A 9-year-old domestic short hair cat was referred to Southern California Veterinary Dental Specialties for swelling and a draining tract on the chin.
The swelling had responded temporarily to antibiotics. Dental disease was not considered by the referring veterinarian due to the fact that tooth was not broken and there was minimal periodontal disease.
The patient was placed under general anesthesia and a complete oral exam and dental radiographs exposed. This confirmed that there was a significant periodontal pocket on the buccal aspect of the tooth.
The dental radiograph confirmed the significant alveolar bone loss.
The tooth was extracted and the defect closed. This treatment allowed the infection to resolve.
Periodontal abscesses are fairly rare in veterinary medicine, but are being diagnosed more commonly in small breed dogs. However, these are typically class II perio-endo abscesses where the endodontic infection occurs due to the periodontal disease extending to the apex of one root of a multi-rooted tooth. True periodontal abscesses where the infection in the periodontal pocket creates a swelling and/or draining tract is much rarer. In addition, periodontal disease is less common in cats, especially to this extent. In humans, they generally occur after a dental cleaning which does not address the deep pocket. The gingival area will heal, trapping the infection in the pocket allowing the infection to flourish.
Teeth which are abscessed due to endodontic disease can be treated with a root canal. However, periodontal disease infection is best treated with extraction.
Keeping periodontal infection on your list for oro-facial swellings will help avoid missing an obvious condition and allowing continued pain and infection for your patients.