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Contact Ulcers / Stomatitis in Dogs


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.



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