Tooth Dislocation or Sudden Loss in Dogs

Dislocation , luxation or sudden loss of teeth in canines is usually caused by trauma to the mouth area. Partial dislocation of the tooth is called luxation and full dislocation out of the socket is referred to as avulsion. Luxation can present vertically (up or down within the socket) or laterally (movement is from side to side). Luxation and avulsion are both urgent conditions that need veterinary intervention without delay. 

Trauma to the mouth is the most common cause of dislocation of the teeth. Luxation and avulsion are both urgent conditions. Any damage or irregularity of the teeth should be investigated by your veterinarian as soon as possible. 

Although the loss of a tooth is fairly easy to spot and a tooth that is significantly loosened may be simple to identify, some forms of tooth dislocation are more difficult to see. If a tooth gets dislocated upwards (intrusive luxation) it will appear shorter, but may not appear to be loose in the socket at first glance.

• Discoloration of tooth
• Pain or tenderness in mouth
• Movement of (adult) tooth in socket
• Bleeding in mouth
• Difficulty chewing or eating
• Excessive or abnormal drooling
• Swollen gums
• Missing tooth
• Visible displacement of tooth

Types

• Avulsion- Complete displacement of the tooth from the tooth socket.
• Concussion- Damage to the structures supporting the tooth without displacement or increased movement of the tooth. A concussed tooth will be tender to touching or tapping, and may exhibit bleeding from the gums.
• Extrusive luxation- Tooth is still attached but exhibits partial displacement out of the socket.
• Intrusive luxation- Tooth is attached but has been pushed deeper into the socket
• Lateral luxation- Tooth is attached but an eccentric displacement of the tooth is present.
• Subluxation- Damage to the structures supporting the tooth that causes abnormal loosening, but no displacement.

Sudden loss or displacement of a tooth is almost always due to trauma to the mouth area. This can be due to falls, blows to the face, disputes with other dogs, car accidents, or biting down on inappropriately hard material, such as bone, stone or metal. Infections of the teeth and gums can weaken the teeth and increase the chance that they will become displaced or broken. 

This type of damage is often referred to a veterinary dentist for both diagnostics and treatment. The veterinarian that is working with you will need information regarding any injuries to the mouth, when the symptoms first started, and if there is any history of previous infection in the mouth or periodontal disease. A thorough examination of the teeth and jaw, as well as x-rays of the affected area, are essential for a full diagnosis. Your veterinarian will likely be able to determine what type of dislocation is present from the physical examination, but the x-ray is needed to check for additional damage to the socket and jaw. X-rays can also help determine if there are any underlying causes that need to be addressed. The underlying conditions that may be revealed by x-ray could include the aforementioned tooth infections or periodontal disease, as well as rarer conditions such as osteoporosis or bone cancer. 

Avulsion, luxation, and concussion are all urgent matters and you should contact your veterinarian as soon as you are aware of the problem. Your veterinarian will either have you come in or will make a referral to a veterinary dentist. 

If the tooth is concussed or luxated, keep your dog calm and quiet while you contact your veterinarian. Your veterinarian may have you realign the tooth in the socket if it is possible and safe to do so. This will protect the root from drying out and help to prevent further damage to the socket. 

If the tooth is completely removed from the socket, pick the tooth up without touching the root. If there is dirt or debris present you may rinse the tooth in lukewarm water for just a few seconds, any longer than a few seconds could cause additional damage to the tooth.  Do not attempt to dry the tooth off or to wrap it in paper or cloth. When it is possible, reinsertion of the tooth into the socket will best protect the roots from drying out, otherwise putting the tooth in a small amount of milk or saliva will keep the roots viable for a short time. 

It is often the case that the tooth may be reinserted, but time is of the essence. Successful replantation of avulsed or luxated teeth usually has the best prognosis the more quickly it is addressed. Oral surgery under anesthesia is generally required to replace or reposition the tooth. Various wires or splints may be used to hold teeth in place while healing. If the tooth cannot safely be reinserted or repositioned, your veterinarinan will make sure to remove any damaged tooth fragments that may be in the socket and suture it closed if warranted.

Most owners, however, won't pursue tooth replacement as it is a costly and specialised procedure.

The first 24 hours after oral surgery you will want to ensure that your dog is kept calm and quiet to speed recovery. Your pet is likely to be groggy and you will want to remove obstacles and hazards in your home. Be cautious with pet to pet interactions during this time, as disorientation and temporary changes in odor can cause conflict even with pets that normally get along. 

How long the splint needs to stay in place depends on the severity of the damage to the tooth and to the alveolar socket. Splints may be removed as soon as 7 to 10 days in the case of minor damage, or they may need to stay in place for 4 to 6 weeks in the event of fractures in the jawbone or tearing of the support structures of the tooth. While the splint is in place chewing should be restricted, and your canine companion will be put on a soft food diet until the tooth has stabilized. The area around the splint will also need to be flushed clean with water at least twice daily while it is in place.

Once the tooth is reattached another x-ray will be taken to check progress, and a root canal will most likely be required to remove any necrotic pulp in the tooth.

In the case of tooth loss, healing occurs quickly over a few days. The gum should be monitored for signs of infection.