Stomatitis is a general term used to describe any inflammatory
change in the mouth. This inflammation can be caused by infections,
chemicals, or foreign material. Unfortunately the condition is
a lasting one because it is a dysfunction of the immune
system..
As plaque
forms on the teeth, there is an over-reaction by the body.
Unfortunately, this immune response causes more harm than benefit.
The intensely red swollen tissues cause considerable pain. The
process also leads to other dental complications. Many
patients have what are called "contact ulcers". These ulcers
develop on the lip tissues that simply lie in contact with the
bacterial accumulation on the teeth. The ulcers are also found on
the tongue as it lies next to the lower teeth. These ulcers can
occur in any breed but are most commonly found in the Maltese,
Scottie, and cocker spaniel breeds.
The
diagnosis can often be made on the clinical appearance of the mouth
and gums, but occasionally biopsy specimens are necessary for
confirmation. Treatment of this condition can be very
frustrating. Our only
realistic goal is successful management. Since the condition is an
over reaction to plaque, any method of plaque control is
useful.
A
conservative approach for mild cases is usually followed initially.
The teeth must first be cleaned of all plaque and tartar
accumulation both above and below the gum line. This can be accomplished only
under anesthesia.
While under the anesthetic, every surface of each tooth is examined
and x-rays are commonly taken to detect any hidden pathology that
could harbor plaque or infection. Therapy has to be aggressive! Any
problems - no matter how minor - must be properly treated, or the
affected tooth extracted. Antibiotics usually do not help
sufficiently but anti-inflammatory drugs may be
prescribed.
Since
plaque begins to re-accumulate in just a few hours after the
cleaning, diligent home care is essential to the control of
inflammation. Ideally, the teeth are brushed with a preparation
containing chlorhexidine, anti-plaque germicide. This product can
also be squeezed into the cheeks for those patients that will not
allow brushing. The chlorhexidine should be applied
daily! Following the aggressive
cleaning and periodontal treatments, most patients improve, however
the degree of improvement is quite individual. It is routine to
recheck the mouth and repeat the cleaning process in as little as
2-4 weeks.
Long-term
commitments to regular home care are required to control this
disease, and affected dogs will need frequent dental cleanings
under anesthesia. Even with intensive care, most dogs will continue
to worsen and may need to have more radical
therapy.
Many dogs
develop more severe inflammations that become extremely painful.
For these dogs, many of the back teeth must be extracted. This
procedure eliminates much of the contact between the mouth's
sensitive tissues and the bacteria that would accumulate on the
teeth. Depending on the severity of the problem, it may be
recommended that all the teeth be extracted, including the fangs.
Though this approach seems extreme, it can bring about substantial
relief and reduce the inflammation to a tolerable level. Dogs
adjust very well to the loss of their teeth and the improvement in
their quality of life is often dramatic and rewarding. Remember
that most dogs (even cats!) swallow their food whole. Unlike us
humans, they do no have to chew their food.
