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Rabbit Teeth: Good, Bad And Ugly

Your rabbit’s teeth are vital to his good health.

Sari Kanfer, DVM
Posted: September 9, 2013, 5:40 p.m. EDT

rabbit incisors
© Gina Cioli/I-5 Studio
A rabbits incisors meet in a scissorlike action, with the upper teeth in front of the lower teeth.

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Rabbits attract us with their cute appearance and fascinate us with their adorable personalities. After falling in love with your bunny, you may be concerned and think, "How can I keep my pet healthy and avoid disease?” You may have heard about some of the illnesses commonly seen with rabbits, and dental problems are commonly mentioned. Your bunny may let you see his big front teeth, called incisors, but rabbits also have back teeth that can only be evaluated by a rabbit-experienced veterinarian with specialized equipment. As a devoted owner, you can do a lot to avoid or manage dental problems in your pet rabbits.

Take A Tooth Tour
Rabbits have six incisors, two big ones on top, two big ones on the bottom, and two tiny ones behind the upper incisors, which are called peg teeth. The incisors meet in a scissoring action, with the upper incisors in front of the lowers, that slices through vegetation. Behind the incisors is a flat space without teeth called a diastema — horses have the same thing, this is where the bit sits in a horse’s mouth. 

Moving farther back in the rabbit’s mouth we find molars, commonly called cheek teeth. There are six on top and five on the bottom on each side. All rabbit teeth are very long, but the majority of each tooth is buried inside the bones of the jaws. The small amount of tooth exposed above the gumline is called the crown and the portion of tooth below the gumline is called the root. The edges of the molars meet at a slight angle, and the jaw moves side to side to crush the food. 

Rabbit teeth are very different from human teeth in that they are constantly growing, an adaptation seen in animals that eat vegetation. All animals that primarily eat vegetation are called herbivores. This includes rabbits, guinea pigs, chinchillas, horses, cattle, deer and more. Their natural diet consists of grass, dried grass, weeds, leaves and branches. These items are very tough and fibrous, and therefore teeth get very worn down from chewing these foods. So herbivores adapted to this diet by having teeth that are constantly growing, in order to replace what is lost by chewing. 

Watch What Your Pet Eats
The recommended diet for rabbits consists of 80 to 90 percent grass hay (timothy, orchard, oat and other grass hays). Alfalfa hay is higher in calcium and protein, so it is good for babies, nursing moms, and old or sickly bunnies. Always offer fresh, high-quality hay. Fresh yard grass is good also, just make sure there are no fertilizers or pesticides used, and make sure your rabbit is safe when it spends time outdoors. Wood-based toys can also help wear down teeth, but hay and grass are the best for wearing down the molars.

The remainder of a rabbit’s diet should be a limited amount of pellets and green leafy vegetables, with a very small amount of treats. The reason that we must limit pellets, vegetables and treats, is that if we don’t, rabbits will fill up on these foods and eat a smaller proportion of hay, which could allow the teeth to grow too long. If you feed your rabbit a diet that is less than 80 percent hay, then he is at risk for dental problems.

Some rabbits have the genes for perfect teeth, and even if fed a terrible diet will never have problems. And then there are the rabbits that are born with bad teeth. But the majority of rabbits are in the middle, and we commonly see middle-aged rabbits developing dental problems from years of not eating enough hay. So the best way to prevent dental problems, as well as intestinal problems and obesity, is to feed your rabbit a diet high in fibrous hay.

