Puppy Dental Care: Teeth, Teething and Tooth Care

Just like human babies, ​puppies have baby teeth that fall out. Most puppies are born without teeth and go through a process known as puppy teething. From birth to six months, sharp puppy teeth erupt from the gums in the jaw in a predictable timeline. Puppies go through teething stages during the development of their teeth, including sore gums, and eventually—the eruption of 28 baby teeth. During teething, puppies may target all kinds of unexpected objects to gnaw and chew on, like baseboards and shoes, to relieve the discomfort. However, most dogs never outgrow the urge to chew. Pet owners are encouraged to learn about how their puppy's teeth grow in so they can best handle their dog as it ages.

Stages of Puppy Teeth and Teething

Birth to 2 Weeks

When your puppy is born, there are no teeth yet. During the first two weeks, you'll notice your puppy nursing and first opening its eyes.

Weeks 2 to 4

In the front of the mouth, narrow-edged teeth known as incisors will begin to emerge. The incisors are the first to appear at about two to three weeks of age. Puppies have six incisors on both the top and bottom jaw.

Premolars and molars also begin to grow behind canines (the pointed teeth between the incisors and premolars) at three to six weeks of age, with three on the top and bottom of each side. Four needle-like canines appear at age four weeks and frame the incisors, one on each side, top, and bottom.

Weeks 5 to 8

The last molars appear by six to eight weeks of age. At about eight weeks, the puppy’s permanent teeth begin pushing out deciduous or "milk teeth." The roots of the baby teeth are absorbed by the body, and in most cases, milk teeth simply fall out.

When the deciduous teeth don't fall out on time, puppies may appear to have a double set of teeth. Retained baby teeth should be extracted by a veterinarian so that permanent teeth have room to grow. Sometimes, a crowded mouth pushes teeth out of alignment, resulting in difficulty eating or poor dental hygiene (which can lead to periodontal disease).

All of your puppy's 28 baby teeth are expected to come in by this time. This is when puppies start to learn how to eat moist and soft puppy food.

Weeks 12 to 16

Breeders often let their puppies go to their new owners' homes around eight weeks. Baby teeth will begin to shed, and permanent adult teeth will start to come in. This process is painful for dogs, so providing puppy safe chew toys is recommended. This is a good time to socialize your dog more, look and touch the inside and outside of its mouth, and prepare for teeth brushing.

6 Months and Older

At this point, all puppy teeth should be gone, and adult teeth emerge. If there are any baby teeth left, let your vet know so it can be removed. Permanent teeth replace the milk teeth tooth-for-tooth and add four premolars and 10 molars. Most pups will have 42 permanent teeth in place by about seven months of age.

Signs to Keep an Eye on During Teething

While it can vary somewhat between breeds, there is a progression you can expect as your puppy develops new teeth. It's important to begin handling your puppy's mouth while it's young so you can periodically check for any potential tooth problems. Any type of facial swelling, changes in eating habits, unexpected night awakenings, or rubbing of the face are signs of possible oral discomfort.

You'll want to take your pup to the veterinarian if you see:

• Two teeth occupying one spot in your puppy's mouth. This can cause the adult tooth to come in crooked, possibly causing later problems.

• Spots of blood on your dog's toys, brown tartar on the teeth, or gums that are bleeding, inflamed, and/or sore. These are common symptoms of periodontal disease, a large oral issue for dogs.

• Broken or cracked teeth. This can cause the nerve of the tooth to expose itself, causing your dog pain or infection.

• Crooked teeth or malocclusion (misalignment of the upper and lower jaw). While some breeds have a trademark bite, unusual ones could cause chewing issues.

• Loose adult teeth. Most often, this is caused by trauma to the mouth or from gum loss due to advanced periodontal disease. It could also be a sign of illness.

How to Keep Teeth Healthy

Schedule a visit with your veterinarian for an initial dental exam for your puppy. This examination will include a look at the teeth, gums, and oral cavity. Ask your vet to demonstrate how to clean your pup's teeth. This way, you'll know what brushes, toothpaste, and techniques to use.

