Dental Disease

TIP – Monitor your rabbits eating habits closely.  As soon as teeth issues are suspected get your rabbit to a vet so the problem can be dealt with quickly.  The longer it’s left, the more complications like abscesses & the weaker your rabbit will be if it is not eating properly.
Dental disease that is left will be fatal.

A rabbits teeth need to be properly formed & in alignment to allow the normal workings of the jaw. If they are not then that is when dental disease occurs. Any cheek teeth that are not aligned, do not wear evenly, causing spurs to form on the edge of the teeth resulting in the rabbit being unable to eat properly.  Any incisors not aligned become overgrown resulting in the rabbit being unable to eat.

Some rabbit breeds are more likely to suffer from teeth problems. Rabbits that have a small & compacted head, & shortened nose especially if they are combined with a Dwarf, are particularly at risk.  These breeds include the Dwarf Lop, Netherland Dwarf, Lionhead & Mini Lop.

Dental disease can bring with it a whole host of complications. Abscesses in the mouth or head area & blocked tear ducts are the most common.  Rabbits have a network of chambers around their head & the infection can spread causing ear & eye infections.
If dental disease is not caught early enough or left it can be fatal.

 

The Teeth

  • A rabbits front teeth include four sharp incisors.  Two at the top & two at the bottom.
  • Behind the upper incisors are two smaller teeth known as peg incisors or peg teeth. The bottom incisors lie comfortably on the peg teeth when the rabbit is at rest.
  • The cheek teeth comprise of twenty two premolars & molars. (The premolars & molars are often referred to as cheek teeth when talked about as a group).
  •  Rabbits do not have any canine teeth.
  • Their teeth continually grow throughout the rabbits lifetime.
A normal pair of incisors.

Functions of the Teeth

  • The Incisors slice food & are used for grooming. They grasp dead hair & remove it from the fur in a pincer motion.
  •  The Molars grind the food on one side of the jaw at a time.
  •  The teeth have deep grooves that create ridges which are excellent for breaking down the fibrous plant material e.g. hay.
  •  The tongue helps to get the food into the mouth.

 

Common Causes of Dental Disease

  • Injury
  • Hereditary. (Genetic).
  • Misalignment of the Teeth. Often referred to as Malocclusion, basically it’s where the upper jaw & lower jaw are misaligned.
  • Old Age. The teeth can shift position.
  • Poor Diet. A diet lacking in fibre.


Symptoms

  • Difficulty eating.
  • Saliva. Wetness usually around the chin.
  • Reluctance to eat hard food.
  • Loss of weight or a decrease in appetite.
  • Smelly breath.
  • Signs of pain, such as hunched up & grinding teeth.
  • Nasal discharge or discharge from the eye sockets. Could indicate an abscess that has been caused by the teeth problem.
  • Poor coat condition.
  • Change in faecal output.  Less than normal & smaller.
  • Swellings on the face.  Could be an abscess or severe inflammation caused by the teeth problem.
  • Mucky bum. Faeces that have stuck round the bum & surrounding area.

 

Treatment

Overgrown Incisors

This is where the front incisors are misaligned so as they grow they do not wear down. This causes them to grow too long & start to curl. The teeth as they curl can start to look like a mammoth’s tusks as they tend to head sideways.  They can also start to curl back on themselves into the mouth & cause injury to the roof of the mouth.

Treatment is regular burring of the teeth.  They should not be clipped as clipping can split the tooth or break unevenly allowing a risk of infection in the tooth root.
For this procedure the rabbit is usually conscious or lightly sedated.
Sometimes it is necessary to have the front teeth removed. This is done under general anaesthetic.  All four incisors will be removed & the peg incisors. It is important that all the pulp tissue is removed otherwise the teeth will grow back.
Read Woody’s story for an example of this happening. Woody’s Story.