Know Common Tooth Troubles
Malocclusion means that teeth are meeting incorrectly. Rabbits can develop malocclusion of just the incisors, or just the molars, or a combination of both. There are a few common ways that dental problems develop in rabbits: 

1) Due to insufficient tooth wear, the molars get too long. This pushes the jaws farther apart and changes how the incisors meet. Initially the incisors start to hit each other, then the lower incisors start to grow in front of the uppers. They can get very long and cut into the lips or look like elephant tusks.
2) With a low-fiber diet, the molars get too long, the upper molars curve sideways and form a sharp spike cutting into the cheek or the lower molars curve inward and form a spike cutting into the tongue. 
3) Chronic poor diet and/or genetics can cause molars to grow crooked instead of straight.
4) A rabbit falls and fractures the upper incisors, and they grow back in abnormally or out of balance with the lower incisors.
5) Insufficient wear causes teeth to get long and hit one another with increased force. This causes inflammation around the tooth roots, and frequently leads to infection and abscess formation. 

Once the teeth become abnormal, in most cases, the teeth are abnormal for life. 

Be Alert To Trouble
Signs to watch for are a change in your rabbits’ eating habits. Be alert to any of the following.

1) If he stops eating hay and pellets, and only eats vegetables. 
2) If he is eating less food overall. 
3) If he runs up to the food as if he’s hungry, sniffs it, then walks away without eating.
4) If he has episodes of anorexia that recur every few months.
5) If you notice moisture around his mouth or on his chin, or a sour odor to his breath, there may be dental problems.

In addition to watching for signs of trouble, make it a habit to examine your pet. Feel your rabbit’s jawbone regularly, know what feels normal, and monitor for any new lumps. You can lift his upper lips and check that the incisors are meeting properly. 

The best way to determine if your rabbit has tooth problems is to take him to a rabbit-experienced veterinarian as soon as you get your rabbit, and then annually for a physical exam that includes an oral exam. Sometimes, the veterinarian will have to do X-rays of your rabbit’s head or look at the teeth under anesthesia to know for certain if your rabbit has bad teeth. 

Find A Rabbit-Savvy Vet
If you bring your young rabbit to a veterinarian and identify a tooth problem in the early stages, there may be a way to reverse or delay progression of dental problems. For very slight abnormalities, it may be as simple as changing the diet: limiting pellets, vegetables and treats, and feeding mostly hay. 

But usually the teeth need more advanced treatment. The sooner dental problems are recognized, the better, because as time goes on, things will get worse and overgrown teeth often lead to abscesses and chronic pain. It is also very helpful to treat tooth problems aggressively at first, to get the best long-term outcome.

It is extremely important to take your rabbit to a veterinarian who is very experienced with performing rabbit tooth trims. Find out if he or she has attended special lectures and labs to learn about trimming teeth, and if the veterinarian has textbooks that cover dental problems in rabbits. Does he or she use a dental drill or dremel to trim molars (good) or do they cut the molar teeth with a rongeur or handfile (not as good)? When using rongeurs to cut the molars, the teeth often fracture and get damaged, and you cannot make fine adjustments to normalize the teeth. A handfile will not allow for sufficient trimming of overgrown teeth. Veterinarians without enough training and experience may misdiagnose problems, or just not treat the problem as aggressively as is needed for the best outcome. You can locate a rabbit veterinarian with dental training by searching online at the Association for Exotic Mammal Veterinarians, www.aemv.org, by contacting your local rabbit rescue group or searching the SmallAnimalChannel veterinarian listing

Treatment: What To Expect
Treatment of elongated molars: If your veterinarian diagnoses your rabbit with malocclusion, the first step, ideally, is X-rays of his skull. X-rays show us how long the teeth are so we know how much to trim, and we can evaluate the roots for inflammation or infection. The next step is placing the rabbit under anesthesia. The molars are very far back in the rabbit’s mouth, and conscious rabbits will not open their mouth wide to allow proper treatment.

While your rabbit is asleep, your rabbit-experienced veterinarian can fully evaluate all of the teeth and determine what treatment your rabbit needs. If the molars are too long, these will be trimmed shorter using a specialized dental drill. If there are loose, rotten teeth, those need to be pulled. If the teeth are growing at an acute angle, your vet can adjust the angle to allow the teeth to meet better.

