Box Turtle Health Issues: Mouth Rot (Stomatitis)


Box Turtle Closeup; this guy doesn't want mouth rot

This guy says he doesn’t want mouth rot
Cropped version of photo by Audrey @ Flickr;
licensed under CC BY 2.0

Infectious stomatitis is an infection in the mouth that can make it look like the mouth is rotting away—giving it its common name of mouth rot.

Mouth rot is more common in other reptiles than in chelonians (box turtles are chelonians). Even so, box turtles can get it, especially if the animal’s environment or diet is poor.

So it’s worth knowing how to recognize and treat it. And treatment is important, because if it gets too advanced, it can affect the bone.

Recognizing Mouth Rot

Early symptoms of mouth rot include:

  • Not eating or eating less
  • Increased saliva around the mouth
  • White substance in and/or around the mouth that looks like cottage cheese
  • Dead skin around the mouth
  • Red spots/blood blisters on the tongue

Left untreated, it can keep spreading. After a while it can cause a swollen head. Eventually it may spread to the bone.

It can also cause pneumonia if the infection gets into the lungs or a stomach infection from swallowing infected mouth tissues/pus. Yuck! Please get treatment before this happens 🙁

Causes of Stomatitis

Mouth rot is what is known as an opportunistic disease or secondary infection. This means that the infection flares up because the turtle’s immune system has been weakened.

Often the cause of the weak immune system is another infection. The turtle’s body is trying hard to fight off that infection, so it can’t control the germs causing the mouth infection.

Both fungus and bacteria can cause stomatitis. So can viruses.

Common bacterial causes can include:

  • Aeromonas
  • Pseudomonas
  • Salmonella

These bacteria often live in/on the turtle without causing problems. But, as mentioned, if something weakens its immune system, they can grow out of control.

Other stresses that can weaken the immune system include a habitat at the wrong temperature, poor nutrition or a parasite infection.

Treating Mouth Rot

You will need a vet’s help to treat mouth rot. It involves flushing out the mouth with antiseptic solution and scrubbing off the affected tissues.

You will also need to treat the other infection, and your pet may need antibiotics. Depending on what, exactly, is going on with your pet, you may need to put topical antibiotics on his mouth and give injected antibiotics for the other infection. Your vet will decide the best course of treatment.

If the infection does not respond quickly, your vet may want to culture the bacteria to identify them. This can help in choosing an antibiotic that will work better.

You may have to work hard to entice your turtle to eat for the first few days. If he refuses food completely, you may have to feed him a puree until he’s willing to eat again.

If you have more than one turtle, you’ll want to isolate the sick one in a hospital tank, probably with the temperature near the high end of box turtles’ preferred gradient (around 80° F). Your vet can give you more specific instructions.

Having a hide box in his isolation tank can help him feel less stressed. These steps can help his immune system work as good as possible and give the antibiotic a better chance to work.

Preventing Stomatitis

Since stomatitis is often a secondary infection, one of the best ways to prevent it is to keep your pet healthy. And if she does get sick, treat her right away so secondary infections don’t have time to take hold.

Make sure her environment is good (especially temperature and UV light), she’s getting a variety of nutritious foods and has regular access to water. Keep the habitat—and especially the water dish—clean, too.Box turtle eating strawberry

Hopefully you’ll never have to deal with mouth rot in your box turtle, but if you do see signs of it, get your pet to the vet for treatment right away.


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