Molar Problems

This is where the cheek teeth are not wearing evenly causing spurs to form on the edges of the teeth.  These spurs then cause injury to the cheeks & tongue.  This is very painful for the rabbit.
Treatment is for the offending teeth to be filed down, the aim is to make the teeth a normal length & size.  This is done under general anaesthetic & an x ray is sometimes taken to get a better idea of what is going on in the mouth.  Cheek teeth aren’t generally removed as it is major surgery & requires intensive aftercare. However, if any of the teeth are loose or diseased then they are removed.  Depending on why your rabbits teeth are misaligned will determine whether regular dentistry is required.

Aftercare

After incisor removal you should cut your rabbit’s food into bite sized pieces. They manage well after incisor removal using their tongue to put food into their mouth. The rabbit will need assistance grooming as the incisors are the teeth that remove dead hair.

After molar filing your rabbit should pretty much be back to eating normally within 24 hours depending on if there were any other complications.
Other complications could be an abscess was found or infection elsewhere in the head.

 

Prevention of Dental Disease

A good high fibre diet can prevent most dental disease. This should consist of grass & an unlimited amount of hay. These are the best foods for wearing your rabbits teeth down. Giving them things to chew on can help, tree branches are particularly good. Rabbits who already have dental disease can be maintained by the diet so that they do not require any further dentals. However, if your rabbits teeth problems are genetic & quite severe the diet can help enormously but your rabbit will likely still require regular dentals.

My Experience

Brothers Midnight, Major, Domino & Cas.
Brother & sister Snuggles & Blossom.

My first experience with teeth problems was with an accidental litter in the early nineties. The above 6 rabbits are 5 brothers & 1 sister.  Major, Domino & Snuggles all had cheek teeth problems, the other 3 were all fine.
Snuggles was the first to start when he stopped eating.  I took him to the vets several times over the problem & he was pumped full of antibiotics & other drugs in an attempt to get him to eat.  I had never had rabbits with teeth problems & it never even occurred to me, I was an inexperienced rabbit owner back then. It was only when we were quite a way down the line with Snuggles that the vet suggested his teeth could be the problem.  He said he’d have a look which required an anaesthetic.
It was an awful day as Snuggles was quite weak & the anaesthetic risk was high back then.  Snuggles came home with no apparent teeth issues.  Sadly,  he died a couple of days later.
Within weeks Domino & Major started with the same symptoms & the vet did exactly the same as before, however, I was not happy & went for a second opinion.  It was found that both Domino & Major had cheek teeth problems.  They immediately had the operation to file the offending teeth. Both hadn’t eaten now for quite some time.  They both survived the operation but it was going to be touch & go with the recovery.
That night Domino passed away, he hadn’t eaten for so long his liver could not get the anaesthetic out of his system.  Major however survived. He had managed to keep eating bits by biting them with his front teeth & swallowing. Major had to have more dentals throughout his life but lived until the age of 10 years.

This was a huge lesson for me in being made aware of teeth problems & realising you have to question the vet & not put blind faith in them.  I strongly suspect Snuggles never had an operation to check his teeth as it must have been the problem taking into account what happened to his brothers.

Woody

Woody’s teeth problems were the worst I have ever had to deal with. It wasn’t just his cheek teeth that were the problem it was his incisors too.  Woody came to me as an unwanted pet when he was 9 months old.  The first thing I noticed about him was he was a little on the thin side & once  home I noticed he was having problems eating.  On inspection of his mouth I could see his incisors were too long.  I took him to the vets & his front teeth were burred. A check of his cheek teeth revealed he was also starting to have problems there too. A better check of his cheek teeth was made when I had him castrated, whilst he was under an anaesthetic it was a good opportunity.  The findings were not great, basically it looked like you’d got a handful of teeth, opened his mouth & randomly thrown the lot in.   This was all down to genetics & bad breeding.

For the next 2 years it was a case of maintaining his teeth the best we could which involved regularly burring of his incisors & filing of his molars.  His tears ducts were also affected by the teeth problems.  The tears no longer ran freely as kinks had occurred within the tear duct tubes.  This meant he had to have regular periods of eye cream & antibiotics when the tears became infected.

