Your dog is eating slower than usual. They dropped their favourite chew toy and have not touched it since. Something is off — but they look fine and they are not crying or whimpering. Dog toothaches are one of the most painful and most overlooked conditions in pet health. By the time most owners notice something is wrong, the problem has been building for weeks. This guide gives you the exact signs, a home exam you can do right now, and a clear decision on when to call your vet.

How to Tell If Your Dog Has a Toothache?

Dog toothache signs include subtle behavioral changes like reduced appetite, dropping food, or chewing on one side, alongside physical signs such as excessive drooling, bad breath (halitosis), pawing at the mouth, and blood in saliva or on toys. Behavioral shifts can include irritability, head shyness, and lethargy. 

Why Dogs Hide Tooth Pain Better Than You Think

Every competitor opens with “dogs hide pain.” None of them explain why — and the reason matters for how you look for it.

Dogs are descended from animals where showing vulnerability meant becoming prey. Pain suppression is not a choice — it is hardwired. A dog in significant dental pain continues to eat, play, and behave largely normally right up until the pain becomes unbearable. By that point the condition has usually moved from reversible to serious.

This means you cannot wait for your dog to show obvious pain before investigating. You look for changes — things that are slightly different from your dog’s normal baseline. A dog that used to eat in 30 seconds now takes 3 minutes. A dog that used to greet you enthusiastically now sits further away. These quiet shifts are how a dog communicates dental pain — not by crying, not by refusing food entirely, but by adjusting their behaviour to avoid the thing that hurts.

Early Signs vs Late Signs — Know Which Stage You Are In

Dental disease progresses in stages. The signs at each stage are different — and so is the urgency.

Identifying which stage your dog is in determines how fast you need to act. A dog in the early stage has time for a routine appointment. A dog in the critical stage does not.

12 Signs Your Dog Has a Toothache

1. Bad Breath That Developed Gradually A mild grassy or meaty smell from your dog’s mouth is normal. A sharp, sour, rotten, or fishy smell that was not there three months ago is not. The odour from a dog’s mouth with periodontal disease comes from bacteria producing sulphur compounds as they break down tissue. That specific sour-rotten smell is one of the earliest detectable signs of dental disease — and most owners dismiss it as “just dog breath.” It is not. Healthy dog breath does not smell offensive.

2. Dropping Food While Eating A dog in dental pain picks up food, bites down, feels a sharp pain response, and drops the piece. You see kernels or chunks of food scattered around the bowl. This happens because the contact with an inflamed gum or damaged tooth triggers a sharp pain that overrides the chewing reflex. Watch your dog’s next meal closely. If food lands on the floor consistently rather than occasionally, that pattern is diagnostic.

3. Eating Only on One Side of the Mouth This is one of the most reliable signs of a specific tooth problem — and one of the most useful home diagnostics available to you. See the dedicated section below on how to use this observation.

4. Sudden Preference for Soft Food A dog that has always eaten dry kibble and begins refusing it in favour of wet food, or begins eating the soft treat but leaving the crunchy one, is avoiding the pressure that hard chewing puts on a painful tooth. This is not pickiness. This is pain management. Read our guide on why your dog eats treats but not food — dental pain is one of the primary medical causes covered there.

5. Pawing at the Mouth or Rubbing the Face A dog trying to relieve mouth pain paws at their muzzle, rubs the side of their face along the carpet or sofa, or repeatedly licks their lips. The rubbing is an attempt to dislodge or reduce the source of discomfort. A dog doing this after meals — when chewing has aggravated the painful area — is a strong signal to look inside the mouth.

6. Excessive Drooling Some breeds drool naturally. The red flag is a change from your dog’s normal baseline — drooling that is heavier than usual, or drooling that contains a pink tinge or visible blood. Blood-tinged saliva almost always means gum bleeding, a fractured tooth, or an oral wound. Wipe your dog’s mouth after eating and check the cloth. Pink or red discolouration is a sign you need to examine the mouth.

7. Reluctance to Be Touched Near the Face A dog that previously allowed you to handle their muzzle, lift their lips, or scratch around their jaw — and now pulls away, turns their head, or growls when you approach that area — is telling you that specific location is painful. The reaction is usually proportional: gentle touching triggers mild evasion, direct pressure on the painful area triggers a sharper response. This localised sensitivity helps you identify not just that there is pain, but roughly where it is.

