Veterinarians have long noted that dental problems are not uncommon among hedgehogs. Several years ago I gave my mother a hedgehog for Mother's Day, and the first time my mother took him to the vet, she was given a little teeny toothbrush and a little tube of chicken flavored toothpaste. Certainly, her vet was well intentioned, but we never could figure out how to get hedgie to tolerate brushing!
As I've gained a few more years of experience with hedgehogs, I unfortunately haven't found a better way to prevent hedgie dental problems, but I have made quite a few observations. First, while dental problems are not uncommon, they are also not the rule. Out of our current total of 50 adults, we only have 3 with dental problems. This seems to pretty representative of the proportion of 'dentally challenged' hedgies that we've had for the last 5 years.
We have observed that age doesn't necessarily equate to tooth loss or dental problems in hedgies. One of my gentlemen, Puck, lost all but three of his teeth by the time he was barely 2, while his father, Elliot, still had a full set of lovely choppers when he passed on at age 6. Still, age 2 to 3 seems a common time for tooth loss to occur. In this population, I'll usually notice some weight loss, which prompts me to check the teeth. The most common things that I will see are teeth that are simply gone, abscessed teeth, or tumors.
The best way I have found to check hedgie teeth at home is to take a tongue depressor and get the hedgie to bite on the flat side of it. Then I gently rotate it until I can get a glimpse in the mouth. This gives a good general look. The vet will probably want to sedate the hedgie in order to get a more thorough view.
In the case of tumors, I will take the hedgie to the vet to have the hedgie sedated while we assess the situation. Jaw tumors are not uncommon (I've had five cases, making it one of the most frequently diagnosed causes of death in our herd in the last 5 years). Sometimes the tumors are distinct and removable, sometimes they have spread along the jaw bone and can't be removed. We do what we can, and otherwise make the hedgie comfortable.
With abscesses, the veterinarian sedates the hedgie and drains the abscess. Sometimes the tooth or teeth have to be removed and antibiotics are prescribed to prevent infection. Recovery from this type of procedure is usually quick, and may only result in the loss of one or a few teeth.
The third type of problem is the most perplexing. The teeth may be very rubbed down, or simply gone. Puck, the aforementioned dentally challenged guy, simply has almost no teeth. He has his two front 'fangs' and one of the bottom front ones, which juts out at an odd angle. There really isn't much to be done, since there's no infection, and nothing to fix or remove. The important thing becomes ensuring that hedgie can still get adequate nutrition.
Ensuring adequate nutrition is pretty much the same for hedgies with all three types of problems. They will be unable to chew hard foods, and will require a softer diet. We typically will either offer our usual diet (a specially selected mix of cat and dog foods), but pre-soaked so as to be palatable, or a special hedgehog food called Select Diet.
Select Diet is a nutrient dense food that consists of soft pellets. Even hedgies with no teeth at all can use their gums to break it down. Puck went from 15 oz to 9 oz while on the regular moistened food for two months, but has maintained a weight of about 12 oz for the past year, since we switched him to Select Diet. Select Diet also has the benefit that it can be left in the bowl for free feeding, while the wetted food spoils rapidly and must be removed after a few hours. I have also heard of people using Science Diet A/D (available from many veterinarians) with toothless hedgies, as it is nutrient dense and soft.
In addition to dental problems, I have seen a few cases of hedgies with tongue problems. Occasionally, hedgies can bite their tongues, causing the tongue to swell up so big that it sticks out of the mouth! While this looks horrible, the swelling will decrease rapidly within 24 hours. Keeping the tongue moist with a few drops of water every hour or two, and giving hedgie a little water with a syringe to keep hydrated can also be helpful.
Even more frightening are instances in which a hedgie's tongue becomes severed. So far I have only heard two cases of this. The first was a hedgie who reportedly sliced off part of his tongue trying to lick one of those cat ball toys with a bell inside. The sharp plastic sliced the end of the tongue cleanly off. The second was a five year old hedgie found in her cage with copious amounts of blood, and the source was traced to the tongue. The best guess at cause was that she either bit it, or somehow it caught in the end of the water bottle, slicing when she tried to pull it free.
In both cases, there was considerable bleeding, but surgery was not necessary. Neither hedgie lost so much of the tongue as to be unable to eat or drink. Soft food and pedialyte and water via syringe were offered several times daily during the initial healing. The second hedgie is still in the healing process, the first was able to resume normal food and drink once she healed.