Late in 2007 things started to change & he was having to have his incisors burred every 3-4 weeks & his tear ducts flushed on a regular basis.  By week 3 his eating had usually reduced causing gut issues & the constant feel of a squishy tummy.  Once the incisors were burred he had about 2 weeks of good eating & then we were back to the squishy tummy & reduced eating. All his problems seemed to be on the increase too & he wasn’t happy.
After a lot of serious consideration weighing up the pros & cons  I made the decision to remove his incisors.
The day of the operation was nerve wrecking as Woody could die due to the length of time the procedure would take. Fortunately,  Woody came round well from the operation but it hadn’t gone quite to plan.
Removal of the incisors isn’t an easy operation as there is a risk of tooth breakage which unfortunately happened to Woody.  It was a waiting game to see if it grew back.  In the meantime Woody had to adapt to eating without his front teeth.  He did struggle to eat but I managed to get enough food in him to keep him ticking over. He also got an infection which showed via pus coming out of his tear ducts so he was put on antibiotics along with eye cream.
Once the infection got under control & Woody had got the hang of eating without his front teeth there was no stopping him. His vegetables had to be cut up into small chunks or grated.  He managed his pellets fine & drinking was no problem.
Unfortunately, 5 months later Woody’s broken tooth had grown back.  I detected something was wrong by his reluctance to eat & examining him I found an injury to his mouth which had been caused by the tooth.  He had the operation to remove the tooth & when it was removed an infection was found.  They had also flushed his tear ducts as they too were full of pus.  A month later after a course of antibiotics the infection in his mouth had cleared but his eyes still needed eye cream.  A short time later the eyes did clear.

A few months later it became apparent that we needed to come up with a better way of managing Woody’s tear ducts. They were having to be flushed every 3 months which wasn’t ideal for Woody.  So we did one last huge flush & got as much pus out as possible.  In fact the vet didn’t give up until he had got to clear tears.  From that day on he was to have eye drops, one drop in each eye for the rest of his life.  On a recheck several months later his eyes were doing so well it was decided to administer the eye drops once every other day.

Over the years Woody’s maintenance increased.  In his last year he was having regularly dentals on his cheek teeth, eyes bathed &  drops applied everyday, frequent gut issues, antibiotics for various infections & a mucky bum so required regularly baths.  Psychological affects on Woody was that he became very obsessive over the food often not allowing his partner, Tansy, anywhere near the food dish.  In the end I fed them separately. After each dental Woody had to be separated from Tansy as he would stress so much over the food & he recovered better on his own.

All was well with the maintenance until I found a pea sized lump on his jaw, his cheek was swollen & his chin was wet.  The wet chin indicated that his cheek teeth required filing again but the pea sized lump was a huge worry & the swollen cheek.  Was it an abscess or tumour? My gut told me it was going to be bad.
At the vets Woody had an x ray & it revealed the cheek teeth on the right were ok but one or two of the roots were starting to push through the jawbone. As for the left side of the cheek  teeth, well that was a different story. It would appear that as impossible as it should be his bottom teeth were not growing & had sunken into his gum, therefore his gums were going over his teeth & when he was chewing, as it is a circular motion, he was catching his cheek as well as the gums over his teeth.
So the vet filed his top teeth as low as possible to give the gums & cheek a chance to heal but obviously the problem was we needed enough time for them to heal before the top teeth grew back & there was nothing for them to grind down on so it was going to happen again. One option was to remove those teeth but it is a tricky operation, some rabbits jaws break. They take the teeth from underneath the jawbone.
The other option was to take him every time his top teeth grew too long.  This posed some serious questions :

  •  What if the teeth grew back at a rapid rate? Which his had a tendency to do.
  •  Was it fair to make him have an operation that often?
  •  How would his heart deal with that many anaesthetics?  He’d already had a lot & his age of 6 years meant he was no spring chicken.

