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11-11-03

Dental Health of Llamas and Alpacas


Laurel L. Tovrea, Veterinary Student
David E Anderson, DVM, MS, DACVS
Head and Associate Professor of Farm Animal Surgery
Director, International Camelid Initiative
Ohio State University
College of Veterinary Medicine
Columbus, Ohio 43210
Phone 614-292-6661
Fax: 614-292-3530
E-mail: Anderson.670@osu.edu


Dentition and Eruption Schedules

Llamas and alpacas both have deciduous teeth, or baby teeth, which are
present at or shortly after birth and will eventually be replaced by
permanent teeth.  The deciduous tooth will usually fall out revealing an
erupting permanent tooth behind it.  Llamas and alpacas have three pairs
of deciduous lower incisors (Id1, Id2, Id3), which occlude with the
dental pad, and three to five pairs of deciduous premolars (Pd1, Pd2,
Pd3, Pd4, Pd5), with two to three pairs on top and one to two pairs on
the bottom.  There are no deciduous molars.  All deciduous incisors and
premolars are present at birth unless the cria is born prematurely.
Premature birth could delay the eruption of deciduous incisors but  I1
is expected to erupt within days after birth.  Premature birth delays
the eruption of premolars and molars also but the length of the delay is
unsure.  In addition to the deciduous lower incisors and deciduous
premolars lamoids also have one pair of upper and one pair of lower
deciduous canines (Cd1) and one pair of upper deciduous incisors (Id3)
that are present in all animals but only visibly erupt in about 5% of
males.
Permanent teeth have eruption times that vary slightly with each animal
but generally fall within the permanent eruption schedule seen below.
Llamas and alpacas have one pair of upper incisors (I3), three pairs of
lower incisors (I1, I2, I3), one pair each of upper and lower canines
(C1), one to two pairs each of upper and lower premolars (PM1, PM2), and
three pairs each of upper and lower molars (M1, M2, M3).   Because of
the fairly consistent eruption schedule of some of the permanent teeth,
it is possible to accurately age llamas and alpacas by their teeth until
about 3 to 5 years of age.  After this time age can only be estimated by
the amount of wear that has occurred on fully erupted teeth, and even
then is variable between llamas and alpacas due to continuous growth of
alpaca incisors well into maturity and the relative deficiency in the
amount of enamel on the lingual surface of the lower incisors of
alpacas.

The canine teeth of adult camelids are especially well developed in the
male and along with the upper incisors, which are similar in shape and
function to the canine teeth, are considered to be the fighting teeth.
The fighting teeth are sharp and angled towards the back of the mouth.
Male llamas and alpacas use these teeth to defend territory and obtain
dominance, particularly during the breeding season.  This behavior is
not especially desirable in a pet or breeding animal.  Fighting among
males can result in serious injury to the forelimbs and scrotal area of
other males and there is also a danger to anyone handling the male such
as owners and veterinarians.

The molars and premolars, or cheek teeth, of the llama and alpaca are
selenodont, meaning they have longitudinal, crescent-shaped ridges.  The
cheek teeth generally exhibit sharp ridges and points typical of
herbivores that eat tough grasses and shrubs.  Even though the lower
cheek teeth are slightly narrower than the uppers, the cheek teeth of
llamas and alpacas do not have sharp enamel points on the lingual
surfaces of the lowers and the labial surfaces of the uppers to the same
degree that equines do.  This is because lamoids chew in a lateral
motion that keeps wear even.  The roots of the cheek teeth are also
closed so there is not continuous growth as in the equine.  This means
that llamas and alpacas will rarely need their cheek teeth filed, or
"floated". 

Eruption schedules

Deciduous: Id1  at birth
Id2  at birth
Id3  at birth
Cd1  variable   present in all animals but
visible in only about 5% of males at 9 months 
Pd3  at birth     not present in all
animals
Pd4 at birth    present in all animals, retained
by many after 5 years of age


Permanent: I1  2 - 2.5 years
I2  3 - 3.25 years
I3  3.1 - 6 years
C1  2 - 7 years average 2.5 - 3.5 years
P3 3.5 - 5 years absent in males and many females
P4 3.5 - 5 years
M1 6 - 9 months
M2 1.5 - 2 years
M3 2.75 - 3.75 years

Dental Health and Preventive Care

As in all other domesticated species, maintaining good dental
health should be a concern of both llama and alpaca owners.  Dental
problems are, however, one of the most common reasons camelids are
presented to the veterinarian.  Signs of possible dental problems
necessitating a dental examination by a veterinarian are weight loss,
quidding or dropping feed during eating, pain when chewing, partially
chewed fibers in fecal pellets, sensitivity to cold drinking water,
swellings on the mandible or over the maxillary tooth roots, protrusion
of incisors beyond the dental pad or lip, and visibly worn or deformed
teeth.  Some of the dental problems and procedures typically encountered
in llamas and alpacas will be discussed.

