What healthy gums look like and where owners notice blood
A cat’s healthy gums are pale pink, with a thin, even edge that fits snugly around the tooth. Some cats, especially ginger ones, have dark pigment spots on the lips and gums — this is normal as long as they do not grow or change.
In cats, blood is usually noticed not in the mouth itself but around it:
The gums carry a dense network of tiny blood vessels, so even mild inflammation makes them bleed. I explain how the gums and blood supply of the mouth work in How a dog’s and cat’s mouth works.
- pink marks on dry food, in the water bowl or on a toy;
- pink or stringy saliva, a wet chin;
- pinkish traces on the front paws and the fur around the mouth after washing;
- blood on the gum when you lift the lip or try to brush the teeth;
- bad breath that does not go away.
A single drop after your cat has bitten something hard may be a minor injury. But if the blood comes back, the gums are red or swollen or there is a smell, it is a sign of disease and worth showing to a vet.
The most common cause: gingivitis and periodontitis
Plaque is a bacterial film that forms on the teeth every day. At the gum line, the bacteria irritate the tissue and gingivitis develops — inflammation of the gums: a red line along the teeth, swelling and bleeding on touch. In cats it often shows first above the canines and on the large upper cheek teeth.
While the inflammation is limited to the gums it is reversible: after a professional clean above and below the gum line and daily home care, the gums can recover. If the plaque stays, the inflammation goes deeper, into the ligament and bone that hold the tooth. This is periodontitis: periodontal pockets (gaps between the gum and the root) form, the gums recede, teeth start to loosen, and lost bone does not grow back on its own.
From the outside, early periodontitis looks just like gingivitis, and the amount of tartar does not show what is happening below the gums: a cat with almost clean teeth can have deep pockets. More in Gingivitis in dogs and cats and Periodontitis in cats; for dogs, see Why are my dog’s gums bleeding?
- 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.
Blood around one tooth: possible tooth resorption (TR)
Tooth resorption (TR) is a condition in which the body’s own cells gradually destroy a tooth, most often starting at the gum line. Gum tissue fills the defect, so you see a red “bump” on the tooth, as if the gum had grown into the crown. This tissue bleeds easily when touched, and the tooth itself is painful.
The typical picture: the gums are red not throughout the mouth but around one or two teeth; your cat chatters or trembles its jaw when the spot is touched, or suddenly drops its food. Yet some lesions hide below the gums and cannot be seen without X-rays, so when I suspect TR I assess every tooth, not just the one that bleeds.
Filling these teeth makes no sense: resorption continues under the filling. Treatment is extraction or, under strict conditions confirmed on an X-ray, crown amputation. More in Tooth resorption in cats.
- TR 1–2A defect at the gum lineA small pit where tooth meets gum, with red gum tissue growing into it. It may already hurt.
- TR 3The defect reaches the pulpThe tooth hurts, especially when touched or while eating, even if it looks almost intact.
- TR 4The crown breaks downThe crown weakens and may break off. What happens to the root depends on the resorption type, which only an X-ray shows.
- TR 5The crown is goneGum covers the root and the tooth seems to have “fallen out”. Root remnants show only on a radiograph.
The whole mouth is red: feline chronic gingivostomatitis (FCGS)
If the redness is not limited to the gum edge but spreads to the lining of the cheeks and the back of the mouth — behind the last teeth, towards the base of the tongue — I think of feline chronic gingivostomatitis (FCGS). It is an excessive inflammatory reaction of the oral lining to plaque: the tissue is bright red, ulcerated or bumpy and bleeds at the slightest touch. The inflammation can be out of proportion to the amount of plaque.
Such a cat usually suffers visibly: it drools, sometimes with blood, approaches the bowl and walks away, loses weight and grooms less. Cleaning the teeth alone does not help here, medicines give only temporary relief, and the mainstay of treatment is extraction of the premolars and molars or of all teeth, guided by X-rays. How FCGS is recognised and treated — in Stomatitis in cats.
A young cat with bleeding gums: juvenile gingivitis
While the teeth are changing, a drop of blood on a toy and slightly red gums are normal; see Kitten teething. But some young cats develop marked inflammation as the permanent teeth erupt or shortly afterwards — juvenile gingivitis. The gums are bright red throughout the mouth and swollen, sometimes overgrow and partly cover the teeth, bleed during meals, and bad breath appears.
Waiting for it to pass on its own is not a good idea: untreated juvenile gingivitis can progress to periodontitis at a young age. Treatment is a professional clean under anaesthesia and, when clinically indicated, correction of overgrown gums (gingivectomy) and extraction of retained temporary teeth, followed by daily home care and more frequent check-ups. An example is the case of a 9-month-old Maine Coon whose overgrown gums were injured every time the jaws closed.
Other causes the vet needs to rule out
If the picture is unusual, I also consider other conditions:
- Injury — a fall from a height, a blow, a fight: there may also be broken teeth or a wound on the palate.
- A broken tooth with an exposed pulp (the living part of the tooth with its nerve and blood vessels): a pink or dark dot is visible in the centre of the fracture. See Can a broken tooth in a cat be saved?
- Eosinophilic lesions — ulcers and nodules on the lip, tongue or palate that can bleed.
- A growth in the mouth — a lump on the gum that bleeds, especially in an older cat. Only a biopsy with histology shows what it is, so it should not be left to wait.
