the tooth smoothly. With gingivitis you may notice:

• a red line along the gum margin — especially above the canines and the back upper teeth;
• swelling: the gum edge becomes thickened and rounded, like a rim;
• bleeding — pink-tinged saliva, blood on the toothbrush, toys or treats;
• bad breath that does not go away;
• plaque or tartar near the gums — yellowish or brown deposits.

Pigmented gums in dogs can hide the redness — then look for swelling, blood and odour. If your main question is where the blood is coming from and how urgent it is, see the separate page on red or bleeding gums: it covers other possible causes and the signs that should not wait.

Is gingivitis painful, and why does it matter

Gingivitis does not usually cause the kind of pain a broken tooth or an abscess does, and behaviour often does not change. But inflamed gums are sensitive: a dog may turn away from the toothbrush, a cat may be reluctant to take hard treats. Dogs and cats tend to hide discomfort, so a normal appetite does not mean all is well in the mouth.

The main danger is not gingivitis itself but what it can lead to. If plaque is not removed, the inflammation gradually moves below the gum line, destroys the periodontal ligament and bone, and periodontal pockets form. That is periodontitis: it hurts, leads to loose and lost teeth, and lost bone does not grow back on its own. Not every case of gingivitis progresses to periodontitis, and the pace differs between animals, but there is no way to predict it in advance.

Gingivitis or periodontitis: what is the difference

They are stages of the same process, but the outlook and treatment differ. From the outside they are easy to confuse: early periodontitis often looks like “ordinary gingivitis with some tartar”.

I cover the stages, signs and treatment of periodontitis in detail in the articles on periodontal disease in dogs and periodontal disease in cats.

Causes of gingivitis and risk factors

The main cause is plaque that is not removed every day. But some animals' gums become inflamed faster than others'. The risk is higher with:

• no daily toothbrushing — only mechanical cleaning removes plaque at the gum line, and ordinary dry food does not;
• crowded or misaligned teeth — in small and brachycephalic breeds the teeth often sit tightly or are rotated, and plaque collects between them;
• retained deciduous teeth — a narrow gap forms next to the permanent tooth where plaque builds up even in a young animal;
• gum overgrowth (gingival hyperplasia) — in dogs of some breeds or with certain medications the gums thicken, and deep “pockets” form under their edge where a toothbrush cannot reach;
• age and general health — deposits usually increase with age; sometimes gum inflammation is sustained by a systemic disease, and further tests may be needed.

Gingivitis in cats: what else to consider

In cats, red gums do not always mean simple plaque-induced gingivitis. I always consider three other conditions:

• tooth resorption (TR) — if the redness is limited to one tooth and there is a red bump of gum tissue growing onto the crown, this is a typical sign of resorption. More in the article on tooth resorption in cats;
• chronic gingivostomatitis (FCGS) — the inflammation is not limited to the gum margin but spreads to the lining at the back of the mouth, the lips or the palate; it is very painful and treated differently. How to recognise it — in the article on stomatitis in cats;
• juvenile gingivitis — in some young cats, marked gum inflammation appears while the permanent teeth are erupting or soon afterwards, sometimes together with gum overgrowth. The reasons for this reaction are not fully understood, and without treatment it can progress to periodontitis at a young age. An example is the case of gingivectomy in a Maine Coon kitten.

These conditions can occur together and alongside periodontitis, which is why an examination under anaesthesia with dental radiographs is especially important in cats.

Why the diagnosis cannot be made by looking

At an in-clinic consultation I can see redness, swelling, plaque and tartar — enough to suspect gingivitis and judge how urgent things are. But the key question — is the bone around the teeth still intact — cannot be answered without anaesthesia. That takes two things:

• periodontal probing — with a thin graduated probe I check the groove around every tooth: with gingivitis there is no attachment loss, with periodontitis the probe sinks into a pocket;
• full-mouth dental radiography — radiographs show the bone level, the roots, tooth resorption and hidden lesions below the gum line that cannot be seen in the mouth.

Both are done under inhalational anaesthesia: probing inflamed gums is unpleasant, and radiographs require the animal to be completely still. Blood tests are needed before anaesthesia; other tests are chosen according to age and health. Sometimes radiographs reveal periodontitis in several teeth, or resorption in a cat, behind what looked like “simple gingivitis” — and the treatment plan changes.

If you are not in Kyiv, start with an online consultation: clear photos of the gums help judge how urgent things are and plan the tests.

How gingivitis is treated

The aim is to remove plaque and tartar wherever they sustain the inflammation — including below the gum margin — and to deal with whatever makes plaque build up. All of this happens within COHAT, a comprehensive oral assessment and treatment under anaesthesia:

Antibiotics do not treat gingivitis: plaque bacteria live in a biofilm, and unless it is removed mechanically the inflammation returns as soon as the course ends. Likewise, gels, sprays and water additives can only supplement care — they do not remove tartar below the gum line.

Scaling without anaesthesia is a cosmetic procedure: the visible part of the crown looks whiter, while plaque below the gums and any periodontitis go unnoticed.

1. 01

   Consultation

   I assess the gums, bite, deciduous teeth and general health and plan the tests needed before anaesthesia.

2. 02

   Diagnostics under anaesthesia

   Probing of every tooth and full-mouth dental radiography. Anaesthesia is given and monitored by a separate veterinary anaesthesiologist.

3. 03

   Professional cleaning

   Removal of plaque and tartar above and below the gum line with ultrasonic and hand instruments, then polishing so that plaque attaches less easily.

4. 04

   Treating the causes

   When clinically indicated: extraction of retained deciduous teeth; for resorption, extraction of the affected tooth or crown amputation; correction of overgrown gums (gingivectomy); treatment of any periodontal pockets found.

5. 05

   Home care and follow-up

   Daily toothbrushing from the day I advise, and a follow-up check to see how the gums have recovered.

Prognosis: can gingivitis be cured?

Yes. Gingivitis is the stage at which treatment can return the gums to normal: after professional cleaning the inflammation gradually settles, and bleeding and odour decrease. How long the result lasts depends on home care: plaque starts forming again within hours of cleaning, and without daily brushing gingivitis comes back.

If plaque was trapped by a retained deciduous tooth, crowding or overgrown gums, removing that cause is part of the treatment — otherwise the inflammation keeps returning in the same place. Cats with juvenile gingivitis usually need more frequent check-ups, and with chronic gingivostomatitis the prognosis and treatment are different.

Preventing gingivitis

The foundation of prevention is daily toothbrushing with a soft brush and veterinary toothpaste. Mechanical cleaning at the gum margin removes plaque before it mineralises. Introduce it gradually, starting with a few seconds, ideally from a young age.

• Every day, not once a week: occasional brushing cannot keep up with new plaque.
• Veterinary toothpaste: animals swallow toothpaste, so human toothpaste is not suitable.
• Products with the VOHC seal: dental diets, treats or chews with proven action against plaque or tartar supplement the toothbrush but do not replace it. How to choose them — in the article on dental treats and chews.
• Regular check-ups: I set the interval individually — according to breed, age, bite and how well brushing works at home.
• Monitoring tooth replacement: in puppies and kittens, check that the deciduous teeth fall out on time.

If the gums are already red and bleeding, I would not start with persistent brushing: get an examination first, because when it hurts, an animal quickly learns to fear the toothbrush.

How much does gingivitis treatment cost

The cost is made up of the consultation, pre-anaesthetic blood tests, anaesthesia and COHAT, whose price depends on the animal's weight.

Frequently asked questions