8. Aggression or Unusual Irritability Dental pain causes significant behavioural change. A normally gentle dog may snap when touched near the head. A dog that played enthusiastically may now growl when another dog approaches their face. One Quora respondent described a dog that was being medicated for aggression as a behaviour problem — until a broken canine tooth was discovered. The aggression resolved immediately after treatment. If your dog’s temperament has changed and you cannot explain why, add dental pain to your list of causes to investigate. See our guide on dog behaviour changes for the full picture of how pain drives temperament shifts.

9. Red, Swollen, or Bleeding Gums Healthy dog gums are salmon pink, firm, and moist. Gums that are red at the tooth line, puffy and swollen, or bleed when touched are inflamed. This is gingivitis — the earliest visible stage of periodontal disease and the first sign that bacteria are attacking the gum tissue. Gingivitis at this stage is reversible. If you see red gums, the window for easier treatment is open — do not wait for it to close.

10. Visible Tartar Buildup Run your eyes along the back teeth — the premolars and molars. Healthy teeth are white to off-white. Yellow-brown crusty buildup along the gum line is calcified tartar. Tartar harbours bacteria, drives gum inflammation, and causes the progressive bone loss of periodontal disease. The more tartar present, the more likely significant dental disease is already established beneath it.

11. Facial Swelling on One Side Swelling that appears under one eye, along the jaw line, or on one cheek is a late-stage sign that frequently indicates a dental abscess — a pocket of infection that has built up around the root of a tooth. An abscess causes severe localised pain, significant swelling, and in some cases a visible draining wound on the face where the abscess has broken through the skin. This is not a “watch and see” sign. A dog with facial swelling on one side needs a vet appointment today.

12. Lethargy or Loss of Appetite Severe dental pain suppresses appetite and energy. A dog that refuses even their favourite foods — not just dry kibble — and is visibly less energetic may have pain that has crossed from uncomfortable to unbearable. At this point the dental problem may also have a systemic component — bacteria spreading beyond the mouth. Check for fever using the method in our dog fever guide. A dog with dental disease and a fever above 103°F needs a same-day vet appointment.

The One-Sided Chewing Diagnostic

Every guide lists one-sided chewing as a symptom. None explain how to turn it into useful information.

Here is how to use it as a home diagnostic: offer your dog a large biscuit or a carrot stick — something hard enough that they need to chew it, large enough that they cannot swallow it whole. Watch from directly in front of them.

A dog with a painful tooth on the right side will position the food on their left side instinctively, avoiding the right. A dog with a painful tooth on the left does the opposite. Watch for three or four chews. The side they consistently favour is the comfortable side. The side they consistently avoid is where the pain is. Now you have a location to examine in your home mouth exam below.

The 6-Point Home Mouth Exam

Do this in good light, with your dog calm and seated. Have a helper hold the dog gently if needed. Move slowly and speak calmly throughout. Stop immediately if your dog shows signs of significant distress.

Point 1 — The lips. Lift the upper and lower lips on both sides. Look for swelling, sores, or any wound along the inner lip surface. A normal lip is smooth and uniformly coloured.

Point 2 — The front teeth (incisors). These small teeth at the very front are easiest to see. Look for chips, discolouration (brown or grey in a tooth that should be white), or recession of the gum line. Any tooth that is darker than its neighbours has likely had the blood supply cut off — that tooth is dead and almost certainly painful.

Point 3 — The canine teeth. These four long pointed teeth are the most frequently fractured. Look at the tip of each canine carefully. A healthy canine comes to a sharp, smooth point. A fractured canine has a flat, broken-off tip — sometimes with a small pink or dark spot at the centre where the pulp is exposed. A pink spot means the nerve is exposed. This is extremely painful and needs urgent treatment.

Point 4 — The premolars and molars. These are the hardest to see — they sit along the sides and back of the mouth. Gently press the cheek back to expose them. Look for: heavy brown tartar buildup, teeth that look darker than others, gum tissue that is higher on one tooth than its neighbours (indicating bone loss), or any tooth that appears to have a crack running down it.

Point 5 — The gum line. Run your eyes along the gum line of every visible tooth. The gum should meet each tooth cleanly with no gap and no recession. Red inflammation at the gum line, pockets between the gum and tooth, or gums that pull away from the tooth roots are signs of active periodontal disease.

