Tumors of the Gums (Epulis) in Dogs

Epulis tumors are tumors located in the gum tissue near the canine’s teeth. Also known as gum boils, they originate in the tissue that connects the teeth to the bone of the jaw. Epulis tumors are generally benign, but some varieties are prone to invading nearby tissues and require removal of the growth and the surrounding tissue. This can sometimes include the removal of all or part of the jawbone. There are three generally recognized types of epulis; fibromatous, ossifying and acanthomatous.

Epulis are benign growths that originate in the tissue that connects the teeth of the dog to its jawbone. There are three types of epulis; fibromatous, ossifying and acanthomatous.

The growth that forms between the dog’s teeth is generally firm, similar in color to the gums and smooth. Some epulides will present with a peduncle attaching it to the gum. 

• Bleeding from mass
• Difficulty chewing
• Displaced teeth
• Drooling
• Loss of appetite
• Pink, raised growth
• Reduced activity level
• Swelling of jaw bones
• Tooth loss
• Unusually bad breath
• Weight loss 

Types

Fibromatous - Growth of tough, fibrous tissue usually located at the margin of the gum, generally smooth and pink, without ulcerations; this is the least likely to require additional treatments such as cryosurgery or chemotherapy

Ossifying - Nonulcerated smooth, pink growth that contains bone cells; this type of epulis is more likely to require radical surgery or to become cancerous 

Acanthomatous - Tumor that originates from the periodontal ligament that holds the root of the tooth in the bone; these cancers are usually found in the front portion of the lower jaw and can be either ulcerated or non-ulcerated; these growths are considered benign but can prove to be locally invasive, so treatment is usually more aggressive

Although these are one of the more common growths that can be found in a canine’s mouth, the cause or causes of epulides have eluded scientists to this point. Most epulis tumors develop in dogs older than six years old, and Boxers seem to be slightly predisposed to developing these growths.

The veterinarian will first want to acquire your dog’s complete health history. A complete blood count, blood chemistry profile, and urinalysis will also be performed to evaluate the overall health of the patient. A sample of the tumor will be taken, usually by incisional biopsy, and a dental x-ray will also be done to reveal dental changes or invasion into the jaw bone itself. X-rays of the chest area may also be done if the veterinarian is concerned about the spread of the cancer to remote locations such as the lung. An MRI may be employed to assess the size of the mass and whether or not it has invaded nearby structures and a CT scan may give a clearer picture of calcification or erosion of the outer layer (cortex) of the bones that have been affected.  The biopsy of the tissue sample will determine if it is indeed an epulis, and which type of epulis it is.

Benign tumors such as epulis, as well as a portion of the surrounding tissue, will generally be excised to avoid further spread into surrounding tissues. With ossifying and acanthomatous epulis there is a likelihood of the jaw being involved. If this is the case, part or all of that portion of the jaw may need to be surgically removed. The excision of all or part of the jaw is referred to as a maxillectomy if it affects the top of the jaw or mandibulectomy if the bottom of the jaw is involved. With ossifying epulis cryosurgery may be employed as well to help ensure that all of the abnormal tissues are fully removed. Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. As the acanthomatous variety of epulis can be known to become very invasive to surrounding tissues it considered a cancerous growth and its treatment is often more aggressive, involving radiation and possibly chemotherapeutic agents.

After any surgical excision, it is essential to keep the site clean and make sure to remove dirt and debris. You will need to examine the site regularly for swelling, bleeding or pus, and keep your dog from interfering with it. Keeping the recovering patient in a calm and quiet environment will help speed healing, as will having appropriate food and water within easy reach.  Specialized feeding and care instructions may be given by your veterinarian to facilitate healing. If a mandibulectomy or maxillectomy was performed due to invasion of the growth into the bone, then your dog may have a protruding tongue where the bone was removed until they get used to retracting their tongue on their own. You may also observe an increase in salivation and clicking noises that occur when your dog chews. There may also be a visible narrowing or drooping of the nose due to the removal of the upper jaw bone.