In the previous lecture, the importance of being able to identify periodontal indices was discussed as well as the importance
of correctly recording that pathology on dental charts. The indices most commonly evaluated are gingivitis, probe depth, gingival
recession, furcation involvement, mobility and periodontal attachment. These indices are the factors along with radiographs
that are involved in grading periodontal disease.
As important as the periodontal indices are in the diagnosis and grading of periodontal disease, there are many other pathologies
that may be encountered during a thorough oral examination. It is important to be able to recognize these anomalies and bring
them to the attention of the veterinarian.
Lymphoplasmacytic Stomatitis (LPS) is a chronic, painful condition that can be very difficult to diagnose and treat. Multiple
tests are needed to rule out other problems. Make sure the animal is FeLV/FIV negative, you may want to consider Bartonella
testing. Most treatments are ineffective; to date the best treatment is a complete dental extraction including the removal
of all dentin. This treatment is usually effective in about 80% of the cases.
Feline Odontoclastic Resorptive Lesions (FORL)
FORL's can be difficult to classify. There are five stages of FORL's that are determined by the amount of crown involved n
o Lesions extend only into the cementum. This stage occurs only subgingivally. – Very
difficult to detect
o Lesions progress through the cementum into the dentin of the root or crown but the
pulp is not exposed. Hyperplastic gingiva may cover these defects.
o Lesions progress into the pulp chamber. Bleeding on probing and spontaneous fractures
of the crown may occur.
o Lesions destroy a significant amount of the crown.
o Lesions have significant root replacement resorption with healing of the gingiva.
There will not be any clinically apparent tooth tissue.
In addition to the stages of FORL's, they can be classified based on radiographic appearance of the periodontal ligament
Type 1 – Lesions are caused by inflammation. The root appears normal, and the periodontal ligament
space is still observable.
Type 2 – The affected tooth is ankylosed to the alveolus. This type of lesion is not associated
with periodontal disease