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Rabbit Care Guide [Pellets, Teeth & Happy Bunny]

Sick Rabbit needing care | LIBEVC

Rabbits are herbivores, which means they consume a diet made up of plant material like leafy grass hay, greens, and commercial pellets. Most of these foods are tough and fibrous, so bunnies have evolved teeth that grow continuously to offset their constant wear. The tough foods like hay, wear down the rabbit’s teeth, which is why their teeth grow continuously, unlike humans, dogs, cats, and other animals.

The fact that rabbits’ teeth never stop growing can cause serious health and dental problems that cause them pain, make them sick and even prevent them from being able to eat properly.

Dr. Shachar Malka from Long Island Exotics Vet Clinic has been treating exotic pets and animals including rabbits for over 15 years. He performs a variety of surgeries using high-end surgical endoscopy equipment that minimizes the risks associated with surgery, allowing for faster recovery. He continues to publish scientific articles on a variety of topics in avian and exotic animal medicine and lectures at international veterinary meetings, as well as other regional events.

Your bunny a total of six incisors, which are the big teeth in the front, two of which are hidden from view. Two pairs in the upper jaw (maxillary), a single pair in the lower jaw (mandibular), and the third hidden pair of upper incisors, called peg teeth.

Then we have the cheek teeth which are separated from the incisors by a large gap. On each side of the mouth, the cheek teeth are comprised of three upper premolars and three upper molars, with two lower premolars and three lower molars. The incisors naturally touch when a rabbit's jaws are at rest, but the cheek teeth do not.

Common dental problems in rabbits:

These issues are very common, but often overlooked. Worse, any one of these issues tend to lead to the development of even further dental problems, which can quickly become life threatening to the animal. That’s why it’s so important to get regular annual checkups that will ultimately save you a lot of heartache and money. Here are the most common dental problems rabbits develop.

  • Malocclusion

This is when the rabbit’s teeth become misaligned and cannot close down entirely, which can cause extremely painful ulcers that make it difficult for bunnies to chew or take food. In turn, the teeth are not worn down properly and the misalignment will only get worse and may later require extensive surgery.

  • Ulcers

The ulcers might cause pain when the rabbit chews, and their teeth cannot wear down properly, which causes them to grow in the wrong direction and eventually more pain and dental issues like maloclussion.

  • Tooth fractures & Spurs on the cheek teeth

Tooth spurs, which are sharp points on the teeth, can be really painful for your rabbit, and might prevent it from eating altogether. This also prevents the teeth from wearing down properly causing even more problems later if not treated early on.

  • Infections

A tooth infection can be impossible to spot yourself, but can unfortunately become a serious health issue. Rabbit bones are small and fragile, so infections travel through the bones to infect others very quickly, and can later require surgery.

  • Abscesses

Unlike other domesticated pets like cats and dogs, a rabbit abscess cannot simply be lanced and drained given the fragility of this small mammal. Light surgery is required in this case.

These issues are extremely common. If left untreated, the rabbit can suffer from anorexia and develop maloclussion, or an infection that easily spreads to their bones and can only be treated with extensive surgery.

Signs of Dental Disease in Rabbits

Rabbits are notorious for their slew of extremely common dental issues, but because they are a prey animal of nearly every land and air predator, they’re also masters of hiding their illnesses. Here are some easy to spot signs that your rabbit is in distress.

Dietary Changes (and Weight Loss)

As a result of the many dental problem they face, rabbits may lose interest in coarse foods such as hay, thus maintaining an incomplete diet. Even if appetite is unaffected, dental problems can still impede proper chewing and digestion. In many cases, associated weight loss, drooling and preferential appetite or anorexia are few common signs of dental disease.

Discharge and Hypersalivation

Tooth roots, especially those of the upper incisors, can become elongated, causing inflammation near the tear ducts. Ultimately this can block tear ducts so that tears stream down the face instead of draining appropriately. Besides the unpleasantness of constantly crying, the blocking of tear ducts is usually accompanied with infection.

The nasal sinuses can also become inflamed as result of elongated tooth roots, precipitating abnormal nasal discharge. Drooling and saliva accumulating in the corners of the mouth, on the chin and dewlap, may signify oral pain and/or the inability to close the mouth properly.

Rabbit owners should ask their exotic pet specialist to conduct a dental examination with an endoscope to determine the presence of elongated tooth roots. If caught early, the teeth may be filed down with special instruments; if not, your rabbit might require surgery.

Bulging Eyes

Abscesses (pus-filled pockets) in the upper cheek teeth can pressure the globe of the eye until it becomes stretched and damaged. This is often mistaken for a primary eye problem even though it originates as a tooth root abscess. Check your rabbit’s cheeks for any lumps, which might suggest the presence of a tooth root abscess. Unlike cats and dogs, rabbit abscesses cannot be lanced and drained and can only be treated with surgery.