Another weird thing was the roots on the left side were very deformed,  like nothing the vet had seen, one root was pear-shaped & they too were starting to push through his jawbone.
The main priority at this stage was to reduce the swelling & get him eating. So it was antibiotics & over the course of the next few weeks the swelling had reduced.  However, he still wasn’t eating great.  It had got to the point of liquidizing his food.  I also gave him lots of ‘treats’ not the food kind as he wasn’t interested but I let him play out around the shed frequently & different places so he kept his interest up, & didn’t just give up which rabbits can so easily do.  He definitely was enjoying more time with Tansy as long as no food was involved.
Woody’s eyes deteriorated next & milky tears were now being produced which is a sign of infection & he stopped eating. There was no obvious sign as to why he had stopped eating so he had injections to try to stimulate his appetite  & I continued to liquidize his food.  I had been regularly weighing him the last few weeks & finally we’d got to a point where there was no weight loss.  The next few weeks we had nothing but good & bad days of eating.  It was so inconsistent to the point it was hard to be objective as to know how he was actually doing.  I had a good talk with my vet & he suspected that the skin had grown back over the teeth.  So it was back to the vets for a check. It was confirmed that the skin had grown back over his teeth & there were several blood vessels going in every direction throughout his gums which was a very bad sign.  It meant that something else was going on like a tumour. Obviously, there was nothing they could do for him & that also explained why he was so up & down with his food.  Some days it would hurt, other days it would not. So the decision was made to put Woody to sleep.
Woody had an amazing strength to get through all those operations over his lifetime, not to mention the daily handling he had to put up with. A lot of rabbits would have given up due to the amount of constant stress. The dedicated care of the vet involved helped tremendously too.  Not all vets would have persevered with those tear ducts to get them clear.  Woody was very lucky to have such a good vet on his side.

Old Age & Teeth

Kitty. As she aged her teeth shifted position causing the roots to kink her tear ducts.
Pebble. As she aged her teeth shifted position so that they wore unevenly.

Several of my middle aged to senior bunnies,  (5- 10 year olds), have acquired teeth problems.  Usually it has been the odd molar that has changed positon so it then begins to wear unevenly.  Most have required only 1 dental operation in their lifetime.
Sometimes this shift in position of the tooth or teeth have caused the roots to press on the tear duct resulting in a kink in the tube thus causing the tear ducts to become blocked.  The rabbit has then been required to have tear duct flushes & eye drops on a regular basis.

Rumble

Rumble’s cheek teeth were a potential for teeth issues but a good diet meant they were never a problem.

Patch

Patch’s cheek teeth were a potential to cause problems, for several years nothing had to be done, only a close eye had to be kept. Eventually, she did have to have a dental as a couple of spurs were found right at the back of her mouth. I believe the diet kept her teeth in check until she became older, & that is when the teeth can shift at which point a good diet will help but not stop the problem.

Daisy

Daisy is one of my current rabbits who had to have a dental back in February 2020. There has never been any sign of teeth problems, it was in a routine check when she was having her vaccinations that the problem was found. She had three spurs on her back lower teeth that were filed. What is unusual about Daisy is that her teeth have always been fine & she is a very good hay eater, so we’re unsure as to why she had the spurs. Daisy is heading for her senior years & one of her eyes is slightly watery, so it may be that her teeth have shifted slightly. She is one to keep a very close eye on from now on.

Among my current bunnies I have 3 with teeth problems:

Daisy – See above.
Thumper – Had to have his cheek teeth filed at the sanctuary before he came to me but no problems since. He arrived here in March 2016.
Toffee – Cheek teeth, unsure if he has had any dentals in the past. Teeth so far, have been kept in check by his diet.

Thumper & Toffee are examples of rabbits that have teeth problems but are being maintained by the correct diet.  I will be as strict with food as I have to be with any of my rabbits to stop dental disease.  I never want a repeat of Woody’s situation.