Epulis

What is an epulis?

An epulis is the most common benign tumor of the mouth in dogs. It is usually located in the gum tissue near the incisors or canine teeth. It originates in the connective tissue that holds the teeth to the bone of the jaw. The literal translation of “epulis” is “gum boil.”

There are three types of epulides (the plural for epulis):

Fibromatous: Consists of tough, fibrous tissue.

Ossifying: In addition to fibrous tissue, also contains bone cells. These may transform into cancerous tumors.

Acanthomatous: More invasive, growing into the normal bone around it and destroying it, but not metastasizing.

What causes an epulis?

The cause of epulides is unknown, but they do occur more commonly in older dogs and Boxers. They occur equally in both sexes.

What signs are associated with an epulis?

Usually, the owner simply notices a firm growth between the teeth. The tumor is usually the same color as the gum tissue, has a smooth surface, and may be attached to the gum via a peduncle (a stalk-like structure). As the epulis enlarges a dog may drool, have difficulty eating or lose his appetite, have bad breath, bleed from the area of the tumor, or even have trouble breathing depending upon the size and location of the tumor. It may push apart and misalign the adjacent teeth. There is often more than one epulis present.

How is an epulis diagnosed?

An epulis may be suspected by its location and appearance, but it is necessary to biopsy the tumor to distinguish if from other oral tumors. A pathologist will examine the tissue microscopically to determine if it is an epulis, and of what type. Other oral tumors include squamous cell carcinoma (malignant), and other benign tumors such as fibromas, lipomas, and histiocytomas.

How is an epulis treated?

Surgery is necessary to remove the epulis. A wide margin (large portion of healthy tissue around the tumor, possible including some bone) needs to be taken to assure all of the epulis is removed. If a portion remains, it will often regrow. The teeth next to the epulis usually need to be removed, as well. Large epulides may also be treated with radiation.

What is the prognosis for a dog with an epulis?

If the epulis is small and all of the tumor is removed, the prognosis is good. The larger the tumor, the more likely a recurrence or complications. Acanthomatous epulides have a more guarded prognosis since they are much more difficult to completely remove. On rare instances, radiation therapy has resulted in the tumor becoming cancerous.

References and Further Reading

Gardner, DG. Epulides in the dog: A review. Journal of Oral Pathology & Medicine 25:32-7, 1996.

Goldschmidt, MH; Thrall, DE. Nonosseous tumors invasive of bone. http://cal.nbc.upenn.edu/saortho/chapter_76/76mast.htm

Howard, P. Neoplasms of the maxilla and mandible. In Birchard, SJ; Sherding, RG (eds.) Saunders Manual of Small Animal Practice. W.B. Saunders Co. Philadelphia, PA; 1994: 957.

Maretta, SM. Recognition and treatment of oral tumors. Presented at the Atlantic Coast Veterinary Conference, Atlantic City, NJ. October 9-11, 2001.

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Spodnick, GJ; Page, RL. Canine and feline oropharyngeal neoplasms. In Bonagura, JD (ed.) Kirk’s Current Veterinary Therapy XII. W.B. Saunders Co. Philadelphia, PA; 1995.

By: Holly Nash, DVM, MS
Veterinary Services Department, Drs. Foster & Smith, Inc
From http://www.peteducation.com