Get your pup used to the idea of tooth brushing around six months when its adult teeth start to come in. Regular brushing will prevent plaque, stinky breath, disease, and other medical problems. It's ideal to brush your puppy's teeth daily, but once or twice a week will work.

The Purpose of Each Dog Tooth

Different kinds of teeth serve various functions, based on the position of the mouth and the shape of the tooth. With some breeds, the shape of the jaw impacts how each type of tooth functions. Most dogs have V-shaped upper and lower jaws which allow the mouth to be opened very wide for grasping and capturing prey—or grabbing and holding toys during play. There are several ways dogs use their teeth:

• Dogs use their incisors to rip and scrape meat from bones. They also use them as a grooming tool to nibble burrs or dirt from their fur.

• Dogs use their two canine teeth, found on each side of the jaw (on the top and bottom), as pointed daggers to inflict stabbing and slashing wounds.

• Dogs have eight premolars in the upper jaw and another eight in the lower jaw. They also have four molars in the top and six in the bottom. The extra molars are designed to crush and are used to process vegetable foods and bones.

• Dogs have specialized carnassial teeth composed of premolars and molars. As they pass each other during the mouth's closure, these teeth act like scissors. The carnassial teeth are innovations of the carnivorous animal that requires shearing action to process flesh.

What a Proper Bite Looks Like

When the mouth is closed, dogs should have a normal "bite." This is very important so that dogs can eat and use their mouth normally.

A normal bite looks like this:

• The lower canine teeth are situated in front of the upper canines.

• The upper incisors overlap the lower incisors.

• The upper premolar points fit into the spaces between lower premolars.

• The upper carnassial teeth overlap the lower ones.
  

Malocclusion refers to the abnormal "bite" or fitting of these teeth. Malocclusion can be normal for certain dog breeds due to differences in the shape of the jaw and mouth. For instance, the flat-faced (brachycephalic) dog breeds like Bulldogs have a normal malocclusion because their lower jaw is longer than the upper. However, this allows the teeth to fit incorrectly, which can cause mouth damage as the dog chews. Thus, a veterinarian or veterinary dentist with orthodontic correction should be aware of malocclusion.

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dog health

Feline Dental Health: Top 10 Questions and Answers

It’s not all too common for cat owners to come in on account of their cat’s mouths. We have theories why.

Cat guardians have less direct contact with their pet’s mouth through chew toys and bouts of tug-of-war (as if a cat could be bothered).

The fact that poking around a cat’s mouth often results in deep puncture wounds (ouch).

Take your pick, add your own, but the majority of cat owners seem largely uninterested in the teeth, gums, lips, and tongue of their feline friend. But when they do ask questions, they’re some of the best, most challenging and interesting inquiries you’ll encounter. Read on; you just may learn something or get a chuckle or two.

1. How many teeth do cats have? I only see two – the fangs.

Cats have 30 adult teeth and 26 baby teeth. That’s far fewer than dogs (42 and 28) and less than humans (32 and 20). Those “fangs” or upper canine teeth often protrude saber-tooth tiger style and lend some cats an intimidating smile.

2. When do cats get their baby and adult teeth?

Observing the eruption or emergence of teeth is a great method for estimating a kitten’s age. This is particularly helpful when faced with a stray kitten. The first teeth to erupt are the tiny front teeth or incisors and the long, pointy canines (“fangs”). The primary (or “baby”) incisors and canines become visible around three to four weeks of age. The teeth immediately behind the canines, the premolars, quickly follow the front teeth. This typically occurs when the kittens are around five to six weeks old. The permanent teeth erupt around 11 to 16 weeks of age, beginning with the incisors followed by the canines at 12 to 20 weeks. The premolars are in place by 16 to 20 weeks of age. The difficult-to-see, way-in-the-back molars emerge around 20 to 24 weeks.

3. Do cats get cavities?

Dental caries, or “cavities”, are rare in cats and dogs. This is due in part to a cat’s relatively low-sugar diet, differences in oral bacteria, and the shape of the teeth. When cavities occur, they can be painful and require similar repair procedures as humans with cavities.

