Summary:
It is well recognised that domesticated chinchillas (Chinchilla lanigera) suffer from a range of dental problems, the most frequent of which is the result of reduced and uneven coronal wear of the premolar and molar (cheek) teeth with resultant root elongation and secondary malocclusion (Crossley 1995 + 1997). Although rarely detected clinically, destruction of dental hard tissue can often be recognised at post-mortem and in prepared skulls. This paper reports the histological confirmation of caries and odontoclastic resorptive lesions in a chinchilla.
Summary:
The order Rodentia is vast, encompassing a large number of species with significant anatomical variations developed during natural adaptation to differing habitats. Many veterinarians have little knowledge of the a natomy of species other than the commoner domestic large herbivores and small carnivores. Clinicians require a basic knowledge of the relevant anatomy of species they are likely to be asked to treat. This article provides sufficient working knowledge of the oral and dental anatomy of those rodents commonly kept as pets to enable veterinarians to interpret clinical and radiographic findings when investigating suspected dental disease.
Abstract
Dental abnormalities are common in chinchillas, although knowledge of the lesions responsible for the clinical signs is incomplete. Animals bred in the UK were examined to gain further knowledge of dental disease in this chinchilla population. Dental abnormalities, particularly those related to tooth elongation, were detected on careful external examination of 35 per cent of apparently healthy chinchillas. Incisor abnormalities were seen on clinical examination in 55 per cent of chinchillas presented because of clinical illness. In all but one case, this occurred secondarily to crown elongation of the cheek teeth or to the absence of opposing teeth, rather than being a primary skeletal problem. Clinical signs commonly attributed to malocclusion, such as ventral mandibular swelling, weight loss, dysphagia, altered chewing pattern and changed food preferences, were not specific to malocclusion, being seen associated with coronal spike formation, root elongation and advanced periodontal lesions. Caries and resorptive lesions rarely caused clinical signs in this population, but were identified during 37 per cent of postmortem examinations. Congenital absence of teeth, skeletal malocclusion and pathological loss of teeth all resulted in significant clinical signs, but were rare. It is concluded that provision of a diet with physical properties more closely matching that of wild chinchillas should improve the dental health of captive animals.
Introduction
In first opinion small animal veterinary practice one is frequently presented with pet rabbits and rodents which have medical problems of possible dental origin.
Unfortunately, for various reasons, many are not recognised as dental cases at an early enough, treatable, stage. Owners not infrequently fail to notice that small pets have a problem until death
is imminent. Even when spotted earlier the problem may still have progressed beyond practical treatment. When signs of a problem are noticed early in the disease process, making a definitive
diagnosis is often difficult, requiring costly investigation. As a result, investigation is often neglected. Both the owners' inability/ unwillingness to pay for treatment, and many veterinary
surgeons' lack of enthusiasm and knowledge of the condition or species concerned, play their part. It is very easy when presented with a sick rabbit or rodent to prescribe a "standard" treatment
regime and hope the patient will get better. Unfortunately this often just allows the condition to progress beyond the stage where correct treatment would have effected control or a
cure.
The following discussion relates mainly to rabbits and the truly herbivorous pet rodents, guinea pigs and chinchillas, which have elodont premolars, molars and
incisor teeth (The teeth continue growing throughout life).
Diagnosis of dental disease in rabbits and rodents.
To make an accurate diagnosis it helps to have sufficient data regarding the patient, its history and the signs observed. In most cases the history and an initial
external examination of a sick animal will give indications as to any probable dental involvement.
Signs indicative of (probable) dental disease in rabbits and rodents:
In order of frequency of observation in the author's practice.
* significant
** very significant
*** extremely significant
**** specific dental problem
*** Weight loss
* Poor coat condition
** Digestive disturbance
*** Noticeable reduction in food intake
*** Dysphagia
*** Epiphora (**** chinchilla)
**** Visible incisor malocclusion/overgrowth
**** Palpable bony swelling of ventral mandible
*** Discomfort on palpation over cheek teeth
** Discomfort on manipulating jaw
*** Reduced range of movement of jaw
*** Inability to fully close jaw
** Conjunctivitis
*** Inappetance
**** Mandibular prognathism
*** Excessive salivation (slobbers)
*** Purulent ocular/nasal discharge
*** Facial abscessation
*** Mandibular abscessation
** Submandibular/cervical lymphadenopathy
*** Exopthalmos
* Systemic disease
** Emaciation
* Death
Oral examination
The long diastema between the incisor and cheek teeth of rabbits and rodents makes effective examination of the premolar and molar (cheek) teeth, along with their
supporting soft tissues, difficult. Although it is possible to use an auriscope as an oral endoscope in some species, the restricted field of view means that many lesions will be missed. Even
when examining a patient under anaesthesia using mouth gags, cheek dilators, mouth mirrors and magnification, it is common for experienced clinicians to miss significant oral lesions. In this
regard, post mortem examinations are a very useful learning tool.
