Rabbit Dental Disease: Malocclusion Explained

Dental disease is the second most common health problem in domestic rabbits after gastrointestinal stasis — affecting an estimated 30–40% of pet rabbits at some point in their lives. Unlike many health conditions, dental problems develop slowly and silently, often remaining undetected until significant damage has occurred. Understanding how rabbit teeth work, what can go wrong, and how to prevent and detect problems is essential knowledge for every rabbit owner.

How Rabbit Teeth Work

Rabbits have two types of teeth that grow continuously throughout their lives — they are what’s known as hypsodont dentition:

• Incisors (front teeth): 4 incisors (2 upper, 2 lower) plus a pair of small “peg teeth” behind the upper incisors. Incisors grow at approximately 2–3mm per week and are visible when you look at your rabbit’s face.
• Cheek teeth (premolars and molars): 22 cheek teeth in total, located further back in the jaw. These are not visible without sedation and specialist equipment.

All of these teeth grow continuously. In a healthy rabbit eating the correct diet, the upper and lower teeth meet correctly (occlude properly) and wear each other down at the same rate as they grow — maintaining the correct length and sharp edges needed for effective chewing.

What Is Malocclusion?

Malocclusion means the teeth do not meet (occlude) correctly. When this happens, the teeth cannot wear each other down properly, and they overgrow. There are two main types:

Incisor Malocclusion

The front teeth don’t meet at the correct angle. Overgrown incisors curve outward and can eventually prevent the rabbit from closing their mouth or eating at all. This is often visible to owners as the front teeth appear long, curved, or sticking out.

Cheek Tooth Malocclusion / Molar Spurs

The cheek teeth develop uneven wear, causing sharp points (“spurs”) on the edges of the teeth. These spurs cut into the tongue and inner cheeks, causing intense, chronic pain. This is the most dangerous form of dental disease because it is completely invisible to owners without veterinary examination under sedation.

Causes of Dental Disease

1. Insufficient Hay

This is the most common and preventable cause. The grinding motion required to chew long-strand hay provides the lateral movement that correctly wears down cheek teeth. Rabbits that eat primarily pellets (which are swallowed with minimal chewing) or soft foods develop molar spurs because their cheek teeth never grind against each other adequately.

2. Genetics and Breed Predisposition

Dwarf breeds (Netherland Dwarf, Mini Lop, Lionhead) and flat-faced breeds have compressed skull anatomy, which often leads to misaligned teeth regardless of diet. Their teeth simply don’t fit together correctly due to the shorter jaw.

3. Trauma

A fall or knock to the mouth can shift teeth out of alignment, leading to acquired malocclusion.

4. Infection

Tooth root infections (abscesses) can destroy the anchoring structures of teeth, causing shifting and misalignment.

Signs of Dental Disease at Home

Because molar disease cannot be seen without specialist examination, the warning signs are indirect — watch for:

• Dropping food while eating (“quidding”) — food falls from the mouth as the rabbit tries to chew
• Changing food preferences — rabbit that previously ate hay starts preferring soft pellets or greens only
• Wet chin or dewlap — drooling from inability to swallow normally
• Weight loss — eating less due to pain
• One-sided chewing — rabbit consistently tilts their head to chew on one side
• Eye discharge — tooth roots in the upper jaw lie very close to the tear ducts; infected roots cause chronic weepy eyes
• Facial swelling or lump under the jaw — can indicate a tooth root abscess
• Reduced grooming — pain makes self-grooming difficult

Diagnosis and Treatment

Incisor malocclusion can be assessed during a conscious physical examination. Molar disease requires sedation or general anaesthesia and specialist equipment to examine properly — X-rays are often essential to assess tooth root health.

Treatment options include:

• Incisor trimming or extraction: Overgrown incisors can be trimmed (with a dental burr, not clippers which crack teeth) or extracted if the malocclusion is severe and the rabbit’s quality of life is compromised
• Molar burring (odontoplasty): Under anaesthesia, the vet uses a dental burr to smooth sharp molar spurs. This often needs repeating every 6–12 weeks in affected rabbits
• Tooth extraction: Severely diseased or abscess-involved teeth may need extraction
• Abscess treatment: Rabbit jaw abscesses are notoriously difficult to treat; they often require surgical debridement, long courses of antibiotics, and possibly removal of surrounding bone

Prevention: It Starts with Hay

The single best thing you can do to prevent dental disease in your rabbit is to ensure unlimited timothy or grass hay is available 24 hours a day. The mechanical abrasion from chewing hay for 6–8 hours per day is what nature designed rabbit teeth for.

Additional dental health measures:

• Provide safe wooden chews (apple, willow, hazel) for additional tooth wear
• Reduce pellets — they require minimal chewing
• Schedule annual vet exams with a dental check — more frequently (every 6 months) for breeds prone to dental problems

The RabbitCare App

Tracking your rabbit’s eating behaviour, food preferences, and weight over time can help you identify the subtle early signs of dental disease. The RabbitCare App (free on Android) includes a daily health log and weight tracking feature — building the data you need to spot a problem early and discuss it meaningfully with your vet.

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References & Sources

1. Harcourt-Brown, F. (2002) — Textbook of Rabbit Medicine, Butterworth-Heinemann
2. Meredith, A. & Lord, B. (Eds.) (2014) — BSAVA Manual of Rabbit Medicine, BSAVA
3. RWAF — “Dental Disease in Rabbits” — rabbitwelfare.co.uk
4. PDSA — “Rabbit Dental Problems” — pdsa.org.uk
5. Capello, V. & Gracis, M. (2005) — Rabbit and Rodent Dentistry Handbook, Zoological Education Network