• Trauma commonly affects the oral cavity, this may be specific, eg dog catching a stone and fracturing a tooth or as part of a greater trauma syndrome, eg maxillofacial trauma from high rise or road traffic accidents.
• It is essential to fully assess the whole animal to ensure that life threatening aspects such as shock, hemorrhage or internal injury are identified and each insult accurately triaged.
• Dental, oral and maxillofacial trauma often exists in combination; if one injury is found there are frequently other injuries which may be less obvious.
• Examples include: tooth fracture (crown or root) Dental fracture Dental trauma: root fracture , tooth luxation Dental trauma: tooth luxation/avulsion , soft tissue laceration, jaw fracture, symphyseal separation, temporomandibular joint displacement Temporomandibular joint: luxation , oronasal communication, pulpal bleed (resulting in tooth discoloration), and pulpitis leading to pulpal necrosis also potentially causing tooth discoloration.
• Tooth discoloration: the result of a pulpal hemorrhage, pulpitis and pulpal necrosis secondary to tooth trauma. Other causes include hematogenous infection of the pulp, excessive orthodontic or occlusal forces or any event causing long term disruption to the blood supply to the tooth.
• Most commonly seen with canine teeth.

Presenting signs

• Tooth or teeth appear altered in color/ transparency.
• Color range: pink-purple, entire crown or crown tip, gray, beige-brown, reduced translucency.
• Crown color may develop and alter (usually darken) over weeks to months.
• Pain.

Acute presentation

• Oral/ dental discomfort/pain however signs are subtle and often missed.
• Tooth or teeth adjacent to an intact tooth (which is or is yet to discolor) may be fractured.
• Subluxation or soft tissue injury may be associated with the injured tooth.
• Tooth may regain normal color if pulpitis is reversible.

Age predisposition

• Traumatic injuries are usually considered more common in young dogs.

Cost considerations

• Retention of affected teeth requires root canal therapy Endodontics: root canal therapy. A study has shown that the vast majority (about 94%) of discolored teeth have pulpal necrosis and that for a significant proportion of these there is no radiographic evidence of endodontic disease.
• Extraction Dental extraction of affected teeth may be the cheapest option but these teeth are usually immobile and present difficult extractions, thus this is not always the case.
• Monitor radiographs Radiology: dental do not give accurate information regarding toothache and require repeat procedures root canal therapy or extraction is thus generally preferred.

Special risks

• Ensure full assessment of all other injuries or insults
• Stabilize systemically first where required!