Puppy teething: what is normal, and when to see your vet
When the baby teeth change, what you see when all is well, how to spot a baby tooth that stays put, what a teething puppy can safely chew, and what teeth do and do not say about age.
In this article
We're dog carers, not vets. This is general information; always check with your own vet.
When do puppies start teething?
Puppies start losing their baby teeth at about 3.5 to 4 months, when the baby incisors make way for adult incisors. By 6 to 7 months, most puppies have a full adult set. Allow some margin for each dog, though: according to Utrecht University, the size of the dog affects when teething starts and how long it lasts.
Puppies are born without visible teeth. The first baby teeth come through at around three weeks, and by 6 weeks they are normally all there: 28 baby teeth in total. The adult set has 42 teeth. How things go in between, and what you do at each stage, is in the table.
| Age | What happens | What you do |
|---|---|---|
| Around three weeks | The first baby teeth come through | Nothing yet: your puppy does not live with you |
| Around 6 weeks | The baby set of 28 teeth is normally complete | Nothing yet: your puppy does not live with you |
| 3.5 to 4 months | The baby incisors are replaced: teething begins | Put chew toys within reach, look in their mouth every week and get them used to you lifting their lips |
| 6 to 7 months | Most puppies have their adult set of 42 teeth | Check that no baby tooth is still sitting next to an adult tooth |
| Seven to eight months | VCA recommends the weekly check up to this age | If anything still worries you, have your vet take a look |
Ages from VCA Animal Hospitals. The Animal Medical Center in New York gives 3 to 7 months for the adult teeth, so allow some margin for each dog. The 'What you do' column is our own advice.
Small breeds
The Merck Veterinary Manual, a reference work for vets, says the timing of when baby teeth fall out and adult teeth come in is set by genetics. Some breeds, small breeds such as the Maltese in particular, are prone to teeth that come through late or not completely. If you have a small breed, watch closely: if a tooth is missing or only half through once teething is over, have your vet take a look.
What are the signs of puppy teething?
Mostly chewing: almost every puppy gets a strong urge to chew while teething. They may also drool more, eat a little less eagerly and be irritable because of a tender mouth. A few spots of blood on a toy, and baby teeth you never find, are part of it too.
- Chewing everything. It is not disobedience: it is part of teething.
- Drooling and less appetite. Their mouth is tender, so they may eat a little less eagerly.
- A little blood. Blood on the gum, lip or tongue is normal when a puppy loses baby teeth.
- A distinctive smell. That 'puppy breath' goes with teething and lasts as long as the teething does.
- Teeth that vanish. Your puppy often swallows a loose baby tooth while eating. That does no harm.
What is not normal when a puppy is teething?
Two teeth in the same spot. If a baby tooth stays put while the adult tooth is already coming through next to it, it is called a persistent baby tooth. The new tooth can then grow in crooked, and food gets stuck between the two. Have your vet check it as soon as possible, even if your puppy seems fine.
It happens most often with the upper canines, then the lower canines, and then the incisors. It is more common in small breeds and in short-nosed breeds such as bulldogs, pugs, Boston terriers and boxers. It also often runs in families, which may point to an inherited tendency.
A baby tooth that stays put takes the place meant for the adult tooth. That tooth then grows in the wrong position, and your puppy ends up with an abnormal bite. Food and plaque build up between the crowded teeth, which can lead to tartar, inflamed gums and eventually tooth loss. If a lower baby canine stays put, the adult canine grows in on the inside, with its tip usually pointing towards the roof of the mouth.
Why you should not wait for the neuter
It is tempting to combine removing a baby tooth with a neuter or spay later on. VCA advises against that in most cases. A baby tooth that is removed in time usually gives the adult tooth the chance to move into its proper place. Leave it too long, and the adult tooth is unlikely to reach its proper place without orthodontic treatment. The extraction is done under general anaesthesia; your vet will discuss what your puppy needs.
If your dog had a retained baby tooth and you are thinking of breeding, tell your vet. Because most persistent baby teeth are genetic, the Merck Veterinary Manual says animals with this problem should not be bred, unless it is known that trauma caused it.
How do you check your puppy's teeth at home?
Look inside your puppy's mouth every week until they are about seven to eight months old. Gently lift the lips, look at the front teeth first and then the canines, and search for places where two teeth sit side by side. Keep it short, and reward your puppy afterwards with a treat or a game.
- 1Pick a calm moment. After a walk, for example, when your puppy is tired and lying on your lap or next to you.
- 2Start with the front teeth. Lift the upper lip and gently pull the lower lip down. This is where teething starts, and where you see the first loose teeth.
- 3Check the upper canines. In the upper jaw, the adult canine comes through in front of the baby tooth, on the nose side. A double canine then looks like a wider, blunter tooth with a narrower, pointed tooth behind it.
- 4Check the lower canines. In the lower jaw, the adult canine comes through on the tongue side. The narrow, pointed baby tooth then sits on the lip side.
- 5Take a photo if you are unsure. Your vet can look at it, and you can see for yourself whether anything changes from week to week.
That weekly look in the mouth also gets your puppy used to being handled. A puppy who stays calm while you lift a lip will find the vet's exam less daunting later on. You can read more about calm first experiences like this in our piece on puppy socialization.
What can a teething puppy chew on?