- Infections and whole-body diseases. Viruses, including feline calicivirus, can cause mouth ulcers. Inflammation and ulcers sometimes accompany kidney disease, and bleeding can accompany a clotting disorder; then the plan includes blood tests, not just dentistry.
How I find out why the gums are bleeding
In a conscious cat only part of the mouth can be seen, and the most important things hide below the gums. So the diagnosis is made step by step:
A separate veterinary anaesthetist runs and monitors the anaesthesia. I do not recommend tartar removal without anaesthesia: it does not show what is below the gums and does not treat the cause.
- 01
Photos or an online consultation
If you are not in Kyiv, start with photos of the gums from the side with the lip gently lifted: they help judge how urgent things are.
- 02
Examination and consultation
I assess the gums, visible teeth, oral lining, breath, weight and general condition, and ask about appetite and eating habits. I plan the tests needed before anaesthesia.
- 03
Pre-anaesthetic tests
Blood tests; a heart scan, abdominal ultrasound and other tests depending on your cat’s age and health. They also help to pick up whole-body diseases.
- 04
Diagnosis under anaesthesia (COHAT)
Probing of every tooth, examination of the whole mouth and full-mouth dental radiography; a biopsy if needed.
- 05
Treatment of the cause
Cleaning above and below the gum line, extraction of teeth with TR or without bone support, pocket treatment, gingivectomy — when clinically indicated and agreed with you.
How much gum examination and treatment costs
The first step is an examination and consultation. After that, the cost is made up of pre-anaesthetic tests, anaesthesia and oral sanitation under the COHAT protocol; the extent of treatment becomes clear only after the X-rays.
When to see a vet
- Bleeding does not stop, swelling of the face grows quickly or your cat has not eaten for more than a day — seek help the same day: in cats even a few days without food are dangerous for the liver.
- Blood on the gums, in the saliva or on food keeps coming back or lasts more than a few days.
- A red “bump” of gum on one tooth or a “hole” at the gum line, and your cat chatters its jaw when touched there.
- Redness at the back of the mouth, drooling, your cat approaches the bowl and walks away.
- A young cat with bright red, swollen or overgrown gums.
- A lump on the gum, an ulcer that does not heal or a broken tooth.
What you can do at home
- If your cat is calm, lift the lip at the side in daylight and take a few photos — for the appointment or an online consultation.
- If your cat clearly prefers soft food, switch to wet food for now until the examination.
- Watch whether your cat is eating and keeping its weight, and note what you see: it helps at the appointment.
- After treatment, brush the teeth daily with a veterinary toothpaste from the day your vet advises. How to get a cat used to it — in How to brush a cat’s teeth.
What not to do at home
- Do not start brushing bleeding gums vigorously before the examination: if it hurts, your cat will quickly learn to fear the brush.
- Do not give human painkillers: paracetamol is especially toxic to cats, and ibuprofen, aspirin and naproxen are dangerous too.
- Do not give antibiotics “just in case”: they do not remove plaque or diseased teeth, and the inflammation comes back.
- Do not treat the gums with hydrogen peroxide, alcohol, human mouthwashes or gels.
- Do not scrape off tartar at home with tools, and do not force your cat’s mouth open.
Frequently asked questions
No. Healthy gums do not bleed, even during toothbrushing. The exception is a kitten changing its teeth, when a drop of blood on a toy can be normal. In other cases bleeding gums mean inflammation or another problem, and it is worth showing your cat to a vet.
Gingivitis is a red line along the gum edge only. With chronic gingivostomatitis the inflammation goes beyond the gums, onto the cheeks and the back of the mouth, and the cat usually suffers visibly while eating. These conditions, and tooth resorption too, can be told apart at an examination, and fully only under anaesthesia with X-rays.
Have an examination first. If your cat has resorption or stomatitis, the brush hurts, and your cat will remember it as unpleasant for a long time. After treatment, daily brushing with a veterinary toothpaste is the best way to keep the gums healthy.
They may reduce the inflammation for a short while, but they do not remove the cause — plaque below the gums or teeth affected by resorption or periodontitis. So the bleeding usually returns after the course. Any medicine for a cat should be prescribed by a vet after an examination.
Because the important things are hidden below the gums: pocket depth, the state of the bone, the roots and resorption. Inflamed gums can be probed and X-rays taken only in a cat that is still and pain-free. Sometimes X-rays behind “simple gingivitis” reveal TR or periodontitis in several teeth, and the treatment plan changes.
In cats appetite is not a reliable guide: they hide pain and simply change how they eat — choosing soft food, chewing on one side, swallowing pieces whole. If the bleeding lasts more than a few days, it is better to have your cat examined rather than wait until it stops eating.
It depends on the cause. Gingivitis is reversible: after a professional clean and daily care the gums recover. Periodontitis can be stopped, and teeth with resorption are extracted, after which they no longer hurt once healed; stomatitis needs its own plan and follow-up checks.
Sources and professional guidelines
- WSAVA Global Dental GuidelinesGlobal guidelines on veterinary dentistry
- 2019 AAHA Dental Care Guidelines for Dogs and CatsClinical guidelines on dental care
- AVDC NomenclatureAVDC nomenclature and terminology
- AVDC: Tooth ResorptionClassification of tooth resorption (TR) by stage and type
- Cornell University — Tooth resorptionOverview of tooth resorption in cats
- Cornell University — Feline chronic gingivostomatitisOverview of chronic gingivostomatitis in cats
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