An epulis in dogs is a common, localized growth found on the gums. These growths, described as tumor-like masses, originate from the periodontal ligament, the tissue securing the tooth in its socket. While the term “epulis” broadly refers to a gum mass, most are considered benign.
Identifying Different Epulis Types
Epulides are categorized into three main types. Fibromatous epulides are the most frequently encountered variety, primarily composed of fibrous connective tissue. These growths present with a smooth, pink surface, appearing mushroom-like or as an unmoving mass, and do not invade surrounding bone or tissues.
Ossifying epulides share a similar appearance to fibromatous types but contain bone cells or an osteoid matrix, which includes immature bone cells called osteoblasts. This bony component can be seen on dental X-rays. Both fibromatous and ossifying epulides are benign and confined to the gum tissue.
Acanthomatous ameloblastoma, previously known as acanthomatous epulis, is a distinct type that, while technically benign because it does not metastasize, exhibits locally aggressive behavior. This type can invade and destroy the underlying jawbone. It appears with a rough, irregular, or cauliflower-like surface and can become ulcerated.
Causes and Clinical Signs
The precise cause of epulides in dogs is not fully understood, but a combination of genetic and environmental factors plays a role. Chronic inflammation or recurrent trauma to the gums, from teeth rubbing against the tissue, are suspected contributing factors. Certain breeds show a higher predisposition to developing these growths, including brachycephalic (short-nosed) breeds like Boxers and English Bulldogs. Other overrepresented breeds include Old English Sheepdogs, Shetland Sheepdogs, Golden Retrievers, American Cocker Spaniels, and Akitas.
Pet owners may first notice an epulis as a firm, pink, fleshy growth on their dog’s gums, near the incisor, canine, or premolar teeth. The texture can range from smooth to cobblestone-like, and the growth may be attached by a stalk or be a broad-based mass. As the epulis enlarges, secondary symptoms may become apparent: excessive drooling, halitosis (bad breath), or bleeding from the mouth. Dogs may display difficulty eating, chew on one side of their mouth, or exhibit visible facial swelling or deformity if the growth significantly impacts the jaw or surrounding structures.
Diagnosis and Treatment Options
A definitive diagnosis of an epulis requires a thorough veterinary examination. The process begins with a visual inspection of the oral cavity, performed under sedation or general anesthesia for a comprehensive view. Dental X-rays (radiographs) are then taken to assess the extent of the growth, to check for any involvement or destruction of the underlying jawbone, which is especially important for suspected acanthomatous types.
To confirm the specific cell type of the growth, a biopsy is performed for histopathological examination. The analysis helps differentiate between the various epulis types and rule out other oral tumors. Advanced imaging like computed tomography (CT) scans may provide even greater detail regarding bone invasion, aiding in precise treatment planning.
Surgical removal is the standard treatment for epulides in dogs. For fibromatous and ossifying epulides, simple excision with clean margins, including the removal of any involved teeth and thorough scraping of the tooth socket, is sufficient to prevent recurrence. These types have a good prognosis following complete removal.
Acanthomatous ameloblastomas require a more aggressive surgical approach due to their locally invasive nature. This can involve wide surgical margins, which may necessitate removing portions of the jawbone (mandibulectomy or maxillectomy), to ensure all invasive cells are eliminated and reduce the chance of regrowth. Radiation therapy is a potential alternative or additional treatment for acanthomatous ameloblastomas, when surgery is not feasible or complete removal is challenging due to tumor size or location. The prognosis for acanthomatous ameloblastomas is guarded without complete removal, but with appropriate aggressive intervention, many dogs can have a good outcome.