Toys made for puppies, sturdy enough that they cannot bite chunks off. Hard toys, nylon chews, cow hooves and ice cubes can damage the teeth. Bones, cooked or otherwise, are also too hard and can damage the intestines if swallowed. Cold is fine, though: pick a rubber teething toy that can go in the freezer.
| Better not | Why | Offer this instead |
|---|---|---|
| Hard toys and nylon chews | Can damage the teeth | A rubber teething toy made for puppies |
| Ice cubes | Can damage the teeth | A rubber teething toy that can go in the freezer |
| Cow hooves | Can damage the teeth | An edible puppy teething ring |
| Bones, cooked or otherwise | Too hard; can damage teeth and intestines | A flavoured puppy chew toy |
| Sticks | Can be hazardous, even though many puppies chew them | On a walk in the dunes or woods, bring their own teething toy |
| Toys that fall apart | Your puppy should not be able to get chunks, fibre or stuffing out of them | Check toys regularly and throw them out once they break |
Sources: VCA Animal Hospitals (what to skip) and the American Kennel Club (the alternatives, sticks and broken toys). The walk tip is ours. Always supervise chewing and play, as the American Kennel Club advises.
Keep chew toys where you can reach them quickly. If your puppy grabs a chair leg or your shoe, swap it calmly for something allowed, and praise them as soon as they chew on that. If your puppy grabs at your hands more often during these weeks, our guide to puppy biting shows how to handle it without punishment.
If your puppy goes to a sitter or dog daycare during the day, send their own chew toy along and mention that they are teething. Then the carer knows why they are gnawing more, and can tell you if they notice anything.
Can you tell a puppy's age from their teeth?
Yes, once they have started teething. The Faculty of Veterinary Medicine at Utrecht University developed a method to estimate the age of puppies based on their teeth. But many puppies only start teething after 15 weeks. So with a puppy that has not started yet, you cannot tell whether it is under 15 weeks.
Those 15 weeks are the minimum age for a puppy from another EU country. According to the NVWA, the Dutch food and product safety authority, the first rabies vaccination must be given at an age of at least 12 weeks and at least 21 days before departure. A puppy from another EU country can therefore only enter the Netherlands from 15 weeks (105 days). About 50,000 dogs are imported into the Netherlands each year, a large share of them puppies. Vets and enforcement officers regularly come across fraudulent passports and puppies imported too young.
For the study, owners sent a photo of their puppy's teeth on two fixed days a week from 10 weeks old, until all the baby incisors had been replaced. In total, 980 puppies started the study; puppies from abroad were excluded. The owners of 227 puppies could not take the photos and stopped. For 8 dogs the adult weight could not be estimated, so they were left out of the analysis. The study shows you can estimate a puppy's age from the way the baby incisors are replaced, provided you take the breed into account.
Even so, the NVWA cannot use the method as a formal enforcement tool, precisely because so many puppies start teething later. It can use the report when puppies have been seized after a violation, to show the country of origin that an animal was too young.
What you can check yourself as a buyer
If you are buying a puppy that was brought in from abroad, the teeth tell you little. The passport tells you more. Here is what you can check:
- 1The passport. A dog from another EU country has an EU pet passport, issued by a vet.
- 2The chip and the vaccination. According to the NVWA, the date of the microchip must be before or the same as the first rabies vaccination.
- 3The dates side by side. Count from the date of birth: for a puppy from another EU country, the first rabies vaccination should be at least 12 weeks later, and the puppy may only leave at least 21 days after that. If the dates do not add up, or some are missing, do not buy.
- 4Your own vet. Bring the passport to the first check-up. Your vet can go through the dates with you and check the teeth at the same time. If you are unsure whether a puppy was really born in the Netherlands, ask your vet to look too.
Frequently asked questions about puppy teething
Better not. A baby tooth that is changing normally falls out by itself, and your puppy often just swallows it. If a baby tooth stays put while the adult tooth is already next to it, have your vet look. According to VCA, extraction by the vet is then the treatment of choice, unless the baby tooth is very loose.
No. Loose baby teeth are often swallowed while eating, and according to VCA Animal Hospitals and the Animal Medical Center that does no harm. So if you never find a tooth on the floor, there is no reason to worry. Do check every week that the adult teeth are coming through properly.
As soon as you see two teeth where one tooth should be, if a lower canine grows inwards, if your puppy struggles to eat, or if a tooth seems to be missing after teething. Look in their mouth every week until they are about seven to eight months old, and you will spot it in time.
Small breeds and short-nosed breeds. Besides bulldogs, pugs, Boston terriers and boxers, VCA also names Chihuahuas. It also often runs in families. If you are buying from a breeder, feel free to ask whether it happened in the parents or in earlier litters.
That typical 'puppy breath' goes with teething, VCA writes, and lasts as long as the teething does. If their breath still smells strong once all the adult teeth are in, or you see red or swollen gums, have your vet look in their mouth.
Better not. VCA lists ice cubes, along with hard toys, nylon chews and cow hooves, as things that can damage the teeth. If you want to use cold, put a rubber teething toy in the freezer. The American Kennel Club calls that a good option. Stay with your puppy while they chew.
Sources
For this article we used:
- Utrecht University — Nieuwe methode om leeftijd van pups te bepalen (in Dutch)
- VCA Animal Hospitals — Persistent Deciduous Teeth (Baby Teeth) in Dogs
- VCA Animal Hospitals — Why Does My Puppy Still Have Baby Teeth
- Merck Veterinary Manual — Developmental Abnormalities of the Mouth and Dentition in Small Animals
- The Animal Medical Center (New York) — Deciduous (Baby) Teeth in Pets
- American Kennel Club — Puppy Teething and Nipping: A Survival Guide
- NVWA — Travelling from EU countries to the Netherlands with your cat or dog
About the authors
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