There could be several reasons why koi fish lose their teeth:
Diet - related issues: If koi fish consume inappropriate foods, such as those with excessive sugar content, it may lead to tooth decay, and subsequently cause tooth loss. For instance, if koi fish have an unrestrained sugar intake, it can result in tooth decay, and eventually, tooth extraction might be necessary.

Trauma: When koi fish fight with other fish or experience collisions, tooth loss may occur due to external injuries. Additionally, their teeth can be dislocated or damaged by hard objects like conch shells.
Water quality problems: Poor water quality or a lack of essential nutrient supplementation can also cause koi fish to lose their teeth. Maintaining clean water and providing a balanced diet is crucial for the health of koi fish.
Methods for preventing and dealing with koi fish tooth loss include:
Adjust the diet: Avoid feeding koi fish foods high in sugar. Ensure a balanced diet by providing nutritious feed suitable for koi fish.
Keep the water clean: Regularly change the water to ensure its cleanliness and prevent the growth of bacteria.
Observe and treat trauma: If you notice that a koi fish is involved in a fight or has collided with something, promptly treat the wound to prevent infection.
Regularly check teeth: Regularly examine the dental condition of koi fish to detect and address problems in a timely manner.
By implementing these measures, the problem of koi fish tooth loss can be effectively prevented and managed, ensuring the health of koi fish.