Point 6 — Smell. With the mouth open, take one deliberate sniff. Normal dog mouth: slightly meaty, neutral. Dental disease: sour, sharp, rotten, or sulphurous. An abscess specifically produces a distinctly sweet-rotten smell that is unlike any other dental odour. If you smell something sharp and offensive, that is bacterial activity. The worse the smell, the more advanced the disease.

After the exam, write down exactly what you found at each point. Your vet needs this information. Use our dog care plan page to record your findings alongside your dog’s health history.

What Is a Slab Fracture?

This is the most common serious tooth injury in dogs — and almost no owner knows what it is.

A slab fracture is when a large piece of the side of a tooth breaks off, typically from chewing something harder than the tooth enamel — antlers, raw bones, nylon chews, or rocks. The fourth premolar, also called the carnassial tooth, is the tooth most frequently affected. It is the large prominent tooth on the upper jaw, visible when you lift the cheek.

When a slab fracture occurs, the inner layer of the tooth — the dentine — and sometimes the pulp cavity become exposed. Exposed dentine is sensitive. Exposed pulp is acutely painful — equivalent to a human’s nerve being exposed to air. The tooth does not look dramatically damaged from a distance. The slab breaks from the outer surface and the remaining tooth looks almost normal. Up close, you see a flat, broken surface rather than the natural curved enamel.

Signs of a slab fracture: sudden face pawing after a chewing session, reluctance to chew on the affected side, and a visible flat broken surface on one of the large upper cheek teeth. A slab fracture needs veterinary treatment — usually root canal therapy or extraction. It does not resolve on its own and worsens rapidly without treatment.

Signs of a Dental Abscess

An abscess is the most serious acute dental emergency a dog can have short of a systemic infection.

It forms when bacteria enter the root of a tooth — through a fracture, deep decay, or severe gum disease — and multiply in the enclosed space around the root tip. Pressure and infection build until the abscess either pushes into surrounding bone or breaks through the skin.

The specific signs of a dental abscess:

A swelling appears under the eye on one side of the face — this is the classic abscess presentation because the root of the carnassial tooth sits directly below the eye socket. The swelling feels warm and firm initially, then softer as it fills with fluid. Your dog is in significant pain when this area is touched. They may be reluctant to open their mouth fully.

In some cases the abscess ruptures through the skin, producing a small weeping wound on the cheek or jaw that drains a foul-smelling fluid. Owners sometimes mistake this for a wound or insect bite. If your dog has a small wound on their face below the eye or along the jaw with no obvious external cause — this is the abscess presentation. The wound is not the primary problem. The infected tooth is.

An abscess also produces systemic signs: mild fever, reduced appetite, and lethargy as the immune system responds to the infection. Check our guide on dog weakness causes if your dog is showing both facial changes and reduced energy — both point to the same underlying infection.

A dental abscess needs same-day veterinary attention. The infection is close to the sinuses and orbital area. Left untreated it spreads.

Which Tooth Hurts? Reading the Signs by Location

Different teeth produce different symptoms when they are painful. This table helps you cross-reference what you observe with where the problem likely is.

Breed-Specific Dental Risk

Your dog’s breed determines when dental problems are most likely to appear and what type they are most likely to face.

Small and brachycephalic breeds need dental checks starting at 2 years old rather than the standard 3. Periodontal disease appears earlier in these breeds, and catching it in the reversible gingivitis stage makes a significant difference to long-term dental health. Check our dog age calculator to understand what life stage your dog is in and when their dental monitoring should start.

Why Dental Pain Becomes a Whole-Body Problem

This is the part every owner needs to understand — because it changes dental care from a cosmetic concern to a health priority.

The mouth is not sealed off from the rest of the body. Blood vessels run through the gum tissue in direct contact with the bacteria that colonise inflamed gums and infected teeth. When gum tissue is inflamed and bleeding — even mildly — bacteria enter the bloodstream every time the dog chews.

These bacteria travel through the circulatory system and lodge in organs with dense blood vessel networks — the heart valves, kidney tissue, and liver. The chronic low-level bacterial exposure causes cumulative damage over months and years. Dogs with severe untreated periodontal disease have measurably higher rates of kidney disease, liver disease, and cardiac valve disease than dogs with healthy mouths.

