Katie Scotter VetMB BA MRCVS, Molecare Veterinary Services 
Tooth root abscesses are a common condition seen in new world camelids in the UK. Unfortunately, it is often noticed by owners too late to avoid deformity and chronic infection, so it is a condition to be aware of and to check for regularly. Early intervention is the key to treatment success and avoiding costly surgical intervention.
Tooth root abscesses commonly occur in conjunction with premolar and molar tooth eruption, but may also occur as a result of gum disease, tooth fracture or jaw fractures. Permanent molar teeth in alpacas and llamas erupt between six months and four years of age, and premolars between three and a half and five years of age. As the teeth erupt, they create an entry point for bacteria which can create an infection in the tooth root.
Tooth root infections initially present as a firm swelling on the jaw. In camelids, the mandible (lower jaw) is the most commonly affected. If left unchecked this swelling becomes larger and the jaw bone begins to deform around the infection and new bone is created. This is called osteomyelitis, and is irreversible. Eventually the abscess will burst out of the mandible, and thick pus will continually drain from a small hole. This is when owners usually call us, and unfortunately permanent bone damage has already occurred by this point. Some animals do respond to conservative therapy with long term antibiotics (at least six weeks) and anti-inflammatories, but usually surgery is required to remove the infection and debride the abscess.
Conservative therapy is much more likely to have an effect on animals if treated before any osteomyelitis has occurred. However, it is very difficult to do this by visual examination and often your camelid will not be clinically affected and be eating normally, therefore regular palpation of the upper and lower jaw is the best method to pick up early signs of infection. Any time you handle your alpacas or llamas is a good time to examine them (e.g. at worming, vaccinating, shearing), the more often the better, but aim to do this at least monthly.
You are looking for a hard swelling on the mandible over the tooth roots. If you are unsure remember each alpaca/llama has two mandibles, so compare one side to the other, to see if the lump you are feeling is on both sides or not! Do not hesitate to speak to your vet if you have any concerns, as early treatment is the most effective.
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