Last updated October 25, 2026
A dog needs a tooth pulled when that tooth is causing pain or infection that can't be fixed with the tooth still in place. By far the most common reason is gum disease, usually once it has destroyed more than half of the bone and ligament holding the tooth. The others are a broken tooth with its pulp exposed, a baby tooth that won't fall out, a tooth that never came through the gum, and problems hidden under the gum line, such as leftover roots, dead teeth and resorption.
You usually can't tell which teeth those are by looking. The decision is made tooth by tooth under anesthesia, with a probe and x-rays, which is why the exam and x-rays at a dog dental cleaning come before any extraction. A tooth that looks fine above the gum can have a dead pulp or a broken root under it.
Gum disease is behind most extractions
When researchers went through the records of 2,201 small and medium dogs treated at two veterinary dental hospitals in Korea, gum disease was the reason for 82% of the more than 21,000 teeth extracted (Kim and colleagues, 2025). Dogs under 5 had an average of 6.5 teeth pulled for it and dogs aged 11 to 15 had 12. By breed, Miniature Schnauzers averaged 13.7 teeth and Spitz dogs 2.
Vets judge a tooth with gum disease by how much of its support is gone, on the four AVDC stages of gum disease. The AAHA guidelines say that once pockets or receding gums pass 50% of the root support, which is stage 4, extraction is indicated. The alternative is bone surgery followed by daily home care, with what AAHA calls a guarded outlook.
Two other findings push a tooth toward extraction. On a tooth with two or three roots, the probe may pass right through the gap between them, which the AVDC calls stage 3 furcation. And a tooth that moves more than 1 mm, or can be pushed up and down in its socket, has the loosest AVDC mobility grade, M3.
Stage 3, with 25 to 50% of the support lost, is where you come in. AAHA says treatment to keep a stage 3 tooth, such as cleaning the root surface or gum surgery, only works if the owner will clean the teeth every day. If that won't happen, extraction is indicated, so be honest with your vet about it before the procedure.
A broken tooth comes out when the pulp is exposed and can't be saved
A chip that stays in the hard outer layers can usually be sealed or crowned. Once the break reaches the pulp, the living core of the tooth, mouth bacteria get in and the pulp becomes infected and dies. The Merck Veterinary Manual says such a tooth needs a root canal or an extraction, so leaving it isn't an option.
Time changes the choice. In 97 broken canines with the pulp exposed, 88% of those treated within 48 hours with a procedure that keeps the pulp alive still had a living pulp three years later, against 23.5% when treatment waited up to three weeks (Clarke, 2001). A fresh break with a pink or red dot is a same-day call.
Many broken teeth that come out are broken where you can't see. In the Korean records, nearly half of the broken teeth that came out had broken at the root. Breaks were most common in the upper fourth premolar and lower first molar, the big shearing teeth at the back.
In a lab test on teeth from dog cadavers, upper fourth premolars broke at an average of about 130 kg (290 lb) of force, inside the range of bite forces measured in dogs (Soltero-Rivera and colleagues, 2018). Cooked bones (which also splinter), dense leg bones such as beef shin or marrow bones, antlers, hooves and hard nylon are what break teeth. Soft raw bones like chicken necks, sized so the dog has to chew and given under supervision, aren't in that group, though raw chicken means washing hands and bowls afterwards. If your thumbnail can't dent a chew, it's too hard.
Baby teeth that stay and teeth that never come through
A baby tooth still in place once its adult replacement is coming through should come out. AAHA calls for immediate extraction, because it pushes the adult tooth out of position and the crowding traps plaque. Our timeline shows when a puppy's baby teeth should fall out.
A gap where an adult tooth should be is a different problem. Merck warns that an unerupted tooth can form a cyst that destroys part of the jaw. At one dental referral practice, 29% of 213 unerupted teeth already had a cyst-like lesion on x-ray, and 69% of the unerupted teeth were the small lower first premolar, just behind the canine (Babbitt and colleagues, 2016). An x-ray shows whether the tooth is there, and if it is causing trouble, it comes out.
Reasons you can't judge by looking
A root can stay in the jaw after an old break or an earlier extraction, with nothing showing above the gum. Leftover root tips were 3.5% of the extractions in the Korean study. The AAHA guidelines call x-rays before and after every extraction essential, partly so that no root is left behind.
A pink, purple, gray or tan tooth with an intact crown is usually dead inside. In one study, 59 of 64 discolored teeth that were opened (92%) had a dying or dead pulp, yet 36 of 84 (43%) showed nothing wrong on x-ray (Hale, 2001). The author recommends a root canal or an extraction for these teeth.
Tooth resorption is the body slowly breaking down the tooth itself, often below the gum line. At a university dental service, x-rays found it in 120 of 224 dogs, more than half (Peralta and colleagues, 2010). That's why no vet can promise you a number of extractions before your dog is asleep, and why extractions are the part of a dog dental cleaning bill nobody can price in advance.
