What are the most common signs to look out for?
- Weight loss
- Swelling of the jaw and face
- Drooling saliva from the mouth
- Long curling incisor teeth deviating laterally
- Matted hair around the incisor teeth
- Discharge from the eyes
- Mild exophthalmos
- Proptosis - the roots invade the orbit
- Grinding of teeth
- Ears back and showing signs of stress
- Accumulation of faeces (sticky Caecotrophs) under the tail
- Matted coat through lack of grooming
- Fly strike
Performing an ideal dental examination
It makes sense to check as much as possible when examining your patient. With dental disease this is particularly important, as the information you gather will help determine if the condition needs urgent attention or surgery.
- History - take a full and detailed history, including a lifetime history of what has been eaten. Pay particular attention to how much hay or grass has or has not been eaten.
- Feel the face – its well worth taking time to palpate the mandible, maxilla and orbit, checking for swellings and pain. It’s from this you may get the first signs of infection, abscess formation or elongated apices.
- Check for movement - assess the lateral movement of the mandible. It should be possible for the rabbit to move its lower jaw from side to side in normal mastication. If there is resistance there may be a problem.
- Check the teeth – do this initially with the aid of an otoscope. Pay attention to the length, quality and occlusion of the incisors and cheek teeth.
- Appreciate some limitations - bear in mind that a visual look in the consulting room will only detect an abnormality in about a half of cases.
- Sedation or anaesthesia - three quarters of dental problems can be detected visually if examined under anaesthesia.
- Open mouth - use a gag and cheek retractors to improve the visualisation inside the mouth.
- Radiography - Xrays will provide excellent views of teeth, apices and bone. This is the preferred method to get a detailed diagnosis and prognosis for most of us in practice. It will of course have to be done under anaesthetic.
Measure, compare and evaluate the radiographic information
In order to make a full assessment of a rabbit’s dental health, you need to take some xrays. Just looking in the consulting room at the teeth will diagnose less than 50% of clinical cases. You’ll need to sedate or anaesthetise the patient in order to take worthwhile images. A conscious lateral image is not enough. It’s generally recommended that you take at least two or three views, with the lateral, dorsoventral and rostro-caudal views being the most useful.
- Lateral view – try to take the radiograph with the incisors slightly separated. This is the most relevant position and will give you most of the information required to make a diagnosis.
- Dorsoventral view – from this position you can assess facial swellings, abscesses etc.
- Rostro-caudal view – this will, in combination with the other views, help build up a 3D interpretation of the dental architecture.
- Oblique view – this is only occasionally taken, but can still give you relevant information.
Take your time when look at the xrays. Record measurements and look for specific changes that may indicate dental disease. Some of our suggestions and questions include;
- Measure the crown length (supragingival)
- Check the position of the apices – are they elongated or intruding?
- Look at the alignment of the palatine bone and the mandibular ventral border – if they are parallel this could indicate cheek teeth elongation
- What are the shapes of the occlusal surfaces – incisors should be chisel shaped and the cheek teeth should have an even zig zag pattern
- What is the degree of mouth opening?
- Do the cheek teeth arcades have a normal pattern?
- What is the degree of apical elongation?
- Is there any root extension?
- Are there any missing teeth or evidence of bone loss associated with periodontitis?
- Poor prognosis? – if you see abnormalities such as ankylosis, resorption, loss of cheek teeth or advanced root elongation, the client should be informed that there is a poor prognosis. Euthanasia may be the best option.
10 dental treatment tips
- Use a high-speed electric burr – these can be attached to a standard dental polishing unit. They’re quick and safe to use.
- Staged burring - if the teeth are very long, begin by drilling to half the crown length, then half again.
- Never ‘clip’ the teeth - it’s painful and risks causing further long term damage from fractures along the tooth.
- Care with rasps – always go slowly if using these hand instruments. There is a risk that teeth may be loosened.
- Use protective equipment - make sure you use protection for the tongue, cheeks and lips.
- Know the dental anatomy - be very careful not to cut through the pulp cavity.
- Extractions – teeth that have become non-functional, or whose base support has been destroyed, are best removed.
- Destroy apical tissue – when extracting incisor teeth, destroy the growing tissue at the apex to ensure no abnormal regrowth.
- Extracting cheek teeth – this is only recommended if the teeth are associated with an abscess. Beware of removing several cheek teeth at one time. Many are slow to recover and some never return to full health
- Reduce stress - if the cheek teeth have sharp spurs on the edges, use a general anaesthetic and avoid excessive stress.
Prevention advice for owners
A high-fibre diet is absolutely essential to avoiding dental disease in rabbits. Owners should feed their pets plenty of hay and grass. At Burgess Pet Care we produce a range of high quality fibre rich diets including;