Toothaches!
A Guide to Dental Disease in Rabbits

Candace Hersey-Benner, DVM
Roaring Brook Veterinary Hospital, Canton, CT

One of the more common medical problems seen in pet rabbits today is dental disease, which is a very serious condition that causes an inability or reluctance to eat.
Rabbits have continuously growing teeth and it is necessary for their diet to be comprised of a wide variety of abrasive vegetation (hay and leafy greens) to provide adequate wear and prevent overgrowth. 
When a rabbit eats food is taken into the mouth with the lips and incisors and then moved via the tongue to the cheek teeth.  Food is then chewed by the cheek teeth with side to side movements of the jaw.  Abnormal movement of the jaw can cause improper wear of the teeth.  This improper wear can be the result of congenital abnormalities (those present at birth), trauma (jaw fracture), dental infections or improper diet.  Abnormal wear caused by an improper diet may not be evident for many years as most affected rabbits are usually 3 years or older when dental disease is first diagnosed.
There are a variety of signs associated with dental disease ranging from the almost undetectable to the severe.  In time, however, most dental problems eventually become painful and the rabbit will show some obvious indications of discomfort or even the inability to eat properly.  Any degree of anorexia, selective eating, dropping food items, bumps along the jaw or on the face, bulging eyes, excessive tear production, nasal discharge, or excessive salivation are all possible indicators existing dental abnormalities.
Overgrown roots, for example, cannot be easily seen but can cause bumps to form along both the upper and lower jaw or can obstruct the flow of tears and cause runny eyes.  An overgrown cheek tooth can form sharp points which can wear against the cheek or the edge of the tongue resulting in ulcers in the mouth. These ulcers can be painful enough to cause a rabbit to stop eating.
A diagnosis can often be made based on a combination of relevant history, physical examination, radiographs (x-rays) of the skull, a sedated oral exam, and blood tests.  Treatment depends on what problems are present in the mouth, and can range from simple trimming to extractions and /or removal of large abscesses.
It is obviously not possible to prevent all types of dental disease, however ensuring that your rabbit is eating an appropriate diet of unlimited timothy grass hay and a variety of fresh leafy greens daily is a great place to start.  Avoid feeding a diet exclusively consisting of commercial pellets and be aware that it is never too late to convert your rabbit over to the right diet.