4. Why are cat bites so bad and likely to get infected?

Anyone who’s worked with and handled enough cats knows that when you’re bitten (note the “when”) by a cat, not only does it hurt, but those deep puncture wounds are likely to become infected or abscessed. The first answer lies within the unique anatomy of one of a cat’s main weapons – those long, sharp, pointy canines. Designed similar to hypodermic needles, these teeth excel at penetrating flesh intensely, damaging underlying structures such as arteries and veins. In addition, like that needle, they carry pathogenic bacteria deep inside the body. As the tooth is withdrawn, the narrow puncture wound closes onto itself, trapping behind infection that later becomes an abscess. Making matters worse, a cat’s mouth contains several species of highly pathogenic microorganisms. Don’t take a chance if you’re bitten. Flush the wound thoroughly and seek medical attention.

5. Can cats re-grow their teeth? Do their teeth keep growing their entire lives?

No and no. Sharks are probably the animal you’re thinking of. After a cat gets all 30 permanent teeth in place, that’s it. No more. Lose one and your cat is forever down to 29. Unlike rodents, a cat’s teeth don’t keep on growing.

6. Do cats need braces?

You jest but some cats do, in fact, need braces to correct some very severe oral malformations. The most common reasons for feline brace-face include lance or saber-like canine projections of the upper canines in Persian cats. “Wry bite” is another problem that results when an uneven bite occurs, causing one or both canines to protrude at odd angles, preventing normal eating and drinking. Braces for cats aren’t for cosmetic but literally life-saving conditions.

7. My vet said my cat had some painful tooth problem that may require extraction of several teeth. Is this legit?

Your cat may be one of the millions of cats affected by an unusual, exceptionally common and extremely painful condition known most often as feline ondoclastic resorptive lesions, or FORLs. Most cats with FORLs are over five years old. The most common clinical signs associated with FORLs include excessive salivation, bleeding from the gum line or teeth, and difficulty eating. Cats will suddenly become “picky” and refuse to eat dry kibble. There are many treatments available, but extraction is still the most commonly performed procedure to relieve this excruciating condition. The exact cause of FORLs has yet to be determined, although researchers are actively pursuing several theories.

8. Can cats get mouth cancer?

Sadly, yes. Oral tumors in cats are very serious and require immediate and aggressive treatment. Squamous cell carcinomas (SCC) are the most common malignant oral tumor in cats, although many other forms of cancer occur. If you observe any lumps, swelling, or discolored areas in your cats’ mouth, have it seen by your veterinarian at once.

9. My cat has swollen gums and entire mouth seems inflamed. What’s going on?

It’s likely your feline has a condition called stomatitis (more correctly referred to as lymphocytic plasmacytic gingivitis pharangitis syndrome). This condition is also very painful and most cats have problems eating and swallowing, weight loss, and excessive salivation. Treatments vary widely and cats respond differently to an assortment of options. The exact cause is unknown although an underlying immune-mediated disorder is strongly suspected. Be patient and work closely with your veterinarian; cats with stomatitis require extended periods of treatment.

10. I can’t brush my cat’s teeth! Am I a bad pet parent?

If not brushing your cat’s teeth is your worst offense, you’re not the worst. Fear not, you can choose to opt for routine cleaning (typically at least once a year) under anesthesia by your veterinarian. While they are sleeping, your vet may take dental x-rays to ensure there are no hidden problems underneath the gums. You can also give them chew treats approved by the Veterinary Oral Health Council (VOHC) to help reduce tartar in cats.

If your cats can tolerate it, try an oral antimicrobial rinse so they get their “mouth wash” a few times each week. Finally, make it a habit to (carefully) lift the lips of your cat and examine their teeth and gums each week to make sure everything looks healthy. So don’t fret— take your cats to your veterinarian at least once a year, have the teeth cleaned by a professional when needed, conduct routine home mouth checks, and use products proven to help keep your kitty’s mouth healthy.