Common dental problems in rabbits and rodents
Unlike the situation in pet carnivores, periodontal disease is not frequently recognised in rabbits and rodents. This is probably mainly due to a lower incidence,
but will also be due to a failure of many clinicians to detect or recognise signs of its presence.
The most frequently recognised dental problem in rabbits and rodents is malocclusion of their easily examined elodont (continually growing aradicular hypsodont)
incisor teeth. Without the normal regular wear from chewing or gnawing activity, these non-functional maloccluded teeth continue growing, further impeding function.
The second most cmmon dental problem in the small herbivores is cheek tooth overgrowth. This often accompanies incisor malocclusion; either as a part of the primary
condition, or as a purely secondary problem; but it is also seen as a primary problem in its own right. Cheek tooth overgrowth may result from lack of wear due to malocclusion or an
insufficiently abrasive diet. It may also occur secondary to periodontal or metabolic (impaired collagen formation) disease. Whether or not the occlusion was normal to start with, a secondary
malocclusion will develop as a result of tooth overgrowth. The exception to this last statement is when root extension occurs as a result of growth without matching eruption, as may sometimes be
seen in chinchillas. In this case there may ocular signs, as described later, without any oral abnormality. In the author's experience, rabbits and guinea pigs do not develop root extension
without visible oral signs of cheek tooth malocclusion or overgrowth.
Whether a malocclusion is primary or secondary, abnormal tooth wear of the naturally curved cheek teeth tends to cause development of sharp enamel spikes/spurs
which irritate the cheeks and tongue leading to:
* pain
* dysphagia
* quidding
* salivation
* inappetance
* weight loss
* abscessation
It seems that root growth continues despite increased resistance to eruption following lack of adequate wear to the crown. Root extension frequently accompanies
cheek tooth malocclusion. The extending maxillary root apices invade the lachrymal bone, obstructing the lachrymal duct and causing epiphora, and the orbit, leading to proptosis of the eye. The
close proximity of the root apex of the rabbit's mesial cheek teeth to the lacrimal duct accounts for the occurrence of epiphora and the frequent spread of periodontal infection from these teeth
to the tear duct, producing a typical purulent occular discharge.
Root extension of the mandibular cheek teeth leads to remodelling or thinning of the adjacent cortical bone with development of palpable swellings along the ventral
surface of the mandible. Suspected mandibular or maxillary root extension is best confirmed radiographically.
Facial and mandibular abscesses quite common and are generally caused by dental problems, though infection of external wounds does also occur.
Dental abscesses may be due to:
* Periodontal infection
* Endodontic infection
* Orthodontic problems
In the latter case the abscess is usually due to a tooth penetrating the oral mucosa making localisation of the problem tooth easy.
Both periodontal and endodontic abscesses may appear away from the source of the problem. Endodontically affected teeth are best identified radiographically.
Observation of periodontal food impaction or the location of periodontal pockets on careful probing may identify an offending tooth or teeth, but even so, radiography is still
advisable.
Treatment options
As the vast majority of the orthodontic problems seen in practice seem to be hereditary, often with generation after generation showing the same problems, genetic
counselling should be given to pet owners and breeders. Culling of affected breeding stock and their offspring is essential. Unfortunately by the time the problem becomes apparent, the affected
animals have generally already produced several litters.
(How much genetic counselling do human patients get before orthodontic treatment is performed on them?) Depending on the situation the main treatment options in
pets are:
* Benign neglect (not advised)
* Incisor tooth shortening
* Cheek tooth occlusal equilibration
* Extraction of affected teeth
* Euthanasia
Whilst benign neglect is a common practice, just maintaining observation for signs of pain or distress, this cannot be recommended. As already mentioned, any delay
in investigation and treatment will allow further progression of the disease process reducing the chances of successful treatment.
The incisor tooth overgrowth problem has traditionally been managed by repeated tooth shortening (preferably trimming using a bur in a high speed dental handpiece),
without investigation of the underlying problem. In cases with recurrent overgrowth, extraction of the offending teeth has been suggested as a more permanent solution. In early cases with a minor
degree of rosro-caudal malocclusion, correction can occasionally be accomplished in rabbits (not rodents) by burring a reverse bevel on the mandibular incisors to create an incline plane like
interlock with the maxillary first incisors. In the majority of cases, occlusal equilibration of the cheek teeth is also required.