Periodontal disease is seen in llamas and alpacas, and can lead
to more serious dental problems.  Plaque and tartar accumulate on
camelid teeth and can cause gingivitis, which can lead to pain or even
tooth loss.  A veterinarian can remove dental plaque and tartar if it is
interfering with oral function, but this is rarely the case. 

Malocclusion is a common problem that occurs in both llamas and
alpacas.  It describes a condition where abnormal positioning of a tooth
or teeth prevents appropriate alignment with teeth of the opposing jaw.
This can result in abnormal wear of teeth, such as elongation of the
incisors (which can be trimmed) or elongation of the points on the cheek
teeth (which can be floated to prevent cheek and tongue lacerations), or
excessive pressure and wear on the dental pad.  Animals with
malocclusion may suffer from difficulty with prehension of food or
chewing resulting in malnutrition, weight loss, and poor body condition.
Malocclusion can have many different causes including trauma (directly
to the teeth or to the bones supporting the teeth), fluorine poisoning
(which causes softening of the enamel and therefore uneven wear of the
teeth), or a congenital abnormality.  A complete oral exam should be
performed on any camelid during the prepurchase exam to ensure that
there is no evidence of malocclusion especially if the owner is planning
to breed the animal. Elongated incisors may be trimmed using a variety
of techniques. We prefer a diamond edged side cutting dremel tool
because this allows smooth cutting without the risk of cracking or
splitting a tooth. Cracking or splitting teeth occurs occasionally when
pliers, tin shears, obstetrical wire, or other implements are used to
trim teeth. These complications can result in tooth root infection.

Retention of deciduous incisors is another common dental
problem.  Normally as the permanent teeth erupt they push out the
deciduous teeth.  Occasionally a permanent tooth will develop in an
abnormal position and fail to push out the deciduous tooth, resulting in
a double row of incisors.  This is readily apparent and can be easily
remedied by removing the deciduous teeth after sedation in most cases.
The deciduous teeth are rostral, or in front of, the permanent teeth.

The fighting teeth (and their potential for harming other
animals and people) have been discussed previously.  Disarming the
fighting teeth is desirable to prevent injury and is one of the most
common dental procedure performed. Extraction is one method of disarming
them but is not usually done since the roots are large and curved and
may requires deep sedation or anesthesia and specialized equipment.
Some veterinarians prefer to cut the crown of the teeth off and cover
the root with a gingival flap, but this should not be done on a young
animal with permanent teeth still erupting.  The fighting teeth are
usually disarmed by trimming them 2 to 4 mm above the gumline thus
leaving the pulp cavity intact.  This procedure requires less time,
instrumentation, and fewer materials than the other two methods, and can
be done while the teeth are still erupting, as may sometimes be required
with a very aggressive young male.  Llamas and alpacas generally
discontinue growth of their teeth by 7 years old so that life-long
trimming is not necessary.

