Tooth pain can cause terrible discomfort for your dog, and is a clear indication that something is wrong. Often, animals learn to live with tooth pain, and show little to no symptoms that they are having a problem, making it hard for their owners to notice.

Subtle signs such as increased drooling, blood in their saliva, and suddenly acting shy when being petted around the head or mouth may be all you see. Other dogs can have trouble eating, favor one side of their mouth when chewing, or whine or spit out food. Dogs in serious pain may stop eating, ignore their chew toys, have foul breath, and may paw at or rub their face on the ground. A quick mouth check may reveal swelling or bleeding in their gums, discolored gums and teeth, or loose or damaged teeth.

There are many reasons why your dog could be experiencing pain in or around their teeth. The most common ones include:

When any tooth pain is evident, you should see your veterinarian right away. Often, it is due to a tooth or gum infection that can migrate into the bone and other tissues, causing nasal and ocular swelling and inflammation. If left untreated, tooth and gum issues can cause irreversible damage, loss of teeth, and other serious systemic problems. 

While most dogs can experience a tooth injury or infection, some breeds and individuals may be predisposed to tumors or retained puppy teeth due to genetics.

Gum disease starts simply as food, bacteria and your dog’s saliva combine to form plaque on the teeth. Within 1 to 3 days, minerals combine with that plaque and hardens into tartar that continues to build up. Over time, tartar can pry away the gums from the teeth, creating open pockets that can harbor bacteria as they multiply and spread, infecting nearby teeth. At the same time, your dog’s immune system will try to attack the bacteria by sending white blood cells which causes gum inflammation.

Gingivitis is the first stage of periodontal disease that can be treated, and presents as swelling, inflammation and bleeding at the gumline. However, if left undisturbed, it can lead to periodontal disease which is irreversible. Over time, that gum inflammation eats away at the gums, teeth and even at the jaw bone, causing fractures and bone loss. Eventually, gum disease can even increase the risk of liver, kidney or heart disease.

An abscess is an infection that occurs when tartar builds up and bacteria has a change to infect the gums and surrounding teeth. As the root of a tooth begins to be eaten away, an abscess forms full of that bacteria that is extremely painful. An abscess can also begin to form after an injury that breaks the tooth, or damages the protective enamel that prevents bacteria from entering the tooth. Abscesses often result in tooth loss, and bacteria can spread from the abscess to other areas of the mouth, nasal cavity and eventually, throughout the body.

A tooth is composed of several parts, including the root underneath the gums that sockets into the jaw bone, and the crown above the gumline. Inside the tooth, the pulp at the center contains nerves and blood vessels that nourish the tooth, and is protected by a layer of dentin that is filled with microscopic canals. The enamel is a hard, protective covering over the dentin that keeps bacteria from entering the tooth.

When the enamel wears away due to plaque, bacteria gains access to the dentin, which can result in tooth decay, or a cavity. Left unchecked, the decay continues eating away at the tooth, resulting in pain and tooth loss.

A break or fracture in a tooth can result in the loss of enamel. Severe breaks can even directly expose the dentin or the tooth pulp. Bacteria can then enter the tooth and begin the processes of decay, abscesses and oral disease. Broken or fractured teeth result from injury which could be accidental. Most commonly, though, breaks and fractures occur from chewing on hard items, such as toys, real or nylon bones, antlers, crate bars, or ice.

Abnormal growths in the mouth can be cancerous or benign, and can push teeth out of place as they grow. Non-cancerous tumors can develop from a gum or tooth infection or periodontal disease, while cancerous growths can have a genetic component.

When the baby teeth of a dog stay in place instead of falling out, they can cause several issues as the adult teeth grow in. These can include abnormal tooth placement, abnormal bites that can injure your dog’s mouth, abnormal jaw position causing trouble biting or chewing, and in some cases, severe pain that can stop a dog from eating. 

In any cases of tooth pain, you’ll need to see your veterinarian. They will conduct an oral exam to look for visible signs of tooth or gum injury, or inflammation. Sometimes, they can see the problem, such as decay on a particular tooth, or an abscessed area. However, they may need to do a more comprehensive exam, as well as conduct an oral cleaning before they can diagnose what is causing the tooth pain.

For a cleaning and more thorough exam, your dog will need to be given anesthesia. During this time, your veterinarian will thoroughly examine the teeth and gums, conduct a cleaning and remove tartar, as well as take dental X-rays to help diagnose the problem. In cases of gingivitis, this may be all your dog needs to alleviate the tooth pain. For other reasons, your veterinarian may treat the issue now, or reschedule for a second appointment.

For a tooth root abscess, or broken or fractured teeth, treatment is either a root canal which hollows out the pulp of a tooth and replaces the enamel which stops the bacterial infection, or removal of the affected tooth, generally followed by prescriptions of antibiotics and pain medications. A fractured or broken tooth in a puppy can also be treated with a vital pulpotomy that encourages the remaining pulp to produce a new dentin wall.

Cavities are treated based on the severity of decay, with early cases simply needing a fluoride varnish or bonding agent to protect from further cavity development. More advanced stages of tooth decay will require removal of the affected enamel and dentin that is replaced with a cap, a root canal, or tooth removal.

Tumors can be surgically removed, and tested to see if they are cancerous. In cases of cancer, often the surrounding tissues are also removed, followed by radiation and chemotherapy. Any kind of tumor can return, so your dog should receive regular oral check-ups to catch them early. Tooth removal is the primary treatment for retained puppy teeth, as well as adult teeth that have been fractured due to overcrowding.

If your dog is experiencing advanced periodontal disease, they may need to have diseased teeth, gums or other tissues surgically removed. Often, a deep gum cleaning is needed, during which antibiotics, bone growth stimulants and sealants may be added to promote healing. While periodontal disease cannot be reversed or cured, you can stop it from progressing with consistent preventative care. 

Oral issues and pain can stop your dog from living a full life, and create a life-threatening situation if left untreated. But while you can’t always stop an injury from happening, prevention of most tooth and gum issues is absolutely possible.

By far, the greatest thing you can do to prevent most of the oral problems that cause tooth pain is to simply brush your dog’s teeth. Just like for us, brushing teeth regularly keeps bacteria from forming plaque, and stops plaque from forming tartar. This simple act can prevent infections, abscesses, decay and gum disease in its tracks. But there are other ways to help prevent or catch oral issues early before they cause your dog discomfort.

Ways to prevent tooth pain in your dog include:

If your dog isn’t comfortable with a toothbrush in their mouth, try different brushes, rinses or medicated dental chews to ensure their mouth stays healthy and bacteria doesn’t have a chance to grow. 

The cost to treat tooth pain can vary considerably, depending on the reason and severity of your dog’s condition. A simple cleaning to remove tartar and treat gingivitis can average around $175, but treatments for advanced gum disease may be upwards of $350 or more. Removing teeth due to decay, absesses, tooth retention or injury can range from $100 to $300, while a root canal can be between $1,500 to $3000. Costs can include anesthesia, blood work and X-rays, needed components of diagnosing and performing oral cleanings and surgeries.