"CUPS" Chronic Ulcerative Paradental Stomatitis is also called Contact Mucositis

This webpage has been updated due to the high case load we have managed where oral inflammation was the overwhelming presenting problem.  These pets are particularly painful for a variety of reasons.  The fantastic news is that we can help with the appropriate diagnosis and treatment plan.  Companion animal owners must have the facts to determine the most logical treatment approach for their pets.

It is so important for animal owners to understand the great benefit of treatment of this disease process!

Why are the "gums so red"?  The answer is: contact mucositis.  These gums are in contact with plaque bacteria, and the result is severe inflammation, ulceration and pain. 

What is "CUPS" and why should we care?  What can we do?

The American Veterinary Dental College (AVDC) established a nomenclature comittee to define terminology.  The term mucositis has been chosen to describe specific locations of the oral inflamation seen in our pets.  Below is a highlight of the AVDC terminology.

Alveolar mucositis: inflammation of alveolar mucosa (i.e., mucosa overlying the alveolar process and extending from the mucogingival junction without obvious demarcation to the vestibular sulcus and to the floor of the mouth).

Sublingual mucositis: inflammation of mucosa on the floor of the mouth.

Labial/buccal mucositis: inflammation of lip/cheek mucosa.

Caudal mucositis: inflammation of mucosa of the caudal oral cavity, bordered medially by the palatoglossal folds and fauces, dorsally by the hard and soft palate, and rostrally by alveolar and buccal mucosa.  We use this term most frequently in cats.

 

"CUPS" update (please read)!

Treatment for CUPS is very critical to the well being of pets.  The bad odor and terrible pain is eliminated with meticulous oral surgery.  Dr. Kressin has managed many pets with CUPS and the treatment has been highly rewarding for pet owners.  Please call for a consultation!

Theoretically, the earlier we treat these pets and get the owners involved in plaque reduction (teeth brushing), the greater the liklihood that the problem can be controlled or eliminated.  The issue we see is that the severity of the pain is so extreme; it is nearly impossible to brush the teeth.  Careful- Painful dogs that you miay think will never bite; may bite to protect themselves.  The first step in treatment is to scale and polish teeth, assess the extent of periodontal disease, and treat appropriately.  Dental x-rays and periodontal probing are essential steps in the diagnosis and treatment plan decision making process.  

 

Tongue lesions develop in locations where the tongue contacts teeth

with plaque bacterial accumulations.

 Lingual and sublingual mucositis

Typical lip ulcer adjacent to the upper canine tooth

Alveolar mucositis (above image)

Painful Lip commisure lesion often seen with CUPS.

Labial/buccal mucositis (above image)

 

Dog Dental Care

Cat's Dental Chart