Puppy Teething: What Is Normal and What Is Not

Teething is loud, messy and mostly uneventful. Puppies chew everything within reach, bleed a little, swallow most of the teeth they lose, and come out the other side perfectly fine.

Two things in that window are worth keeping an eye on, because both are considerably easier to fix during teething than afterwards.

The timeline

• 2 to 4 weeks: baby teeth start coming through
• 6 to 8 weeks: all 28 baby teeth present
• 12 to 16 weeks: baby incisors, the small front teeth, start falling out
• 4 to 6 months: the rest follow; canines and premolars are replaced
• 6 to 8 months: all 42 adult teeth in place

Small breeds tend to run slightly later and have more crowding problems, because the same number of adult teeth has to fit into a much smaller jaw.

What is normal

• Chewing everything. Constant, indiscriminate and driven by discomfort
• A little blood on toys or in the water bowl
• Finding teeth, or more often not finding them, because they are usually swallowed harmlessly
• Slightly sore gums, red where a tooth is coming through
• Mild, brief appetite reduction, or preferring softer food for a few days
• Drooling a bit more than usual

What is not

• Refusing food for more than a day, or obvious pain when eating
• Swelling on the face or jaw
• Persistent bad smell from the mouth
• Bleeding that does not stop, rather than a smear on a toy
• A broken tooth, which exposes the pulp and is painful and prone to infection
• Pawing at the mouth repeatedly, which can mean something is lodged across the roof of the mouth or between teeth

Retained baby teeth

The most important thing on this page. Sometimes an adult tooth comes through while the baby tooth stays put, leaving two teeth where there should be one, most often the upper canines.

This matters because:

• Food and hair trap between them, which causes early gum disease
• The adult tooth is pushed out of position, which can affect the bite permanently
• They do not resolve on their own

The usual rule is that no two of the same tooth should be present at the same time. Check your puppy's mouth monthly from four months, and if you see a doubled tooth, mention it. Retained teeth are usually removed, and this is frequently done at the same time as neutering to avoid a second anaesthetic.

Bite alignment

The jaw grows in stages and a bite that looks slightly off at four months can correct itself. Some do not, and a misaligned bite where a tooth digs into the opposite gum or palate is painful and needs addressing.

Ask your vet to look at the bite at the puppy vaccination visits. Catching a problem while the jaw is still growing gives more options than finding it at a year old.

Managing the chewing

The urge to chew is not disobedience and cannot be trained away during teething. It can be redirected.

• Offer appropriate chews, several, in different textures
• Chill them. A wet cloth twisted and frozen, or a rubber toy from the fridge, soothes gums
• Rotate toys so they stay interesting
• Move what you value. Shoes, cables and chair legs are your responsibility during these months
• Redirect rather than punish. Take the wrong item, give the right one, praise when it is taken

What not to give

• Cooked bones, which splinter
• Hard nylon bones, antlers and hooves, which fracture adult teeth. The rule of thumb: if you cannot dent it with a thumbnail, it can break a tooth
• Stones and sticks, which break teeth and cause mouth injuries
• Old shoes. A puppy cannot tell the difference between an old shoe and a new one

Biting hands

Distinct from teething, though it peaks in the same period. Puppies learn bite control from littermates and need to keep learning it from you: when teeth touch skin, the game stops immediately and briefly. Consistency from everyone in the house matters more than technique.

Do not encourage hand-wrestling and then object when a bigger dog does the same thing.

Start brushing now

Teething is the ideal time to get a puppy used to having its mouth handled, even though you are not yet brushing properly. A few seconds a day with a finger, then a soft brush and dog toothpaste, builds a dog that tolerates dental care for life. Almost nobody does this, which is why dental disease is so common in adult dogs.

Teething problems are cheap to catch and expensive to leave. A retained baby tooth removed during the neutering anaesthetic costs almost nothing extra; the same tooth found at three years old means gum disease, a separate anaesthetic and a bigger bill.

Consultations and surgery within your plan's sub-limit are covered on Skeepy Pet HMO plans, so the check that spots it while it is still trivial is part of the visits you are already making.