If you have any questions or concerns, you should always visit or call your veterinarian – they are your best resource to ensure the health and well-being of your pets.

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Discolored Teeth in Dogs

Stained Tooth and Teeth in Dogs

Teeth discoloration is any variation from normal tooth color. However, the normal color of teeth varies, dependent on the shade, thickness, and translucency of the enamel covering the tooth.

Any variation from normal tooth color is discoloration. The normal color of teeth varies, dependent on the shade, thickness and translucency of the enamel covering the tooth. Extrinsic discoloration occurs when exogenous pigment accumulates on the surface of teeth. That is, the cause of the discoloration is from an external source, rather than from a physical condition. Intrinsic discoloration is characterized by secondary factors that are happening inside the tooth, discoloring the underlying dentin.

Symptoms and Types

Intrinsic discoloration is characterized by secondary factors that are happening inside the tooth, discoloring the underlying dentin. Extrinsic discoloration, meanwhile, occurs when exogenous pigment accumulates on the surface of teeth. That is, the cause of the discoloration is from an external source, rather than from a physical condition.

Common symptoms associated with both discoloration types include:

• Abnormal coloration of one or more teeth

• Fractured tooth

• Pitted enamel (the glossy covering of the tooth) with staining

• Rings or lines of discoloration around one or more teeth

Causes

Extrinsic discoloration

• Bacterial stains from plaque (mucin, debris, bacteria and a thin film of food) and calculus

• Foods

• Bleeding gums

• Dental restorative materials

• Medications

• Metal

Intrinsic discoloration

• Internal (trauma, injury)

• Localized red blood cell destruction in the tooth (trauma)

• Systemic infections

• Medications (tetracycline)

• Exposure to too much fluorine (ingestion of toothpaste containing fluoride)

• High levels of bilirubin in the blood (from bile, the liquid in the gallbladder that helps to dissolve food in the intestines)

• Amelogenesis imperfecta (a condition in which dental enamel does not calcify enough)

• Dentinogenesis imperfecta. (a condition in which the dentin does not develop correctly)

Diagnosis

A complete blood profile is to be conducted, including a chemical blood profile, a complete blood count, and a urinalysis. You will need to give a thorough history of your dog's health, onset of symptoms, and possible conditions that might have caused this condition, such as diet, injury, recent illnesses, etc. The history you provide may give your veterinarian clues to the origin of the dental condition.

An oral exam is part of a thorough physical exam. Your veterinarian will need to x-ray your dog's teeth in order to identify internal or external resorption, and whether restorative materials or bacterial stain from bacteria are entering the crown of the teeth. Your veterinarian may also use a strong fiber optic light that is focused on the teeth to determine vital from dead dental pulp (the nerves and blood vessels in the tooth). If the tooth (or teeth) need to be removed, your veterinarian will most likely need to subdue your dog with general anesthetize in order to extract it.

Treatment

Extrinsic stain removal can be performed for cosmetic reasons. These procedures often involve internal and/or external treatments such as bleaching, veneers and crowns.

Intrinsic stain removal may be done to improve the function of the teeth and to relieve pain for your dog. This often involves using endodontic treatment (endodontics treat the interior of the tooth, pulp and surrounding tissue of the teeth). Crowns and veneers may be used to protect the teeth and the pulp in the teeth.

Living and Management

Any discolored teeth should be treated to prevent plaque and calculus buildup and to prevent further periodontal disease. Discolored teeth are more prone to fracture, which could result in tooth abscessation (formation of an abscess, usually in response to bacterial infection).

Discoloration may be prevented in future litters by avoiding giving certain medications to the pregnant pup. With proper attention, discoloration of teeth can be prevented in puppies.

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Signs of Gum Disease in Dogs

Bacteria are everywhere on human and canine bodies, but when they get under your dog’s gums in the form of plaque, they can lead to gum disease— the most common dental condition that occurs in adult dogs, according to the American Veterinary Medical Association (AVMA).