After trimming the molars shorter, this allows the incisors to meet better, and these need to be trimmed shorter as well. The aim for trimming teeth is to get them to meet as normally as possible. Experienced exotic vets can usually get better long-term results by trimming teeth back to more normal occlusive angles and crown heights. Less experienced veterinarians might just trim off the sharp edges. 

If your rabbit has stopped eating or is too skinny, then he should have several days, or sometimes a few weeks, of syringe-feeding and pain medication before he goes under anesthesia. If rabbits are sick, then they may not be strong enough to handle the anesthesia right away. And supportive care after the tooth trimming is just as important. Sometimes it may be a few days before your rabbit will be able to eat on his own, so he will need to be syringe-fed and have pain medication and antibiotics.

Once your rabbit has developed molar malocclusion, he will need to have his teeth monitored closely. Most rabbits with malocclusion require anesthesia and molar trims every three to six months for the rest of their lives. In some cases, their teeth will improve from the trimming and high-fiber diet, especially in mild cases that are caught early. 

Treatment of incisor malocclusion with normal molars: If on skull X-rays your veterinarian determines that the molars are completely normal, but the incisors are maloccluded, then we can try to train the incisors to meet correctly. The incisors are trimmed using a dental drill with the rabbit awake. The incisors are trimmed short and are angled to encourage them to scissor properly, with the upper incisors in front of the lowers. In some cases, performing this corrective incisor trimming every one or two weeks for several weeks can train the incisors to meet normally again. Sometimes the molars need to be trimmed shorter under anesthesia at least once to allow the incisors to meet at a better angle. 

If the incisors do not normalize after this treatment, then it is ideal to remove the incisors entirely. Gasp! A rabbit without incisors, you ask? In reality, removing the abnormal incisors gets rid of a source of constant frustration and pain, and rabbits can eat hay, pellets and veggies just fine. The veggies just need to be long and thin, like parsley, or cut into small pieces. Rabbits with abnormal incisors already are unable to use their incisors to grab and cut food, so they are usually thankful to have the bad incisors out of their way. The rabbit does need to be under anesthesia for the incisors to be pulled, but it will have lifelong benefits.

If the abnormal incisors are not removed, then they need to be trimmed every month for the life of the rabbit. This can be stressful to the rabbit, and sometimes painful. If a dental drill is used, there is minimal discomfort. If nail trimmers or bone cutters are used, they cause trauma to the tooth as well as pain from the concussive forces. They can cause splitting of the tooth longitudinally, resulting in infection of the root. Some people trim their rabbit’s incisors using nail trimmers. This is not recommended, and frequently leads to worsening tooth problems. Working with an experienced rabbit vet will give your rabbit the best chance of staying pain-free and happy.

Can A Rabbit Live With Malocclusion?
If the malocclusion is properly treated, then the answer to this question is yes! Some people hesitate to put their rabbit through tooth trims under anesthesia or surgery, fearing pain and suffering for their pet. When rabbits are asleep under anesthesia, they don’t feel anything, and after the procedure they receive pain medications, and usually recover quickly. The amount of discomfort from the procedures is minimal, especially compared to the suffering from untreated, abnormal teeth. 

Some people feel that euthanasia is better than having to get molar trims every four months. But if you talk to rabbit owners who have been through the molar trims, abscess surgeries or incisor extractions, you will hear that the rabbits are otherwise healthy and happy, and the owners are glad they have their beloved friend racing through the house, doing binkies. Most rabbits with malocclusion that receive proper treatment can live long happy lives.

For more articles about rabbit health, click here>>
For rabbit health questions and answers, click here>>

Posted: September 9, 2013, 5:40 p.m. EDT


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Rabbit Teeth: Good, Bad And Ugly

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Excellent article. I treat quite a few rabbits, and this is one of the best client information sheets I've seen.
Deborah, Newberry, FL
Posted: 9/17/2013 8:32:20 AM
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