Hope for rabbit with teeth problems?

Question
Dear Dana Krempels

I live in Denmark, but have previously benefitted from your answer concerning my 3,5 year old male dwarf rabbit who had mucus in the stool.

Now the mucus isnt really a problem any more. It has been gone for some months. Since then he has seen the vet for a check-up and they found out that his teeth has grown spurs that had injured his cheek and tongue.
The vet was not that optimistic and quite quick (i thought) to suggest that he should be put to sleep. For me that was a chock because he seemed absolutely fine - eating all kinds of things including his quite hard food - big Vitakraft nuggets, was very active and interested in things around the house. He is an indoor rabbit, running freely. But of course he must have experienced pain from the mouth.
Eventually the vet suggested tooth trimming after all - i was willing to do anything that could give him a chance.
His trim was done under full sedation - administered through the ear vein though.. Which afterwards I have heard is not the best choice. Still, his vet is one of the few people in Denmark who is a recognized rabbit "expert".
After his trim, he recovered very quickly, was on his feet soon after waking up. In the month that has now passed he has been thriving. Eating a lot and going nuts around the house. Absolutely happy bunny!
Now however the last 4 days he has changed his behaviour. He is eating and drinking less (but still eating the hard nuggets) and is much more quiet and retreats to his cage or behind the armchair.
I can hear a strange sound when he is eating, and he is a bit wet under his mouth. So I'm concerned that his spurs has already grown back, and causing him trouble again. Although that way he is acting now, he also did when I collected him from his former home. And back then it stopped again and he bounced back.
He has never been fed hay (I give him hay, but he eats almost nothing of it) and fresh grass is not his favourite either. He eats lots of leaves - dandelion, raspberry and strawberry leaves, clover and cloverflowers, parsley and more. But I'm not sure if that helps wearing his teeth properly? He never really gnaws anything - if I give him a branch, he just leaves it be. I guess he doesnt see the point ! :-) Anyway I wanted to ask you whether you think it would be realistic to make him eat lots of hay/grass and branches. Simply by not feeding him anything else. I have heard of people who did so succesfully, but I'm really scared that he'll just stop eating completely.
Of course his teeth will have to be okay before he can chew fx a wooden branch.. So I'm really looking for some hope that another trim would have a perspective.. That there could be some way for me to ensure more dental wear afterwards. I would be okay with having his teeth done 2 or 3 times a year. But not once a month.. I have read your previous answers and that you use a revlon file on rabbit teeth. I really would wish I could do that, but I know that is probably quite unrealistic. Maybe I could do the front teeth, since he is a very cooperative rabbit generally. But maybe the front teeth are not even the biggest problem.

Well, a very long story - sorry for that! Would be happy for any answer and/or comment you have on this. I know I might end up loosing him, but it really breaks my heart if it ends that way.. I've grown very attached to that little creature!

Regards
Tina

Answer
Dear Tina,

Rabbits can have chronic dental problems and molar spurs, and this is often because simply filing off the spurs does not address the underlying problem, which is misaligned molars.  I hope your vet might find this useful:

http://www.bio.miami.edu/hare/rabbit_dental.pdf

It shows how to diagnose rabbit dental disease.

I was lucky enough to attend a fascinating series of talks by Dr. Luis LeGrande (Toronto, Canada vet) on just this problem.  He recommends a drastic course of action:  file the molars right down the gumline (being careful not to harm the gums themselves) and then feeding a diet of strictly hay for two weeks.  Then the procedure is repeated.  This allows the hard food to push the rabbit's gums back down to a normal position, as over the years they will sometimes grow too long.  But because the gums adhere and are pulled upwards with the teeth as they grow, this is not always visible on simple oral exam.  Radiography is necessary for full diagnosis.

In short, this might require a couple of drastic molar filings, but it could result in a big improvement that will keep your bunny comfortable for a much longer time.  If your vet wishes to contact Dr. LeGrande about this procedure, I can provide his email address to you privately.  Just write to me at dana@miami.edu

I hope this will help!

Dana