Tooth Root Abscesses

Tooth root abscesses, or periapical abscesses, are usually seen
during the period of eruption of the permanent premolars and molars
around 5 years of age.  The molars are the most commonly infected teeth.
This has been attributed to feeding stemmy hay during their eruption
period.  As a result of chewing the overly coarse hay, food particles
disrupt the periodontal membrane and become the perfect breeding ground
for bacteria.  Owners can help prevent this by feeding good quality,
more easily chewed feed during this time.  Tooth root abscesses can also
be caused by disruption of the pulp cavity during routine dental
procedures such as trimming the fighting teeth. Tooth abscesses are
occasionally seen in very young llamas and alpacas because of septicemia
(bacterial infection in blood stream) and in very old animals (patent
infundibulum with geriatric dental disease).
Physical exam of affected llamas and alpacas usually reveals a focal
swelling over the affected tooth root.  This is also the most common
owner complaint.  The swelling may or may not have a fistulous tract
with purulent drainage (more often not seen as the abscesses often
rupture into the oral cavity).  The most frequently infected tooth is a
lower molar so the swelling would occur on the mandible (>90%) more
often than the maxilla (<10%), but can occur with any tooth.  Animals
may also be presented for reluctance to eat, abnormal chewing behavior,
unilateral nasal discharge, hypersalivation, weight loss, and pain.  Any
of these signs requires further investigation by a veterinarian to
correctly diagnose the nature of the problem and correct it.  Though
physical exam is helpful in diagnosing a periapical abscess, radiographs
of the skull under sedation or anesthesia will need to be taken to reach
a definitive diagnosis.  Radiographs will also determine the amount of
damage to the bone and may help determine the cause of the abscess, such
as a broken tooth, fractured jaw, or retention of a deciduous tooth.

There are several methods for treating a tooth root abscess.  They may
be treated with long-term antibiotics alone (30 % success rate), by
curettage and antibiotics (60% success rate), by root canal (we have
done several successful root canals, but unknown success rate), or by
extraction of the infected tooth (90% success rate).  Long-term
antibiotics for a llama or alpaca may end up costing more than
extraction of the tooth and reoccurrence is common, and sometimes
curettage and root canal may fail, necessitating repeating the procedure
at additional cost to the client and discomfort to the animal.  The
preferred method for treating periapical abscesses at The Ohio State
University Veterinary Teaching Hospital is extraction. 

Antibiotics will be prescribed perioperatively and continue for 10-14
days after the surgery.  These may be changed based on results of a
culture and sensitivity of bone samples obtained during surgery.
Bacteria commonly cultured from these abscesses are Bacteroides sp.,
Actinomyces sp., and Peptostreptococcus sp.  Fortunately these
infections very rarely, if ever, become systemic.  In addition to
antibiotics, the wound may be flushed once or twice daily until
granulation tissue completely fills the defect, which can take 14-21
days.

Antibiotic Selection

Bacteria Drug % susceptible
A. pyogenes ceftiofur 100 %
penicillin 100 %
tetracycline 82 %
sulfonamides 71%

Actinomyces sp. Ceftiofur 100%
penicilin 100%
tetracycline 93%
sulfonamides 87%

E. coli Ceftiofur 83%
penicilin 0%
tetracycline 71%
sulfonamides 65%


Some of the complications associated with the treatment of periapical
abscesses are bone sequestra, damage to other teeth or tooth roots,
fracture of the jaw, and even aspiration pneumonia.  Retaining the
services of an experienced veterinarian with the proper facilities and
equipment can minimize these complications and ensure optimal treatment
and results.  You may need to contact your local llama or alpaca
association to locate an experienced camelid veterinarian.

Dental problems are a common occurrence in camelids.  Owner awareness of
normal dentition and common abnormalities, along with continued
vigilance for any of the aforementioned signs can help prevent problems
or detect them earlier. Early detection facilitates more timely and
appropriate treatment by your veterinarian, and less discomfort for your
llamas and alpacas.


References

Fowler, ME (ed.): Digestive System, in Medicine and Surgery of South
American Camelids.
Ames, Iowa State University Press, 1992, pp. 306-312 and
333-334.

Fowler, ME (ed.): Surgery, in Medicine and Surgery of South American
Camelids.
Ames, Iowa State University Press, 1992, pp. 112-120.

Wheeler, JC.  Aging llamas and alpacas by their teeth.  Llama World,
1982; Summer: 12-17.

Kock, MD.  Canine tooth extraction and pulpotomy in the adult male
llama.  J Am Vet Med Assoc
1984; 185 (11): 1304-1306

Fowler, ME.  Health care of the geriatric llama and alpaca.  Veterinary
Clinics of North America: Food
Animal Practice, 1994; 10: 2, pp. 392-395

Anderson, DE.  Periapical tooth root infections in South American
camelids.  GALA, 1999; 14:5, pp. 39-40

Riviere, HL, EJ Gentz, KL Timm.  Presence of enamel on the incisors of
the llama  (Lama glama) and alpaca
(Lama pacos).  Anatomical Record, 1997; 249, pp. 441-448


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