Treatment of the cheek teeth by removing enamel spikes and occlusal equilibration is sometimes possible, though the long term results are poor in most cases. As
with the correction of rabbit incisor malocclusion, the treatment is most successful if performed at an early stage, in mild cases. Dietary alteration (providing hay as the largest component of
the diet) to increase the rate of attrition is highly beneficial in these cases. In more advanced cases the provision of a more abrasive diet is helpful, but it is usually necessary to repeat
occlusal equilabration at regular intervals.
Whilst extraction of rabbits' incisors is useful in cases of malocclusion with recurrent overgrowth of these teeth, the long term results are disappointing in over
50% of cases due to the development of significant cheek tooth problems. Although it may not be visually obvious at the time of incisor extraction, most of the rabbits treated by the author have
had radiographic changes suggestive of cheek tooth problems, even when everything appeared normal on oral examination. As would be expected, if there is concurrent cheek tooth disease
(periodontal disease, malocclusion, overgrowth etc.), any improvement following treatment of just the incisor problem tends to be of short duration.
The treatment of dental abscesses in rabbits and rodents requires identification of the cause. If due to periodontal or endodontic disease, extraction of the
affected teeth is necessary in addition to local treatment {drainage, curretage, application of a Ca(OH)2 dressing}. When the abscess is due to mucosal penetration of an enamel spike, removal of
the spike, plus treatment of the underlying malocclusion will be effective.
Treatment policy
Due to the low value of most pet rabbits and rodents, the cost of investigation and treatment of dental disease is a significant factor to many owners. They want to
know if it is worth having treatment. As a result, it is no longer the author's policy to immediately recommend treatment of dental problems in these animals, but rather to suggest a thorough
examination and assessment under anaesthesia to see whether treatment is likely to be beneficial, and if so, whether recurrence should be expected. The biggest problem has been finding reliable
prognostic indicators.
This approach has significantly increased the take up of dental services for these species from around 20% to 50% of cases. This still leaves half the affected
animals. Of these, about half the owners opt for immediate euthanasia, whilst the other cases go onto a tooth shortening or benign neglect program.
Prognostic indicators
As mentioned previously, cheek tooth problems are an indication of a poor prognosis, but their presence or their full extent are often not identified on clinical
examination. Radiology, whilst not being totally reliable, does seem to give a good indication of the extent and degree of cheek tooth problems. When the results of physical examination are
combined with radiological assessment it is possible to formulate a more reliable prognosis.
Any severely debilitated patients are put onto a nursing care program prior to full assessment. Failure to respond to intensive care indicates a grave prognosis. In
these cases where there is a very high anaesthetic risk, the choice is between euthanasia and an attempt at investigation and treatment. If such animals survive induction of anaesthesia treatment
might be possible, so the attempt is worthwhile, though the majority die on induction, which is basically equivalent to performing euthanasia anyway.
If no serious problems are found during the definitive oral examination and the radiographs look OK, then treatment is usually worthwhile. Treated animals should be
followed up. Re-examination and re-treatment should be arranged if signs fail to disappear, or if they recur at a later date.
If there are gross changes, abnormal root morphology, significant root extension, bone loss, osteomyelitis etc. then euthanasia is probably the most humane
option.
Between the two extremes, the author treats those cases where the owner is keen to have a go and euthanases the others. Recurrence of signs in treated animals from
this group is taken as an indication for euthanasia.
References
1. Brown, S.A. (1993). Incisor removal in the rabbit, TNAVC 1993 proceedings, pages 791-792.
2. Crossley, D.A. (1994). Extraction of rabbit incisor teeth, EVDS Forum 1993 no. 4
3. Harkness, J.E. and Wagner, J.E. (1989). The Biology and Medicine of Rabbits and Rodents, third edition, Published by Lea & Febiger,
Philadelphia.
4. Kennedy, A.H. (1970). Chinchilla Diseases and Ailments, Published by Clay Publishing, Bewdley, Ontario.
5. Lobprise, H.B. and Wiggs, R.B. (1991). Dental and oral disease in lagomorphs, J.Vet.Dent, 1991:8(2)
6. Okerman, L. (1988). Diseases of Domestic Rabbits, published by Blackwell Scientific Publications, Oxford.
7. Richardson, V.C.G. (1992). Diseases of Domestic Giunea Pigs, Published by Blackwell Scientific Publications, Oxford.
8. Wiggs, R.B. and Lobprise, H.B. (1990). Dental disease in rodents, J.Vet.Dent, 1990:7(3)
9. Wiggs, R.B. and Lobprise, H.B. (1995). Dentistry in pet lagomorphs and rodents, in: BSAVA Manual of Small Animal Dentistry, second edition (Eds. D.A.Crossley
& S. Penman). published by BSAVAQuelle: http://web.archive.org/web/20060907175425/http://periodont.spallek.com/peris9.html
SUMMARY
Blood testing is routinely used for health assessment in species for which normal ranges are known. Insufficient data is available for many exotic species including chinchillas. Chinchillas are
susceptible to a wide range of disorders so blood testing is expected to be a useful clinical tool for this species. Although basic haematology parameters have been published, little work appears
to have been done on serum chemistry. Blood samples were collected from clinically healthy and diseased chinchillas, and submitted to a commercial veterinary laboratory. Haematology and serum
chemistry analyses were performed in order to furnish reference ranges and to assess whether such tests were of value in the early diagnosis of dental disease in chinchillas. Some parameters
showed wide variations between animals. Variation was not found to be related to age, sex, a history of fur chewing or the presence of early dental lesions. High serum creatinine kinase levels
occurred in animals which struggled during capture with other parameters varying most in animals with advanced diseased.
