Dental Emergencies

How would I know if my dog has an emergency dental problem?

A dental emergency for dogs occurs when they are in noticeable pain or discomfort when using their mouth. This could be while they are eating, playing with toys, or just trying to open their mouth to yawn or bark.

In addition, your dog may have a dental emergency if you notice unusual symptoms such as swelling of the face, bleeding, the presence of pus, excessive drooling, or the jaw being held in an abnormal position. If you notice any of these signs, it is a good idea to have your dog seen by your veterinarian as soon as possible.

What are the most common types of dental emergencies for dogs?

Trauma to the head is the most common cause of a dental emergency. The injury may affect the jaws, teeth, facial bones, palate or soft tissues of the mouth. Accidents like falling from a high place, being struck by a vehicle, fighting with other animals, chewing inappropriate items, and chemical or thermal burns can cause trauma to your dog’s mouth. These injuries can tear or damage the tissues inside the mouth or fracture or dislocate the jaw and bones of the face.

Dogs with head trauma are first examined and treated for shock, oral wounds that may interfere with breathing, or other life-threatening conditions. Once stabilized, they may be anesthetized to evaluate the full extent of their injuries. Radiographs are taken, wounds are cleaned and treated, lacerations are sutured, and any fractures or dislocations are considered for possible surgical repair.

These cases are treated with antibiotics and pain medication. Severe cases may require the placement of feeding tubes through the nose or directly into the stomach, depending on the extent of the damage.

Fractures of the tooth may occur from chewing on rocks or other hard objects, oral tumors or pre-existing dental disease that loosens or weakens the teeth, gums or jaws. Some dogs will break their teeth during panicked anxiety-related behaviors such as chewing on wire crate bars.

A fractured tooth can expose pulp and nerves, which are visible as a red dot in the center of the tooth. A displaced tooth may be partially or completely pushed out of the socket and usually causes bleeding and tearing of the gums. Recently, I saw a dog whose owner was hitting balls with a baseball bat for the dog to retrieve. When the dog anticipated the swing, the owner hit him in the face and knocked the 100-pound dog’s upper canine tooth clean out of his head with no other trauma.

Dogs with fractured or displaced teeth may stop eating, drop food or chatter their jaws. They require immediate pain control and antibiotic therapy to prevent infection. In some cases, surgery is necessary to remove the affected tooth. Owners may choose to seek referral to a veterinary dentist for root-canal therapy to save the tooth rather than extracting it.

Teeth that have been partially or even completely dislocated may be successfully reimplanted depending on the amount of time the tooth has been out of the socket. Ideally, the tooth should be replaced immediately, but if this is not possible, the tooth can be placed in fresh milk, which maintains the vitality of the cells around the tooth for three to six hours.

Foreign objects that get stuck in the mouth are usually sticks or mulch. These objects can penetrate through tissues and create swelling or infection in the mouth, nasal sinuses or the space behind the eye. Sticks can become lodged across the hard palate and stuck between the teeth. Linear objects, such as string from a rope toy, can wrap around the tongue and cut into nearby tissue.

Dogs with oral foreign bodies will cough, gag, drool and paw at their mouth. Sedation is usually required to remove the object, clean the wounds caused by the object, and suture as needed. Antibiotics and pain medication are prescribed as well.

“Locked or dropped jaw” is a condition in dogs that occurs when the temporomandibular joint (TMJ) moves out of place and is unable to open or close. This is corrected by sedating the dog and replacing the jaw in its normal position. Surgery may be required if the problem recurs.

Dogs with TMJ dysfunction keeping the jaw closed are usually painful and distressed, whereas dogs with a dropped, open jaw are not painful and usually have benign paralysis of the facial nerve. This is treated with anti-inflammatories and by helping the dog eat and drink until the condition resolves on its own.

Masticatory muscle myositis (MMM) is an autoimmune condition that typically occurs in large-breed dogs. Inflammatory cells attack the muscles of the head that control the jaws. This condition is painful and dogs may be unwilling or unable to open their mouth. Dogs with MMM have either swollen, tender muscles at the top and sides of their head, or atrophied, shrunken muscles that cause the head to appear bony. When the condition is painful, medication is prescribed so these dogs can eat and drink more comfortably.

MMM can be diagnosed with a blood test and muscle biopsy. Once the diagnosis is confirmed, these dogs are treated with anti-inflammatory medications, usually steroids, that will reduce inflammation and restore function.

Dental abscesses form as the result of untreated dental disease or fractured teeth. These conditions are a pocket of infection that provides an avenue for bacteria to travel into the tooth roots and form an abscess. A dental abscess most often appears as a swelling right below the eye, and may result in eye bulging, a raised third eyelid or a turned-out eye.

Dental abscesses can be treated with antibiotics, anti-inflammatory and pain medications on an outpatient basis. Surgery may be eventually required to drain the abscess and treat the underlying periodontal disease. The upper fourth premolar, or carnassial tooth, is most commonly affected. If the abscess is not cleared up with medication, the tooth may need to be extracted.

What can I do to prevent dental emergencies?

Most dental emergencies in dogs are caused by poor oral hygiene and the development of a bacterial infection. These can be prevented by cleaning your dog’s teeth on a regular basis. You can do this by brushing them manually with toothpaste and a soft toothbrush. My favorite toothbrush to use to clean my dog’s teeth is a child’s spin brush. It has a small head with soft bristles and spins quietly. Both the large and small breeds tolerate it better than the back-and-forth brushing motion.

Dental chews can help reduce tartar build-up, but care should be taken to ensure they are chewed slowly rather than swallowed. Dental chews and bones can cause serious digestive issues if swallowed whole or in large pieces.

Dogs that develop tartar accumulations on their teeth and are resistant to having their teeth brushed may need to see their veterinarian for periodic ultrasonic dental procedures. Mild anesthesia is usually required for a thorough cleaning and polishing.