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Apical Abscesses in Rabbits    Tooth root abscesses in rabbits, formally known as apical abscesses, are defined as pus-filled capsules or pockets within the animal’s tooth or mouth. These abscesses are painful for the animal and tend to grow within inflamed areas of the gums, where infection is more likely to spread. Symptoms and Types Some common signs include: Oral cavity Loose teeth Abnormal teeth or bite alignment (cheek teeth elongation) Overgrowth of the incisor teeth (used to grasp and bit food) Oral tissue swelling, especially along the soft tissues A preference towards eating softer foods Loss of weight, can be extreme Obstruction of the tear or nasal ducts Respiratory irritation (e.g., sinusitis and rhinitis) Signs of pain or discomfort, which may include inability or lack of interest in moving, lethargy, hiding, hunched posture or depression Causes There are many different reasons an abscess forms under a tooth or near a tooth’s root. For example, an infection can occur in cases of tooth or dental decay. However, rabbit abscesses are unlike those that form in other animals, like cats and dogs. They do not rupture on their own and drain infrequently. Rather, they tend to puncture the bone of the rabbit, often requiring surgical treatment. The most common cause of tooth root abscesses in rabbits is tooth elongation. This is a chronic and common condition because rabbit teeth tend to grow constantly — at the rate of nearly one-half an inch every month. The cheek teeth can then become spiked and erode, or gradually wear into the soft tissue near the teeth, allowing abscess-causing bacteria to enter into the gums. Tissue damage can also lead to the formation of an abscess. Other causes and factors contributing to tooth root abscesses include: Infection with pyogenic bacteria (e.g., Streptococcus spp., Fusobacterium nucleatum, Prevotella spp. and Peptostreptococcus micros) Trauma to the teeth or roots, including clipping of the teeth or cutting the pulp when trimming teeth, which can expose them to bacteria Acquired teeth elongation, which can occur from an exclusive pellet diet Suppression of the immune system, which can occur from the overuse of topical or oral steroids Diagnosis Diagnosis involves ruling out other conditions contributing to tooth decay. A veterinarian will look for signs of dental disease and swelling in the mouth, and may take a culture to identify a possible infection. Treatment Treatment can be done on an outpatient basis, unless the rabbit has large abscesses or wounds which may get infected. Some animals may require long-term pain therapy and management, consisting of non-steroidal anti-inflammatory drugs for inflammation control and to help reduce pain. (Needle aspiration can be used to help drain excessive fluids.) In severe cases, the animal will need to undergo surgery to remove affected teeth. Many times, extraction is time consuming because rabbits have curved tooth roots. However, if such a procedure is done, the veterinarian will prescribe medication, including antibiotics to help reduce bacterial infections and pain. Living and Management A well-balanced diet is a vital part of management, as it helps prevent tooth decay. This means feeding the rabbit low-carbohydrate and low-fat foods, and enough water to keep it hydrated. The veterinarian will re-evaluate the rabbit every one to three months to trim its teeth and search for any cavities or oral growths. Be aware, chronic pain is a potential side effect of this condition.