Chronic Ulcerative Paradental Stomatitis (CUPS)

Chronic Ulcerative Paradental Stomatitis (CUPS) is a disease primarily of dogs. This is a form of periodontal disease in which ulcerative lesions develop that are extremely painful. Dogs with CUPS usually have symptoms including extremely foul breath, oral sensitivity, reluctance to eat hard foods or reluctance to chew on hard toys. They may also drool excessively and frequently become quiet or withdrawn.

When CUPS lesions are present, there is inflammation on the gingiva and lining of the mouth (oral mucosa) that matches up with the crowns of the teeth.  It can be thought of as a severe inflammatory reaction where the mucosa that is in close contact with the plaque and calculus on the teeth or where saliva heavily laden with bacteria contacts the oral tissues.  The problem is caused by the chronic presence of plaque bacteria and the result is an extreme inflammatory reaction.

Typically when the teeth are ultrasonically scaled and polished and then home care including brushing is instituted these ulcerations can be improved.  Ongoing immaculate plaque control is necessary to prevent symptoms from returning.  This includes daily tooth brushing and more frequent professional cleaning.  Without these, the inflammation will persist and likely worsen over time.

Medications (antibiotics/steroids) may be necessary to help control the inflammation.  In some cases, the inflammation and ulcers can be very bad and control cannot be reasonably obtained without tooth extractions.