Bitsy is a beautiful 3 year old Yorkshire Terrier. We saw her for the first time here at
She improved quite a bit with the antibiotics, so her parents decided to just have the abscessed tooth removed and they would address the rest of her dental disease later. When a baby tooth is retained it crowds the adult tooth causing trapping of food and debris between the teeth. This leads to infection which can be painful to the pet and can lead to damage of the tissues around both the baby and the adult tooth. The best thing to do for an abscessed tooth is to remove it so that the infection doesn’t spread to other teeth or into the blood stream where it can affect other organs.
Bitsy recovered well initially, but shortly after her antibiotics were gone her appetite dropped again and now she seemed to be painful when opening or touching her jaw. She was much more reluctant to allow anyone examine her mouth. It was decided that she should have X-rays taken to check for additional tooth root abscesses or conditions and to clean the rest of her teeth.
Once under anesthesia her mouth could be examined more closely. Bitsy had 
developed ulcers on the back edges of her tongue, around her back teeth and on the overlying cheek areas. This is a condition called Chronic Ulcerative Paradental Stomatitis or CUPS. The ulcers are commonly referred to as “kissing lesions” because they occur in the tissues that touch the teeth.
With CUPS the body is overreacting to the plaque bacteria adhered to the teeth causing painful ulcers that start to destroy the supportive structures around the teeth. They typically improve when on antibiotics to kill the bacteria (such as with Bitsy’s initial visit), but once they are stopped the process returns. Many have tried controlling this condition with rigorous oral home care, such as daily brushing and mouth rinses to prevent plaque buildup, but in most cases the best results are achieved by extracting all the teeth in the mouth. Plaque cannot build up once the teeth have been removed.
Since Bitsy’s problem area appeared to be isolated to the very back of her mouth (other than the area that had healed once the baby tooth was removed), her parents elected to just have the teeth with the diseased gum tissue and bone loss removed; there were 14 teeth total. They will attempt to preserve the front teeth with regular brushing and professional cleaning every 6-12 months. If the condition progresses further, then they will address it at that time.
Bitsy’s gums looked great at her two week recheck and she was pain free and eating