Teeth that can sometimes be saved
The canines and the big back teeth do most of a dog's work, so they're the ones most worth saving when the bone around them is healthy.
| Reason | What tips it toward extraction | What might keep the tooth |
|---|---|---|
| Gum disease, stage 3 | No one will brush daily | Root cleaning or gum surgery, then daily brushing |
| Gum disease, stage 4 | Over 50% of support gone, a probe through the roots, a tooth that moves over 1 mm | Bone surgery and daily home care, guarded outlook |
| Broken tooth, pulp exposed | Root fracture, bone loss, a dog under 11 months | Root canal, or vital pulp therapy if the break is fresh |
| Baby tooth that stays | Always, once the adult tooth comes through | Nothing |
| Tooth biting into the gum or palate | When moving or shortening it isn't possible | Orthodontics or shortening the crown |
| Stomatitis | Ulcers that don't settle after gum treatment | Cleaning and treating gum disease first |
Stomatitis, painful ulcers where the cheek touches the teeth, doesn't always mean every tooth comes out. Of 42 dogs treated at one dental specialty service, 81% recovered fully, mostly through treatment of their gum disease, and 17% ended up with no teeth (Ford and colleagues, 2025).
Before the day, ask which teeth might be saved and who would do that work. Agree how your vet will reach you if the x-rays show more than expected. If a broken canine or big back tooth is on the list, ask whether a referral to a veterinary dentist is an option.
Signs at home that mean a vet check
None of these proves a tooth must come out, but each needs a vet to look.
- A loose adult tooth
- A broken tooth, especially with a pink, red or dark dot in the middle
- A swelling below the eye or along the jaw
- Two teeth in one spot in a puppy over about 6 months
- A pink, purple or gray tooth
- Chewing on one side, dropping food, or pawing at the mouth
A fresh break and any facial swelling are same-day calls. The rest need a booked appointment soon, as long as your dog is eating and bright.
What happens on the day and after
Extractions are oral surgery, which AAHA says only a vet may do. Your dog is under general anesthesia. Teeth with more than one root are often cut into pieces and lifted out under a flap of gum that is then stitched closed. Nerve blocks numb the mouth and ease the switch to pain medicine at home, and after most extractions antibiotics aren't needed (AAHA).
Expect soft food and no hard chews or tug games while the gum heals, for as long as your vet advises. AAHA recommends a recheck 10 to 14 days later. Extractions let the tissue heal, and in the Merck Veterinary Manual's words dogs do "surprisingly well" without the teeth.
Questions owners ask
Can a loose tooth in a dog tighten up again?
An adult tooth that's loose from gum disease has lost bone, and AAHA calls that loss irreversible. Treatment can sometimes stabilize it, but it won't firm up on its own. A wobbly baby tooth in a puppy of 3 to 6 months is normal.
Can I pull my dog's loose tooth at home?
No. Even a loose tooth is often held by a long root, and a root that snaps off can stay in the jaw and become infected. A vet takes an x-ray afterwards to check nothing is left.
Can a dog eat normally after teeth are pulled?
Most can once the gum has healed, including dogs that lose many teeth. Your vet will tell you when to go back to dry food.
References
- Bellows J, Berg ML, Dennis S, et al. 2019 AAHA dental care guidelines for dogs and cats. J Am Anim Hosp Assoc. 2019;55(2), 49-69. doi 10.5326/JAAHA-MS-6933
- Kim CG, Kwon D, Lee K, Kim SE, Jo HM. Prevalence of reasons for tooth extraction in small- and medium-breed dogs. Animals (Basel). 2025;15(2), 224. doi 10.3390/ani15020224
- American Veterinary Dental College. AVDC nomenclature (periodontal stages, furcation and mobility).
- Clarke DE. Vital pulp therapy for complicated crown fracture of permanent canine teeth in dogs, a three-year retrospective study. J Vet Dent. 2001;18(3), 117-121. doi 10.1177/089875640101800301
- Soltero-Rivera M, Elliott MI, Hast MW, et al. Fracture limits of maxillary fourth premolar teeth in domestic dogs under applied forces. Front Vet Sci. 2018;5, 339. doi 10.3389/fvets.2018.00339
- Babbitt SG, Krakowski Volker M, Luskin IR. Incidence of radiographic cystic lesions associated with unerupted teeth in dogs. J Vet Dent. 2016;33(4), 226-233. doi 10.1177/0898756416683490
- Hale FA. Localized intrinsic staining of teeth due to pulpitis and pulp necrosis in dogs. J Vet Dent. 2001;18(1), 14-20. doi 10.1177/089875640101800102
- Peralta S, Verstraete FJM, Kass PH. Radiographic evaluation of the types of tooth resorption in dogs. Am J Vet Res. 2010;71(7), 784-793. doi 10.2460/ajvr.71.7.784
- Ford J, Bell C, Donovan TA, Martel D. Surgical outcomes in canine lymphoplasmacytic stomatitis, a retrospective study of 42 dogs (2012-2022). Front Vet Sci. 2025;12, 1681133. doi 10.3389/fvets.2025.1681133
- Merck Veterinary Manual. Reiter AM. Dental disorders of dogs (pet owner version, updated October 2025).
- Merck Veterinary Manual. Mulherin BL. Endodontic disease in small animals (professional version, updated September 2024).