How periodontal disease differs from FCGS and TR
Periodontal disease is inflammation of the gums, the ligament that holds the tooth, the bone and the periodontal pockets. The damage is concentrated around the teeth, at the gumline and below it.
FCGS (chronic gingivostomatitis) is inflammation of the lining of the mouth beyond the gums: the alveolar and cheek lining, the areas behind the dental arches and other zones, depending on how far the process has spread. TR (tooth resorption) is destruction of the tooth tissue, often at the neck of the tooth. These are three different diagnoses, and I tell them apart under anaesthesia with X-rays.
How periodontal disease develops in cats
As in dogs, the main factor in the development of plaque-induced gingivitis is bacterial dental plaque. Over time part of the plaque mineralises and forms tartar, whose surface encourages further build-up of biofilm. Plaque-induced gingivitis is limited to the gums and, where there is no loss of periodontal attachment, can be reversible. When periodontal disease develops, the damage spreads to the deeper tissues of the periodontium with loss of attachment and of the alveolar bone.
In cats tartar often builds up on the canines and premolars. The process can go on unnoticed for years.
The gums and bone around the teeth are full of tiny blood vessels, so with periodontitis bacteria from the pockets also enter the blood. I explain how this works in How a dog’s and cat’s mouth works.
- PD0HealthyGums fit tightly around the tooth; bone is at its normal level.
- PD1GingivitisPlaque at the gumline; gums are red and bleed. Bone is intact — this stage is reversible.
- PD2–PD3PeriodontitisA periodontal pocket forms; up to half of the bone support is lost.
- PD4Advanced periodontitisMore than half of the support is lost; roots are exposed and the tooth is loose.
Signs in cats
Persistent halitosis — in the great majority of cases with a dental source. Red, bleeding gums. Drooling. Refusing dry food. A cat may “drop” food from its mouth, chew on one side or avoid having its face touched.
Reduced grooming is an indirect sign, which I always ask about at the appointment.
- Bad breath and bleeding gums
- Refusing dry food or chewing cautiously
- Drooling, avoiding having the face touched
- Less licking of the coat around the face
Why a cat may keep eating even with periodontal disease
Cats are masters at masking pain. A cat adapts how it eats: it chooses soft food, eats on one side, swallows quickly. The owner sees a “normal appetite” and puts the visit off.
At the appointment I ask about small things: has the food changed, does the cat turn down treats, does it avoid having its face touched. These details are often more important than appetite overall.
Diagnosis and treatment
A full examination under anaesthesia with periodontal probing and dental X-rays. I distinguish periodontal disease from TR and FCGS and assess every tooth.
Treatment: oral cavity sanitation, treatment below the gumline, periodontal treatment where clinically indicated, extraction of teeth that are no longer supported by bone. Brushing at home with veterinary toothpaste — if the cat tolerates it.
Prevention and monitoring
Regular dental check-ups under anaesthesia, taking individual risks into account. Brushing at home is useful but does not replace oral cavity sanitation.
If a cat already has TR or FCGS, periodontal disease may be present as well — and monitoring is important.
When to see a vet
- Bad breath, red gums or drooling
- The cat refuses dry food or eats cautiously
- Noticeable darkening of teeth or visible damage
- The cat avoids having its face touched or licks its coat less
- Blood in the bowl or on toys
- The cat has chewed on one side for more than a week
- After earlier treatment — a follow-up examination as recommended by the vet
What not to do at home
- Do not compare with experience of dogs — cats have different accompanying conditions
- Do not try to brush the teeth by force if the cat reacts painfully
- Do not put off an examination because of “normal” behaviour at mealtimes
- Do not confuse periodontal disease with stomatitis — the approach is different
- Do not treat with antibiotics alone without examining the teeth
Frequently asked questions
Yes, it is widespread, especially in adult and older cats. Only an examination under anaesthesia with X-rays gives the exact picture.
They are different processes, but they can occur together. X-rays help tell them apart and plan treatment.
Periodontal disease is damage around the teeth. FCGS is inflammation of the lining of the mouth beyond the gums. The treatment approach is different.
Dental images help assess the bony support and hidden damage, while the depth of the periodontal pockets is measured during periodontal probing. An external examination does not show how deep the process goes.
At early stages — yes, with oral cavity sanitation and care. At later stages, teeth that have lost their support are extracted to remove the pain.
It reduces plaque between procedures but does not replace professional treatment below the gumline.
Sources and professional guidelines
- WSAVA Global Dental GuidelinesGlobal guidelines for veterinary dentistry
- AAHA Dental Care Guidelines for Dogs and CatsClinical guidelines for dental care
- AVDC NomenclatureAVDC nomenclature and terminology
© dr.vetstomat. Original content.
Copying and publishing text and visual materials without the author's written consent is not permitted, except as allowed by law.