There are three main types of epulis in dogs (also referred to as gum boils, masses found on the dog's gums) and their treatment may vary from one another. Epulides are benign tumors often found in the mouth of dogs. The term benign means that this type of tumor does not spread to other body parts as malignant tumors do. While most epulides act in a benign matter, they may need to be surgically removed and some of them may return after some time. The different types of epulides in dogs include the fibromatous epulis, the ossifying epulis and the acanthomatous epulis. Following is a description of each.
Fibromatous Epulis in Dogs
As the name implies, these type of epulides are made of fibrous tissue and they are commonly found on the margins of the dog's gums.
These types of epulides tend to be smooth, non-ulcerated growths that are pink in color. They are often found by the gums in the front of the dog's mouth between two adjacent teeth. Nowadays, these epulides are referred to as "peripheral odontogenic fibromas."
When these growths grow large enough, they may cause bleeding due to being in a location where the dog happens to bite down on. Dog owners may therefore notice blood-tinged saliva at times.
This type of gum mass requires surgical intervention to remove and the procedure is curative.
"The term “epulis” has been adapted in veterinary nomenclature to describe specific gingival tumors arising from periodontal ligament cells... In recent years, the nomenclature for these odontogenic tumors has changed. Fibromatous and ossifying epulides are now often referred to under the same heading of “peripheral odontogenic fibromas."~Veterinary Practice News
Ossifying Epulis in Dogs
As the name implies, this type of epulis is hard, smooth and bone-like. This type of mass requires surgical intervention to remove, but sometimes the surgery is more radical than just simply removing tissue as it may be needed to remove underlying bone. This may entail partial removal of bone from the upper jaw, (partial maxillectomy), or partial removal of the bottom jaw, (partial mandibulectomy).
While an ossifying epulis is categorized as a benign tumor that does not spread to other body parts, it can be precancerous and turn into a malignant cancer.
"We usually have to remove the tumor, teeth nearby and sometimes even part of the jaw bone. That is how locally invasive they can be... I would highly recommend a veterinary dentist or a veterinary surgeon with extensive oral surgery experience." ~Dr. Gary
Acanthomatous Epulis in Dogs
Nowadays, the new term for this type of epulis is canine acanthomatous ameloblastoma. These types of epulides can present as smooth or ulcerated and are commonly found in the front part of the dog's bottom jaw.
Canine acanthomatous ameloblastoma is more aggressive compared to the other two types of epulides affecting dogs because it has a tendency to destroy the underlying bone.
Because of this tumor's destructive nature, vets recommend surgically removing them with wide margins (additional removal of healthy tissue around the epulis so to prevent it from returning.
When this type of epulis becomes attached to the jaw bone and is allowed to spread, it may be necessary to remove a portion of the jaw (mandibulectomy, the removal of lower jaw or maxillectomy, the removal of the upper jaw). Radiation therapy is also another option.
Having a CT scan done prior to surgery or radiation can be helpful so to have an idea of the extent of the tumor. This comes handy so to get adequate margins in the case of surgery or proper positioning of the radiation beam in the case of radiation.
" I have done a few of these procedures during my career and have not had any problems with them. As long as there is enough bone remaining in the jaw so the jaw is not compromised, then this area will fill in with scar tissue."~Dr. Loretta
At the Vet's Office
You vet will ask you questions such as when did the mass first appear, if your dog has problems chewing, if you have noticed any bleeding. Your vet will then conduct a physical examination with a thorough oral examination.
The vet will check the mass and its surface (smooth, often sign of a benign growth, versus ulcerated which can be problematic). The appearance of an ulcerated mass may be sometimes though due from trauma caused by the opposite teeth chewing on it.
The vet will also check the surrounding teeth and their mobility. Generally, with benign growths, there may be gradual shifting of the surrounding teeth positions, while in malignant growths there may be loose teeth due to the body’s own cells eating away tooth structure. Lymph nodes under the dog's jaw area may also be checked by palpation.
Because benign tumors are difficult to differentiate from malignant ones, the vet will want to conduct a variety of tests to rule malignant oral cancers out. Chest x-rays may check for spread of cancer and teeth x-rays along with a biopsy of tissue sent out to a pathologist can provide a clearer picture of what the mass is.
Treatment of epulis tends to vary depending on what type it is. A more conservative approach may be taken for the less invasive forms, while acanthomatous ameloblastoma requires a more aggressive surgical approach. Owners who are not willing to have the dog's jaw or part of the jaw removed may elect to try radiation therapy for canine acanthomatous ameloblastoma, but there may be chances for malignant tumors to develop in the treated area.
- Fibrous epulis surrounding the lower right canine tooth in a Boxer dog. The dog is anesthetised prior to removal of the epulis. Author Joel Mills, Creative CommonsAttribution-Share Alike 3.0 Unported
- Source: Vetpedia: Clinical appearance of ossifying epulis. Usually fixed and with a bony texture on palpation. http://www.vetpedia.net/siteen/content/tumours-oral-cavity
- Source: Vetpedia: Clinical appearance of acanthomatous epulis. http://www.vetpedia.net/siteen/content/tumours-oral-cavity
- Veterinary Practice News: The Epulis: What’s In A Name?