Policy Statements

We are often asked whether it is possible, or advantageous, to perform dental procedures on rabbits without anaesthesia or sedation.

This is a complex question, as it depends entirely on the character of the rabbit, the nature of the dental problem, the equipment available and the expertise of the Veterinary Surgeon and Veterinary Nurses involved. Trimming of overlong incisors may be performed with powered dental equipment with gentle but firm physical restraint. Towel wrapping, the “bunny burrito” technique, may be very useful here. Sedation may be required in some rabbits.

Cheek (back) teeth treatment is more complicated, requiring visualisation of the teeth. Difficulty arises because they are hidden at the back of the mouth, in contrast to the easily visible incisors, as well as greatly limiting the safe use of effective dental equipment in this area.

Gags are occasionally recommended to keep the mouth open. These are widely used in anaesthetised rabbits to hold the mouth open and the head in position, but are not safe to use in a rabbit which is not adequately anaesthetised due to the risk of tooth or jaw fracture if the rabbit tries to close its mouth. Without this, visibility is limited, which makes it easy to miss significant dental problems, especially at the very back of the mouth, and increases the risk of damaging the soft tissues of the mouth when carrying out conscious dentistry.

Powered dental equipment rotates rapidly and may cause significant injuries to the tongue, cheek or gums if it comes into contact with them. It is therefore wise not to use where visibility is not sufficient to avoid the risk of damage. Furthermore, there is the danger of conscious animals moving, causing power tools to slip and inflict injury on the mouth.

The choice of equipment for use in conscious dentistry is therefore limited to hand held i.e. non powered equipment. Whilst this is appropriate for small spurs on the inside edge of the lower teeth, it is much more difficult to use these elsewhere, should other teeth require attention. If the entire back tooth is leaning it, rather than just spurring, it is inappropriate to use hand equipment to clip the tooth, as this can fracture and loosen the tooth.

Files can be used in the mouth to avoid clipping. However, large blood vessels at the back of the mouth are vulnerable to being caught with the tip of a file, and potentially fatal haemorrhage may result.

The experience of the veterinary surgeon performing such a procedure, and the expertise of the veterinary nurse handling the rabbit strongly influence the safety and end result of any dental procedure. The decision on whether to carry out dental work and how to do so is the clinical responsibility of the veterinary surgeon, after a discussion of the relative risks and benefits with the owner of all techniques available. It is impossible here to categorically state what should and should not be done in each circumstance, but conscious dentistry should not simply be considered as a short cut alternative to dentistry under GA. Whatever method is employed, a full clinical examination of the rabbit, with particular reference to the mouth and associated structures, should be performed first (eg. intra and extra-oral examination, and assessment of eyes and ears to look for associated pathology).

Our opinion at the RWA&F is that incisor dental shortening can be carried out conscious in the majority of rabbits, (but that this should be done using appropriate tools, and not by clipping which can shatter or split teeth) but that cheek tooth dentistry is best carried out under a short, well maintained anaesthetic to allow full visualisation and assessment of dental disease. However, there may be circumstances where a limited amount of cheek tooth dentistry may be more safely performed conscious. A typical situation is the presence of a single or small number of dental spurs in an easily visualised position, in a calm rabbit, particularly when the animal is not considered a suitable candidate for an anaesthetic (eg. through severe dehydration or malnutrition for the dental lesion present, or other underlying disease). This may perhaps be carried out to relieve pain in a seriously unwell rabbit in order to improve his or her fluid and nutritional status prior to a full dental under general anaesthetic. However, if conscious dentistry is considered the default option due to the risks of anaesthesia generally, it is worth reviewing practice anaesthetic protocols for rabbits.

The risks of the procedure must be balanced against the potential advantages in every case, and fully discussed with the veterinary surgeon.

Please note that this advice is not aimed at the equivalent situation in guinea pigs, whose dental pathology is different, usually involving whole teeth and a significantly increased risk of severely and permanently damaging the teeth involved.