Managing Gingival Hyperplasia: Tilda’s Ongoing Dental Care Journey

Tilda is an 8-year-old Boxer with gingival hyperplasia (GH). Her breed is unfortunately quite prone to it. She’s also a much-loved member of Dr Nicole’s family, and she’s had close monitoring of her condition and consistent follow-up throughout her life.

GH involves an overgrowth of the gum tissue that can partially cover the teeth and lead to discomfort, bleeding when chewing, and areas where plaque can build up easily. These pockets are different to those seen in periodontal disease. There’s no loss of attachment. Instead, excess tissue sits over the tooth surface, making it difficult to manage with normal home care, like brushing a pet’s teeth. Over time, halitosis (bad breath) and gingivitis become more noticeable, which then makes the condition even worse.

Tilda comes in for regular scale and polishes every 6–12 months. In these photos, it had been about 8 months since her last treatment. Even at this stage, we were already seeing changes, although many of the cases we see are far more advanced. When it’s left too long, the gum overgrowth can become quite severe and, in some cases, can cover the teeth almost completely.

In the before photos, you can see plaque and calculus on the teeth, along with gingivitis and gingival hyperplasia. She then had a scale and polish, along with removal of the excess gum tissue (gingivectomy) and reshaping back to a more normal contour (gingivoplasty). This is done using a combination of radiocautery and careful scalpel work to avoid any heat damage to the teeth. Patients like Tilda are given good pain relief afterwards, but gum tissue heals quickly, so most are back to normal within a few days.

Tilda’s family usually knows it’s time for her next treatment because they smell it first. In fact, some of them will start complaining about her breath until she’s booked in. Along with that, there can be gum bleeding and some changes in how she’s chewing.

After treatment, she’s a much, much happier dog, and the difference in her breath is appreciated throughout the household. Tilda will continue with regular dental procedures under general anaesthetic, typically twice a year, to manage her condition.

In addition to keeping her gingival hyperplasia in check, as Tilda gets older, her regular dental procedures under anaesthetic also create a good opportunity for a thorough look over and to assess any unusual lumps. This has already proven to be a real advantage for her.

She had a small, inconspicuous lump on the inside of her ear, in a spot that was difficult to properly assess while she was awake. It had been put off for a couple of months because of this. During her dental, it was removed. It turned out to be a mast cell tumour, which is a common cancer in Boxers. It required wide margins, which meant a fairly large section of tissue had to be taken, but it was still possible to preserve the ear. The results came back as low grade with clean margins, so no further treatment was needed.