Puppy Teething: Safe Comfort, Tooth Changes and Warning Signs

By Dr Duncan Houston

A tiny tooth on the floor or a faint pink mark on a toy can be part of normal puppy development. Persistent bleeding, a broken tooth or a puppy refusing food needs a different response.

Teething is the change from baby teeth to permanent teeth. You can make this stage easier with safe chewing opportunities, gentle handling and timely checks of how the new teeth fit together.

Quick Answer

Puppies usually replace their baby teeth during the middle months of puppyhood, with the adult set generally present by around 6 to 7 months. Offer appropriately sized, flexible toys and avoid hard bones, antlers, ice and human teething medicines. Arrange a veterinary check for significant pain, persistent bleeding, a broken tooth or an adult tooth appearing beside a baby tooth that has not fallen out.

What happens during teething?

Dogs normally develop 28 baby teeth and later 42 permanent teeth. Baby teeth begin appearing in the first weeks of life; the timing of replacement varies by tooth and individual puppy.

The Merck Veterinary Manual's overview of dental development describes permanent teeth appearing during the following months and being present by about seven months. These are developmental guides, not deadlines for every visible tooth.

You may never find a shed tooth because puppies often swallow them. That is usually harmless. Chewing is also normal exploration, so its presence does not prove that gums are painful, and it need not disappear when teething finishes.

Comfort that does not damage teeth

Choose toys designed for the puppy's size and chewing strength. They should be large enough to avoid swallowing and flexible enough not to act like a hard object against a tooth. Supervise new toys and discard them when pieces loosen.

A suitable chilled toy may feel soothing. Avoid objects frozen rock-hard, and do not assume a food-filled toy is safe if your puppy can bite off the material surrounding it.

AAHA advises avoiding hard chewing items that can fracture teeth. Bones, antlers and hooves are inappropriate choices, and adult teeth are not immune to the same damage. Rope and fabric toys also need inspection because swallowed strands can cause serious intestinal problems.

Keep electrical cords, batteries, socks and small household objects out of reach. Trade calmly for an unsuitable item and reward chewing an approved toy. Do not pull hard on a toy caught around a tooth or turn every retrieval into a chase.

Food and mouth handling

Continue a complete puppy growth diet appropriate for expected adult size. Extra calcium or supplements do not speed healthy tooth development and can unbalance an otherwise suitable diet.

If a comfortable puppy prefers softer food, ask your vet whether moistening its usual food or using an equivalent complete wet diet would help. A puppy that is hungry but drops food, cries while eating or stops eating needs an examination rather than repeated menu changes.

Introduce lip lifting and brief toothbrushing practice gently, with rewards. Avoid scrubbing sore gums or forcing the mouth open. Once comfortable, build towards daily brushing with a soft brush and pet toothpaste. Do not use human toothpaste or human teething gels.

When two teeth occupy the same space

A baby tooth should normally be shed as its permanent successor comes through. If both remain, the new tooth may be displaced and food can collect between them. This is particularly important around the canine teeth.

The AAHA dental guidelines recommend early attention to persistent baby teeth when permanent teeth begin erupting. Contact your vet when you see this, rather than automatically waiting for a future neutering appointment.

Do not pull a tooth yourself. Baby teeth have roots, and force can fracture the root or injure the developing permanent tooth. Dental radiographs may be needed to understand what is below the gum.

A baby tooth without a permanent replacement is a different situation. As Merck's guidance on developmental dental abnormalities explains, some can remain when healthy and appropriately positioned, but examination and imaging are needed to make that decision.

Normal changes versus signs that need care

Fever, significant diarrhoea, vomiting, marked lethargy and prolonged appetite loss are not routine teething signs. Young puppies have limited reserves, so do not wait 24 hours before asking for advice when one is failing to eat or drink.

Common mistakes

• Explaining every chewing or appetite change as teething.
• Giving a harder toy because a puppy destroys soft ones.
• Using human pain relief, including ibuprofen, without veterinary direction.
• Assuming a small baby-tooth fracture does not matter.
• Forcing brushing through pain and creating lasting fear of mouth handling.

Frequently asked questions

Is it normal for my puppy to swallow a baby tooth?

Usually, yes. Many shed teeth are never seen. A swallowed toy or other foreign object is a separate concern and needs veterinary advice.

Can I give my puppy a frozen carrot?

A rock-hard frozen item is not a good choice for vulnerable teeth. Use a suitably sized flexible chew or chilled toy and supervise.

Should teething cause bad breath?

A brief change may occur, but persistent strong odour, discharge or discomfort warrants a mouth examination.

When should the vet check the adult teeth?

Around six months is a useful planned check, with earlier assessment whenever you notice pain, crowding or a persistent baby tooth.

Most puppies navigate tooth replacement well with sensible chewing choices and gentle care. The important distinction is between mild temporary changes and a mouth that hurts or is developing abnormally.

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If a new tooth or chewing change has you uncertain, ASK A VET™ can help you prepare useful questions for your puppy's veterinary team.