Epulis

What is an epulis (pl. epulides)?

An epulis is a benign oral tumour that affects the gum. It arises from the periodontal ligament which lines the tooth cavity and surrounds the tooth. Epulides are fibrous and are covered by normal mucous membranes and appear firm and smooth. Sometimes they ossify and then have a bony interior.

Are they dangerous?

Although an epulis is a tumour, it is classed as benign (not cancerous) and does not metastasise, i.e. spread to other organs. However they can sometimes proliferate extensively locally. This can result in bleeding and ulceration and ultimately loosening of teeth to the extent that surgery is required.

Is there any age or breed predisposition?

Epulides arise from middle age onwards and are particularly common in Boxers although by no means confined entirely to this breed.

Can they be mistaken for any other type of tumour?

There is a type of epulis known as an acanthomatous epulis (or peripheral ameloblastoma or acanthomatous ameloblastoma). This tumour will invade and destroy bone over a period of time. These are still classed as benign tumours since they do not spread to other organs. 

"There is a type of epulis known as an acanthomatous epulis (or peripheral ameloblastoma or acanthomatous ameloblastoma). This tumour will invade and destroy bone over a period of time."

There are other oral tumours that occur in the mouth that are malignant (cancerous). These include squamous cell carcinomas and fibrosarcomas. Any unusual growth in the mouth is worth a professional opinion.

Is it necessary to have an epulis removed?

This depends on many considerations including age and type of dog, state of health, position of the growth, etc. Although initially hard and smooth, as the epulis enlarges it can change shape and become cauliflower like. They often grow from the gum up the side of the tooth and when they reach the crown can be lacerated when the dog is eating. In addition bacteria and debris get trapped between the growth and the tooth causing erosion of the gum (periodontal disease) leading to loosening of the tooth and a septic mouth.

Radiographs may be taken to further assess the extent of the lesion and the health of the associated teeth.

What treatment is required?

If causing trouble the growth has to be removed under anaesthetic and the normal anatomy of the gum restored. This may involve the extraction of the associated tooth. Any infection (periodontal disease) must be treated and therefore a course of antibiotics may have to be prescribed.

Is removal successful?

Most of the masses can be simply removed with minimal excision. Recurrence does occur and therefore repeat surgery may be necessary. Laboratory examination of any growths removed is always worthwhile since other tumours do occur in the mouth and may require different treatments.

Is an acanthomatous epulis treated differently?

Although still treated as a benign tumour this type of epulis usually invades the underlying bone so a more extensive surgical excision is necessary and histopathology carried out.