This case report describes the treatment of oral problems in a dog with persistent repetitive myoclonus caused by previous infection with canine distemper virus. Maxilla and mandible had undergone extensive remodelling; a number of teeth were missing or previously extracted. Remaining teeth were malpositioned and some were fractured, extensive oronasal fistulae were present bilaterally and the oral mucosa had chronic self-induced trauma. As myoclonus continued during general anaesthesia the patient required a neuromuscular block to facilitate oral surgery. Soft tissue healing was complicated by the myoclonus; the patient required staged treatment and revision surgery of oronasal fistula repair. The patient was also assessed by an internal medicine and neurology team and underwent blood tests and cytology, radiography and computed tomography of the head and thorax to determine suitability of dental treatment. The goal of involved oral surgery was to achieve as much comfort as possible, as the combination of continuing orthognathic forces and presence of fistulae and mucosal lesions caused problems with persistent pain and adequate nutrition.