New guidelines call for earlier diagnosis, intervention in feline dental disease

The Feline Veterinary Medical Association (FelineVMA) has published new comprehensive guidelines that raise the bar for oral health care in cats by providing evidence-based recommendations spanning diagnosis, treatment, anesthesia, prevention, and client communication.

Appearing in the November issue of the Journal of Feline Medicine and Surgery, the 2025 FelineVMA Feline Oral Health and Dental Care Guidelines is the most detailed resource on feline dentistry to date, outlining advances in tooth resorption classification, earlier intervention for feline chronic gingivostomatitis (FCGS), and structured referral pathways.

By promoting routine use of intraoral radiography, consistent client education, and spectrum-of-care approaches, the guidelines aim to reduce untreated oral pain and improve long-term outcomes for feline patients.

Oral and dental diseases are common health problems in the domestic cat, but can be difficult to identify given the cat's powerful instinct to conceal illness and pain, according to the guidelines. The document is written for all members of the veterinary team and includes guidance on supporting owners as active participants in their cat's dental health care.

"Oral and dental diseases are among the most common health problems in cats, yet they're often unrecognized," Dr. Heidi Lobprise, co-chair of the guidelines task force, said in a press release. "These guidelines equip veterinary professionals with practical, evidence-based tools to diagnose and manage these conditions earlier and more effectively."

Guidelines highlights

Periodontal disease (PD) remains the most prevalent oral condition in feline patients, with gingival inflammation reported in up to 96% of cats in some studies, according to the guidelines.

"The term PD encompasses gingivitis, which is the early reversible stage of the disease process, and the progressive changes leading to periodontitis, where there is an irreversible loss of the supporting structures of the teeth. In gingivitis, the gum tissue may be erythematous, swollen or painful," the guidelines state.

Periodontal disease indices and steps for assessment are included in the guidelines, which encourage full-mouth dental radiography to determine the amount of alveolar bone loss for each tooth and whether the attachment loss is horizontal or vertical.

Additional areas of focus include feline chronic gingivostomatitis (FCGS), tooth resorption, and trauma; patient assessment, evaluation, and documentation; anesthesia and analgesia; and specific considerations in relation to tooth extraction.

Early extraction therapy-partial caudal or full-mouth-is reaffirmed as the most effective treatment for FCGS, with cited resolution or substantial improvement rates approaching 67% in some studies. Long-term corticosteroid use is discouraged due to limited efficacy and risks of immunosuppression.

For refractory cases, the guidelines review adjunctive therapies including ciclosporin, interferon omega, and stem cell therapy, while noting many remain supported only by limited or anecdotal evidence.

Expanded coverage is given to tooth resorption (TR), a common and progressive disease affecting 28% to 67% of cats, depending on the population.

"Despite various hypotheses, the etiology of TR remains unclear," the guidelines state. "Studies have shown an increase in prevalence with increasing age, while findings regarding a specific breed predisposition have not been consistent."

Pain alleviation is the principal aim of treatment.

"Unfortunately, no prevention for tooth resorption has been found and there is no method of stopping the progression of an already existing lesion," the guidelines state, which list tooth extraction, crown amputation, and monitoring as treatment options.

Additional topics covered in the guidelines include oral carcinomas, equipment considerations, and use of antibiotics.

Surgery and referrals

The FelineVMA guidelines reiterate that comprehensive feline dental assessment and treatment cannot be performed in awake patients. Full-mouth dental radiography, thorough charting, scaling, and surgical procedures require general anesthesia and multimodal analgesia. Detailed workflow recommendations cover preanesthetic evaluation, the typical workflow and staging of oral and dental surgical procedures, postoperative care, and nutritional support.

For the first time, the FelineVMA guidelines offer explicit criteria to help general practitioners determine when referral to a board-certified veterinary dentist is advisable, which are as follows:

• Retained or displaced root tips
• Maxillofacial trauma or jaw fractures
• Suspected oral masses requiring biopsy or advanced imaging
• Systemically compromised or high-risk anesthetic patients
• Need for full-mouth extractions, complex endodontics, or orthodontics
• Practices without intraoral radiography capability or facing high risk of iatrogenic fracture

The task force encourages maintaining relationships with dental specialists for consultation and continuity of care.

In addition, the guidelines feature supplemental online resources, such as videos, a feline dental chart, feline dental care brochure, feline Stomatitis Disease Activity Index (SDAI) scoring chart, and additional information on periodontal disease. Resources for cat owners can be found on the FelineVMA website.

Task force co-chair Dr. Kelly St. Denis emphasized the guidelines' attention to veterinary team alignment and owner education: "By educating caregivers with consistent, science-based messaging, we can ensure more cats receive the dental care they need and deserve."