Epulides (epulis for singular) are the most common benign oral tumors in dogs. There are two kinds of epulides: peripheral odontogenic fibroma and acanthomatous ameloblastoma. Epulides are benign; they do not spread to other areas of the body. However they tend to regrow after incomplete excision and can be locally invasive/destructive.
What Is An Epulis?
An epulis is a tumor located in the gum tissue surrounding the dog's teeth. The tumor originates from the tissue that connects the teeth to the bone of the jaw. These tumors are benign. They tend to invade nearby oral tissue and will require the removal of the tumor growth and surrounding tissue. It can even lead to the removal of all or part of the jawbone.
Signs of Epulides in Dogs
Epulides are growths that form between the dog's teeth. They are usually firm, smooth, and similar in color to the gums. Epulides are more common in middle-aged dogs. Medium to large breed dogs are affected most commonly. A dog with an epulis may show one or more of the following signs:
- Bleeding gums
- Displaced teeth
- Increased drooling
- Swollen jaw
- Tooth loss
- Particularly bad breath
- Weight loss
- Difficulty chewing
- Reduced physical activity
Types of Epulides
Determining which type of epulis your dog has will help determine the specific course of action. Treatment options vary with the type of oral tumor.
- Peripheral odontogenic fibroma (previously known as either fibromatous or ossifying epulides.) This epulis originates from the ligament that attaches the tooth to the jaw bone. They do not invade into the underlying bone. They appear similar to focal gingival hyperplasia. They are usually slow growing and firm and found in the front portion of the upper jaw, directly under the nose.
- Acanthomatous ameloblastoma (previously known as acanthomatous epulides) also originates from the periodontal ligament holding the tooth in the jaw. This form of epulides is locally aggressive and frequently invades the underlying bone. They are most commonly found on the front portion of the lower jaw.
If you notice a mass, odor, or other changes to your dog's gums or mouth, or if any of the signs listed above are present, a visit to the veterinarian is in order. Your vet will examine your dog's mouth. This could entail administering a light sedative to help your veterinarian get a good look as many dogs resist their mouth being examined. If a mass is seen, a biopsy is recommended to rule out other types of cancer. Radiographs (x-rays) can identify if there is invasion into the upper or lower jaw bone. A CT scan provides more accurate information regarding the size and extensiveness of the tumor. Once the diagnosis is confirmed, surgery is the next recommended step.
Surgical removal is curative. Smaller tumors can be removed quickly and with minimal risk for complications. The surgery is more complex if the tumor spans multiple teeth. For large and invasive tumors, referral to a board certified veterinary surgeon or dentist is the best option. A CT scan is essential for planning complicated resections.
Peripheral odontogenic fibromas usually can be removed with a superficial surgery. Surgery is also the treatment of choice for acanthomatous ameloblastomas. The difference is the latter tumors invade bone, therefore complete excision requires partial mandibulectomy (removal of the lower jaw) or maxillectomy (removal of the upper jaw). You may feel distressed thinking about removing a portion of your dog's jaw, however most pets do well with this surgery. Once your dog's fur grows back, you probably won't even notice a difference in your dog's appearance. If the lesion is small, or the original surgery resulted in incomplete resection, radiation is another treatment option. In select cases, chemotherapy (bleomycin) is injected directly into the tumor to shrink the mass. This is usually a last resort option as surgery is highly effective in curing dogs with epulides.
Post-operative care depends on individual characteristics of each dog and the extensiveness of the surgery. Dogs with small tumors resume their normal activity and attitude quickly. More extensive surgeries require more intensive care. This could entail stronger pain medications, dietary alterations (e.g. pureed or soft food only), and/or antibiotics for your dog.
For either peripheral odontogenic fibromas or acanthomatous ameloblastoma tumors, If the tumor is removed entirely, the chance for regrowth is minimal. This does not mean that other epulides cannot develop in a different location in the mouth.
How to Prevent Epulides
Epulides cannot be prevented. Monitoring your dog's teeth and oral health is important as early detection is key to the best outcome. Be sure to keep up with your dog's oral health regimen. This involves daily brushing of your dog's teeth to keep tartar and plaque under control and allow for frequent observations of your pet's oral cavity. If you notice anything suspicious contact your veterinarian immediately. Epulides are not contagious, so they cannot be passed from dog to dog or dog to human.