This is why veterinary dentistry exists as a discipline separate from standard check-ups. A dog whose teeth “look okay” from the outside may have significant sub-gingival disease invisible without X-rays — and that invisible disease is actively contributing to organ damage. Read our full dog illness guide to understand how dental disease fits into the broader picture of your dog’s systemic health.

What to Do Right Now

If you found clear signs of dental problems in the home exam: Book a vet appointment. For early signs — mild redness, some tartar, slight bad breath — within the week is appropriate. For late signs — facial swelling, visible fracture, blood in saliva, or suspected abscess — call your vet today.

If you are not sure what you found: Take a clear photograph of your dog’s mouth in good lighting. Send it to your vet through their online portal or messaging system if available. Most practices can advise from a photograph whether an urgent appointment is needed. Do not wait weeks to investigate something you found in today’s exam.

What not to do: Do not give human pain medications. Ibuprofen and paracetamol are both toxic to dogs. Do not apply human toothache gels — clove oil and benzocaine products intended for humans are dangerous to dogs when swallowed. For safe pain management options while you wait for the appointment, read our guide on at-home pain management for dogs.

If your dog has not had a dental check in the past 12 months: Book one regardless of what the home exam shows. Periodontal disease affects approximately 80% of dogs over three years old — meaning most dogs have it before their owners know. X-rays taken during a professional dental exam reveal disease below the gum line that no home exam can detect. Early-stage disease caught at this level is far less expensive and less invasive to treat than disease caught at the abscess stage.

FAQs

How can I tell if my dog has a toothache without going to the vet?

Do the 6-point home mouth exam in this guide. Look for red gum lines, tartar buildup, discoloured teeth, broken canine tips, or any tooth that looks different from the others. Offer a hard biscuit and observe whether your dog chews on one side consistently. Smell the breath — offensive sour odour is a reliable early sign. These observations cannot replace a vet diagnosis, but they tell you whether you are dealing with an early-stage issue or something that needs urgent attention.

Do dogs cry or whimper when they have a toothache?

Rarely. Dogs suppress visible pain responses instinctively. A dog with a toothache severe enough to make them whimper is in extreme pain — the kind that has been building for a long time before reaching that threshold. Do not wait for your dog to vocalise dental pain. By the time vocalisation occurs, the condition is usually in the late or critical stage. Look for the behavioural changes described in this guide — they appear much earlier than any vocalisation.

What does a broken dog tooth look like?

A broken tooth has a flat, irregular surface rather than the smooth curved enamel of a healthy tooth. For canine teeth — the long pointed front ones — a fracture appears as a flat break-off across the tip, sometimes with a small pink or dark spot at the centre. Pink means exposed pulp — this is a dental emergency. A slab fracture on the large upper cheek teeth shows as a missing section of the tooth’s outer surface, revealing a flat or slightly concave exposed area underneath.

Can a dog live with a toothache?

Dogs adapt to chronic pain better than most owners realise — which is exactly what makes untreated dental pain dangerous. A dog can live with significant dental pain for months while appearing largely normal, all while the infection progresses, the bone loss continues, and bacteria enter the bloodstream. “Living with it” is not a safe option. Untreated dental disease causes measurable damage to the kidneys, liver, and heart over time. Treatment also produces a dramatic improvement in behaviour and energy that most owners describe as their dog “becoming young again.”

How much does it cost to treat a dog toothache?

Costs vary significantly by country, location, and severity. A professional dental clean under anaesthesia typically ranges from £200–£500 in the UK and $300–$800 in the US for a standard clean and examination. Tooth extraction adds to this cost. Treating a dental abscess requiring specialist surgery is considerably more expensive. Early treatment — catching gingivitis before it becomes periodontal disease — is substantially less expensive than late-stage treatment. Annual dental checks are the single most cost-effective dental investment.

Are some foods better for dog dental health?

Dry kibble does provide mild mechanical cleaning from the chewing action, but it is not sufficient to prevent periodontal disease on its own. Veterinary-approved dental chews — those with the Veterinary Oral Health Council (VOHC) seal — have proven plaque and tartar reduction data behind them. Raw vegetables like carrots provide mechanical cleaning without the calorie load of dental treats. The most effective dental hygiene is daily tooth brushing with a dog-specific toothpaste — which eliminates plaque before it mineralises into tartar.

This article is for informational purposes only and is not a substitute for professional veterinary advice. Always consult your vet before making health decisions for your dog