In some instances the grinding of teeth can be a sign of abdominal discomfort in rabbits. Most often, teeth-grinding is a sign that your rabbit is in pain. Have your vet examine your bunny as soon as possible if you notice a recurring grinding of teeth.

Causes of Dental Disease in Rabbits


Selective breeding for types can yield anatomical changes (such as a “compressed face” similar to that of a boxer, pug, or bulldog) that contribute to dental disease. Unfortunately, genetic problems like these have no cure and require lifelong management. Although many breeds are especially susceptible to these changes, the most commonly affected ones are lop breeds, lionheads, and dwarf rabbits.


Many owners believe that bunnies need only be offered a diet of pellets, but it’s not true! Limiting the diet in this way has a negative impact on overall health, and can lead to dental problems, specifically. Pellets may simply break apart in the mouth without allowing for the teeth to be worn down appropriately during the chewing process.

Eating hay, on the other hand, requires a side-to-side grinding motion that prevents overgrowth of the cheek teeth. The most commonly used hay is timothy but other grass such as orchard hay or oat hay are solid options. Young bunnies, lactating does, and sick rabbits should eat alfalfa hay, a rich and flavorful grass. Hay should be available to your bunny all day. As for pellets, a one-eighth cup or spoonful a day is enough.


A fractured jaw may heal in an abnormal position, and broken teeth can begin to grow at an improper angle. These traumas can produce permanent changes in the conformation of the mouth that lead to dental disease. They may also encourage infection, as when abscesses form in exposed tooth pulp. A veterinarian might be able to fix these issues, but the earlier you bring your rabbit in for an exam, the better the chances.

Local Infections / Systemic Disease

Tooth root abscesses develop as a result of long term dental problems, especially when elongation leads to inflammation. Pronounced changes in calcium levels of the body can alter the structure of bone surrounding the teeth causing them to shift position and leading to malocclusion, the misalignment and inability to properly close the jaw.

At Home Prevention and Early Detection

Catching dental disease in its early stages improves the chances for successful treatment. The simple strategies below can be used to monitor and ensure the dental health of your rabbit.

1) Keep track of the diet noting any obvious changes. How much pelleted and fresh food (e.g., leafy greens) is your rabbit eating day to day? Make sure your rabbit is eating hay throughout the day.

2) Feel the sides the head, in front and below the eyes, on the cheekbones, and under the jaw. Left and right sides should feel very similar, so make a note of unusual lumps and contact your exotics’ veterinary specialist.

3) Have a look at the incisors by gently lifting the upper lips. These should meet evenly and if they do not, inform your exotics veterinarian.

4) If you notice persistent drooling or excess moisture around the mouth, chin and dewlap, or “double chin” speak with your exotics’ veterinary specialist.

5) Foul odor is not normal.

6) Check the eyes and nose for noticeable amount or colored discharge.

Even when these precautions are taken, dental problems often go undetected without the help of a trained exotics’ veterinary specialist. For this reason, LIBEVC recommends annual health exams for your pet religiously.

Treating Dental Disease in Rabbits

When dental problems are detected or suspected, a full comprehensive dental exam can be performed during an annual exam to accurately locate difficult to find dental problems.

Dental exams are best performed under sedation or general anesthesia. Rabbit veterinary specialists are specially trained in the use of safe and appropriate anesthetic techniques for small mammals and rabbits. General anesthesia is typically achieved using isoflurane gas administered via a mask. Vitals like heart rate and blood oxygen levels are monitored throughout with specialized equipment.

Once a rabbit is sufficiently sedated or anesthetized, radiographs (x-rays) of the skull are taken in order to detect any underlying disease.

To begin a dental exam, the mouth is opened using a speculum. At LIBEVC we use endoscopy to illuminate and obtain a closer view of the details of the teeth, gums, palate, and tongue. We record the procedure and can share accurate information with the owner. Endoscopy allows us to perform a thorough exam and precise treatment. This procedure is superior to looking inside a mouth of an awake rabbit with just a speculum or regular light source.

If resurfacing of the teeth is required, to remove tooth spurs for example, a small rotary tool is used with diamond bits specifically designed for dentistry.

A dental infection typically requires treatment with antibiotic medications, which are given via a syrupy liquid or injections. Infections are identified by analyzing slides of discharge, or other suspicious fluids, under a microscope. We may also recommend submitting samples of the above for culture and further analysis.

When a more serious dental problem is diagnosed, which may call for surgical intervention, we will discuss treatment options with you and schedule an appropriate time for a procedure to take place. Common surgeries we conduct include treatments for malocclusions, abscesses, and bone infections.

At LIBEVC, Dr. Malka has extensive experience in oral surgeries and has collaborated in research and the development of state of the art, specialized techniques that are not yet performed in other facilities.

Dental disease in rabbits is unfortunately common and chronic. Prevention, early detection and treatment, are the key for your rabbit health.

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