Changes

==Introduction==

==Introduction==

Alterations in the position, shape and structure of the molars leads to malocclusion of the cheek teeth. Deterioration of tooth and bone quality can also contribute to the development of malocclusion.

Alterations in the position, shape and structure of the molars leads to malocclusion of the cheek teeth. Deterioration of tooth and bone quality can also contribute to the development of malocclusion.

The pressure of opposing cheek teeth leads to stoppage of growth and alteration in the pulp cavity and germinal tissues accentuates the hitherto normal angulation of the teeth. In normal rabbits, the cheek teeth are tilted: uppers, laterally towards the cheeks; lowers, medially towards the tongue. This is accentuated once the germinal tissues are affected. Initially the teeth tend to curl then become progressively distored. Sometimes these abnormal growing patterns result in the formation of discrete spurs with extremely sharp edges. This can lead to loosening of the teeth, thus increasing the risk of foreign material entering the socket.

The pressure of opposing cheek teeth leads to stoppage of growth and alteration in the pulp cavity and germinal tissues accentuates the hitherto normal angulation of the teeth. In normal rabbits, the cheek teeth are tilted: uppers, laterally towards the cheeks; lowers, medially towards the tongue. This is accentuated once the germinal tissues are affected. Initially the teeth tend to curl then become progressively distorted. Sometimes these abnormal growing patterns result in the formation of discrete spurs with extremely sharp edges. This can lead to loosening of the teeth, thus increasing the risk of foreign material entering the socket.

Continuous growth and pressure against the crowns of the teeth in the opposing jaw stops the jaw closing and strains the masseter and temporalis muscles – a vicious cycle leading to atrophy of disuse of the jaw and a further reduction of bone density.   

Continuous growth and pressure against the crowns of the teeth in the opposing jaw stops the jaw closing and strains the masseter and temporalis muscles – a vicious cycle leading to atrophy of disuse of the jaw and a further reduction of bone density.   

Malocclusion of the cheek teeth can lead to [[Incisor Overgrowth – Rabbit|incisor overgrowth]], and the observation of long protruding incisors might be the first sign of a cheek teeth problem the owner will notice.       

Malocclusion of the cheek teeth can lead to [[Incisor Overgrowth – Rabbit|incisor overgrowth]], and the observation of long protruding incisors might be the first sign of a cheek teeth problem the owner will notice.       

==Clinical Signs==

==Clinical Signs==

Clinical signs relate to the pain experienced and the inability of the rabbits to eat normally:  

Clinical signs relate to the pain experienced and the inability of the rabbits to eat normally:  

'''Lack of grooming''' leads to a poor coat, build-up of skin debris and [[Mites - Rabbit#Cheyletiella parasitovorax|''Cheyletiella'' mite infestations]].

'''Lack of grooming''' leads to a poor coat, build-up of skin debris and [[Mites – Rabbit#Cheyletiella parasitovorax|''Cheyletiella'' mite infestations]].

'''Digestive disorders''' are often seen: ileus, reduced number of droppings, intestinal obstruction from the ingestion of fur mats.

'''Digestive disorders''' are often seen: ileus, reduced number of droppings, intestinal obstruction from the ingestion of fur mats.

'''Uneaten caecotrophs''' due to a difficulty in reaching and ingesting the droppings. This leads to soiling of the perineal skin and can become a [[Cutaneous Blowfly Myiasis – Rabbit|fly strike]] if severe enough.

'''Uneaten caecotrophs''' due to a difficulty in reaching and ingesting the droppings. This leads to soiling of the perineal skin and can become a [[Cutaneous Blowfly Myiasis – Rabbit|fly strike]] if severe enough.

'''Epiphora and dacryocystitis''' due to impingement on the nasolacrimal duct by the elongated roots and the upper incisors, often with secondary bacterial infection.

'''Epiphora and [[Dacryocystitis – Rabbit|dacryocystitis]]''' due to impingement on the nasolacrimal duct by the elongated roots and the upper incisors, often with secondary bacterial infection.

'''Abscesses''' seen as hard lumps along the ventral border of the mandible, or retrobulbar abscesses.

'''Abscesses''' seen as hard lumps along the ventral border of the mandible, or retrobulbar abscesses.

'''[[Incisor Overgrowth - Rabbit|Incisor malocclusion and overgrowth]]''' due to the lack of correct chewing motion due to cheek teeth malocclusion.

'''[[Incisor Overgrowth – Rabbit|Incisor malocclusion and overgrowth]]''' due to the lack of correct chewing motion due to cheek teeth malocclusion.

'''Pain and anorexia''' due to the spurs on the cheek teeth. There is often profuse salivation and staining of the fur under the chin and on the forelegs.

'''Pain and anorexia''' due to the spurs on the cheek teeth. There is often profuse salivation and staining of the fur under the chin and on the forelegs.

==Trimming Cheek Teeth==

==Trimming Cheek Teeth==

This is often requested by owners to prevent regrowth of spurs that require regular trimming. However the extraction of cheek teeth is inadvisable and often unnecessary, unless periapical abscesses due to the dental disease are present.

This is often requested by owners to prevent regrowth of spurs that require regular trimming. However the extraction of cheek teeth is inadvisable and often unnecessary, unless periapical abscesses due to the dental disease are present.

Extraction of cheek teeth follows the same principles as [[Incisor Overgrowth - Rabbit#Extraction of incisors|incisor extraction]] – special sharp elevators or bent hypodermic needles are used to cut the periodontal ligaments around these box-shaped structures.

Extraction of cheek teeth follows the same principles as [[Incisor Overgrowth – Rabbit#Extraction of incisors|incisor extraction]] – special sharp elevators or bent hypodermic needles are used to cut the periodontal ligaments around these box-shaped structures.

It is not necessary to remove the opposing cheek tooth as an upper tooth occludes with two lower teeth and vice versa. Also, adjacent teeth tend to tip towards any gap that is left.

It is not necessary to remove the opposing cheek tooth as an upper tooth occludes with two lower teeth and vice versa. Also, adjacent teeth tend to tip towards any gap that is left.

'''Intra-oral approach''': <br>

'''Intra-oral approach''': <br>

This technique is used when there is no gross apical ankylosis. The procedure is essentially the same as that for [[Incisor Overgrowth - Rabbit#Extraction of incisors|incisor extraction]] except that forceps are used for the final extraction after the tooth has been fully mobilised in its “socket”.

This technique is used when there is no gross apical ankylosis. The procedure is essentially the same as that for [[Incisor Overgrowth – Rabbit#Extraction of incisors|incisor extraction]] except that forceps are used for the final extraction after the tooth has been fully mobilised in its “socket”.

Luxators are used to loosen the periodontal membrane especially on the mesial (palatal/lingual) and lateral (buccal) aspects of the tooth. Careful elevation with horizontal sectioning and removal of successive portions is generally effective when the root is too long to remove in one piece.  

Luxators are used to loosen the periodontal membrane especially on the mesial (palatal/lingual) and lateral (buccal) aspects of the tooth. Careful elevation with horizontal sectioning and removal of successive portions is generally effective when the root is too long to remove in one piece.  

Avoid muesli type mixes.

Avoid muesli type mixes.

            

            

==References==

==References==

Harcourt-Brown, F. (2002) '''Textbook of Rabbit Medicine''', ''Elsevier Health Sciences''

Harcourt-Brown, F. (2002) '''Textbook of Rabbit Medicine''', ''Elsevier Health Sciences''

{{review}}

{{review}}

[[Category:Rabbit Dentition]]

[[Category:Rabbit Dentition]]

[[Category:Expert Review - Exotics]]

[[Category:Expert Review - Exotics]]