Abstract Background Dental disorders, of which tooth root abscesses are best documented, are highly prevalent in alpacas. Identification of risk factors can be valuable for prevention of dental disorders in this species. Hypothesis/Objectives To identify risk factors associated with wear abnormalities, malpositioning, diastemata, periodontal disease (PD), and occlusal pulp exposure at the level of the cheek teeth. Animals Two hundred twenty-eight alpacas (Vicugna pacos) from 25 farms. Methods Cross-sectional study. Dental examinations were performed on sedated animals. Risk factors were determined by clinical examination and interview. Multivariable logistic regression was used to identify risk factors for wear abnormalities, malpositioned teeth, diastemata, PD, and occlusal pulp exposure. Results Mandibular swelling was significantly associated with PD (odds ratio [OR], 11.37; 95% confidence interval [CI], 3.27-48.81; P < .001). Nearly 73% of included animals with mandibular swelling concurrently had PD. For every increase in herd size of 1 animal, the risk for PD increased by 2% (95% CI, 1-4%; P = .01). The association between severe stages of PD and body condition score (BCS) indicates a painful situation, impairing animal welfare (P < .001). For each 1-day increase in interval between pasture cleanings, the odds of finding pulp exposure for a single animal was estimated to increase by 1% (95% CI, 0-2%; P = .05). Conclusion and Clinical Importance Simple management tools such as measuring BCS, palpating the mandible for bony swellings, removing feces from pasture on a regular basis and decreasing herd size might help identify animals at risk for dental disorders or prevent their development.