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"CUPS" Chronic Ulcerative Paradental Stomatitis
Chronic ulcerative paradental stomatitis "CUPS" is a is a painful condition in dogs. Severe oral inflammation and ulceration is caused by the dog's exaggerated immune response to deposits of calculus and plaque bacteria on tooth surfaces. This immune response is sometimes referred to a "immune intolerance". Tissues such as the inside lip and tongue contact calculus and plaque and result in painful oral ulcers. These lesions have been called "kissing ulcers".
What can pet owners do?
Recognition of the problem is important. If you smell bad breath or see oral ulcers, your pet needs help. Early recognition may help control the progression of CUPS by having the teeth professionally scaled, polished and in performing daily teeth brushing to reduce plaque and calculus accumulations. Animals with extensive CUPS are too painful to tolerate teeth brushing. Many of them refuse to eat or avoid chewing in painful areas. Inadequate chewing and failing to brush the teeth results in further plaque and calculus accumulations and more ulcers.
What treatments are available?
A comprehensive oral health assessment and treatment are needed. Scaling, polishing, periodontal probing, taking dental radiographs and recording the findings on the dental chart are important. Some patients benefit from performing selective dental extraction. Others require full mouth dental extractions. By removing the teeth where plaque and calculus accumulate, the pet has less immune response, less inflammation, ulceration and pain. The benefits are very remarkable. We have seen dogs unwilling to eat (because of their pain), immediately return to eating within five hours of full mouth dental extractions.
Lip reconstruction can be particularly helpful for these patients with the elimination of pain. Imagine how these oral tissues might feel in your mouth. Animals have very similar anatomy, physiology and tissue innervation (nerve supply) as humans have. Dr. Kressin believes it is our responsibility to treat and eliminate pain.
Do Cats get "CUPS"?
Cats do suffer from a similar immune mediated disease process. To read more about this condition in cats; read about feline stomatitis.
"CUPS"; painful inflammation at locations
where the tongue is contact with teeth.
The back of the tongue contacts the
molar teeth with ulcer formation.
This underside of this dog's tongue
was severely ulceratred and bleeding.
This area of ulceration was the location
the tongue was touching the teeth.
"CUPS" or "kissing lesion" above the upper
canine tooth. This view is taken with the
upper lip lifted up demonstrating the
ulcerated lip directly contacts the canine tooth.
"CUPS" or "kissing lesions" at the lip
commisure. This is where the upper
and lower lips meet in back of the mouth.
These tissues contact the teeth.
Closer view of kissing lesions to show
the entire lip surface in contact with
teeth may be affected.
Severe stomatitis or "CUPS" in the
entire upper premolar and molar areas.
Lower right molar area severely ulcerated.
The same dog as above demonstrating
the upper premolar area and lip
commisure inflammed and ulcerated.
Upper canine and premolar areas
inflammed and ulcerated from "CUPS".
Opposite of same dog as the above
photo series.
Dental extraction offers the best
long term prognosis for chronic "CUPS".
Extraction sites sutured closed to
reduce pain.
Extraction sutured closed.
Extractions sites sutured closed for
patient comfort and rapid healing.
Dog Dental Care
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