Conclusion
As elodont teeth are being formed throughout life anything (metabolic disease, teratogens, vitamin or mineral imbalances, natural and unnatural forces, trauma, inflammation and infection)
affecting histodifferentiation, growth, maturation, matrix secretion or mineralisation will have the potential to cause of developmental dental disease at any age, whereas teeth of limited growth
are minimally affected after their roots are formed. Lack of tooth wear is a major problem in domestic herbivores that are fed concentrate rations. In the case of those with continuously growing
teeth this rapidly results in coronal elongation, increased occlusal contact and prolonged occlusal pressure with obstruction of eruption and knock-on consequences at the growing tooth apex.
Apical changes affect the formation of tooth tissue leading to various forms of dysplasia varying from altered tooth curvature to gross disruption of tissue morphology. Clinically there are many
complicating cofactors in the etiology of dental disease in elodont species. Herbivores are prey species and as such they are extremely susceptible to stress. Stress with resultant high serum
cortisol levels appears to be a major factor influencing the rate of progression of disease. Nutritional imbalance, if severe, can cause dental changes, whilst a lesser degree of imbalance or
deficiency has a similar effect to stress in increasing the rate of progression of changes caused by physical factors. A combination of more natural diet and environmental conditions would appear
to be the most practical measures for reducing the incidence of dental disease in elodont herbivores.
Summary:
Chinchillas are herbivorous rodents with teeth that all grow continuously. In captivity they are commonly affected by dental disease. Since the range of dental disease occurring in wild chinchillas is unknown, the dentition of museum specimens originally obtained from the wild was assessed and compared with specimens prepared from captive bred animals.
Skulls from wild-caught chinchillas showed minimal evidence of dental disease and the teeth were all short, cheek tooth lengths averaging 5.9 mm. Cheek tooth lengths in zoo specimens (average 6.6 mm), clinically normal (average 7.4 mm) and captive bred animals with dental disease (average 10 mm) were significantly elongated by comparison (p < 0.0001). Captive bred specimens showed a wide range of tooth related lesions.
These results suggest that some aspect of captivity is responsible for the development of dental disease in chinchillas. It is suggested that the diet (its physical form and composition) is the main etiological factor, and that provision of a diet closely matching that of wild chinchillas should significantly reduce the incidence of dental disease in captive chinchillas.
Introduction:
A common clinical problem seen in chinchillas (Chinchilla lanigera) is "wet eyes" due to lacrimal overflow.
Aim:
To investigate the site or sites of obstruction of the lacrimal drainage system in chinchillas showing signs of lacrimal overflow.
Method:
Radiography, CT scanning, anatomical dissection, and histological examination of affected animals. signs of lacrimal overflow.
Results:
The main site of obstruction of lacrimal drainage is in the descending portion of the lacrimal canal between the orbit and the incisor tooth root apex. Bony remodelling around elongating maxillary premolar and first two molar tooth roots intrudes into the lacrimal canal compressing and sometimes occluding or even obliterating the lacrimal canal and duct. No evidence has been found for obstruction adjacent to the incisor root apices in the specimens examined so far.
Discussion:
Lacrimal drainage in healthy chinchillas is similar to that in other rodents. This species is adapted to a highly abrasive herbivorous diet, having continuously growing cheek teeth (in addition to the continuously growing incisors). When these teeth are not worn adequately, i.e. when domestic animals are fed commercial diets, the teeth continue to elongate. Eventually occlusal pressure prevents eruption, so the roots intrude inducing remodelling of adjacent tissue including the lacrimal canal.
Conclusions:
Chinchillas should be fed a herbivorous diet which requires prolonged chewing in order to wear the teeth adequately.
Abstract
Computerised tomographic scanning was used to investigate tooth structure in chinchillas (Chinchilla laniger), both cheek tooth crown and root abnormalities being common in this species. This paper describes a common form of dental disease affecting species with continuously growing teeth, with particular reference to the chinchilla, and confirms the potential role of computed tomography (CT) in its early diagnosis. CT imaging is compared with previously available methods of investigation which frequently fail to detect early pathological changes.