Epulis

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Epulis

By: Dr. Bari Spielman

Section: Overview

An epulis is a tumor of the periodontal ligament, which is the structure that holds the tooth in place. Epulides are the most common benign oral tumors in dogs; cats rarely have benign oral tumors. These rumors occur in dogs of any age, but they are generally found in middle-age dogs over six years old. They are more common in brachycephalic or short-nosed breeds; boxers have a higher incidence of fibromatous epulis. There is no specific cause identified.

There are three types of epulides that are recognized, and they are grouped by their tissue origin.

Fibromatous. These are pedunculated (on a stalk or stem) and non-ulcerating (no interruptions on the outside of the growth).

Ossifying. These are pedunculated, and non-ulcerating.

Acanthomatous. These are locally invasive and often destroy bone. Although they are benign, they behave the most aggressively.

Some individuals with mild cases are asymptomatic, which means they do not show any clinical signs, and the epulis is picked up on routine examination.

What to Watch For

A slowly enlarging mass positioned along the gingival margin

Displacement of teeth

Facial deformities

Excessive salivation

Halitosis (bad breath)

Dysphagia (difficulty eating)

Weight loss

Bleeding from the mouth

Diagnosis

Baseline tests, to include a complete blood count (CBC), biochemical profile, and urinalysis, are usually within normal limits.

Careful inspection and examination of the entire oral cavity

Radiographs (X-rays) of the mouth

Thoracic (chest) radiographs to rule out metastatic (spread) disease

CT scan in some cases

Biopsy of the mass for a definitive diagnosis and to differentiate it from other oral tumors

Treatment

Surgical excision or removal is the treatment of choice. Depending on the type and size of epulis, different degrees of surgical aggressiveness are recommended.

Fibromatous epulis. Surgical excision is usually curative.

Ossifying epulis. Surgical excision is usually curative.

Acanthomatous epulis. Because of the aggressiveness of these tumors, a wider surgical excision is recommended, and depending on its location, may necessitate removal of the lower jaw (partial mandibulectomy) or upper jaw (maxillectomy).

Diet is also an important part of therapy. Soft foods may help prevent tumor ulceration or be soothing after tumor excision. Radiation therapy may be helpful in those epulides that are inoperable.

Home Care

A thorough oral examination should be performed during routine check-ups to monitor for recurrence at the recommendation of your veterinarian.

It is very important to follow the instructions given to you by your veterinarian. A soft diet and special oral rinses may be of benefit in some cases.

Prognosis varies depending on the type, location, size, and ability to remove the epulis.

There is no known prevention of an epulis.

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