Most of what many people think they know about gum disease in dogs is false. While many pet parents believe that tartar, a brown-colored coating on the teeth, causes gum disease, it actually does not— at least not by itself. Perhaps you lift up your pup's lip and look for tartar, but it is actually bacterial plaque that causes gum disease. Tartar, which is just calcified, hardened plaque, does provide more hiding places for bacteria to thrive, however.

Learn more about the most common signs of gum disease and how to prevent this condition in your dog, below.

Signs of Gum Disease in Dogs

These are the top five signs of gum disease in dogs:

• Gingivitis. Symptoms of gingivitis include redness and swelling of the gums.

• Bad breath. Maybe even before you notice gingivitis, pet parents may notice that their dog has bad breath. While you may think that doggy breath is normal— it's not. It’s a common misconception because so many dogs have gum disease, but it isn’t normal. The most frequent cause of bad breath in dogs is dental disease.

• Receding gums. A separation of the gums away from the teeth is a sign of gum disease. In the most advanced stage of the disease, the gum tissue will recede and expose the roots of the teeth.

• Bleeding. If your dog’s gums bleed when they chew, when you’re probing their mouths or brushing their teeth, it could be a sign of advancing periodontal disease.

• Loose teeth. This is a sign of later stages of periodontal disease.

Diagnosis and Treatment of Gum Disease in Dogs

If a dog’s gingivitis is diagnosed and treated before it advances to full-scale periodontal disease, it is reversible.

If gingivitis continues to advance, however, it could mean serious health consequences for your dog. Most dogs, especially those under 20 pounds, develop various stages of gum disease and, depending on their genetics, this can develop in dogs as early as 18 months old.

As gingivitis advances into more serious periodontal disease, your dog will begin to lose bone and tissue surrounding the teeth and your veterinarian may be forced to extract teeth.

Other consequences may include fractures of the jaw as a result of a weakened jaw bone, bone infection, and development of a hole (or fistula) into the naval cavity, causing nasal discharge. Periodontitis can also have systemic effects on the heart, liver and kidneys, according to the AVMA.

How to Prevent Gum Disease in Dogs

The number one way to prevent gum disease in dogs is to brush your dog’s teeth daily or at minimum twice a week.

There are many other products, such as chews and water additives, that can help you maintain your dog’s gum health, but use only those with the Veterinary Oral Health Council seal of approval and to only use them to assist in maintaining oral health— not as a substitute for brushing.

The next step in maintaining your dog’s oral health is scheduling a professional dental cleaning with a veterinarian. This includes cleaning under general anesthesia with scaling and polishing.

Small dogs (under 20 pounds) should undergo a cleaning at least annually, in addition to brushing at home, while large breed dogs can generally have their teeth cleaned every two to three years.

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DOG HEALTH

Your Dog's Gums and Problems to Watch For

Gums can be an often-overlooked part of a dog’s mouth, but they’re just as important to keep clean and healthy as your dog’s teeth! Below, learn more about what color your dog’s gums should be, gum problems to look out for, and how to help your dog maintain healthy gums.

What Color Should My Dog’s Gums Be?

If you want to know what healthy dog gums look like, look no further than the seafood bar at your local grocery store. Healthy gums should appear shrimp-colored pink and unhealthy gums will appear red and inflamed.

Certain diseases can cause discoloration of the gums. For instance, red, inflamed gums can be a sign of gingivitis. Gingivitis is caused by plaque, which is composed mostly of bacteria. Plaque can accumulate on the tooth surface especially in the space underneath the gum line. Gingivitis is also caused by the body's oral immune system reacting to the plaque bacteria on the teeth.

If your dog’s gums are other colors, that can also be indicative of additional health problems. If the gums are pale or white, that could be a sign of anemia. If the gums are blue that often means that your dog is not getting oxygen. If the gums are yellow in a dog, it can be a sign of Leptospirosis, a bacterial infection that can cause liver disease, and jaundice, which can also be a sign of liver disease.

Common Gum Problems in Dogs

Another sign of unhealthy gums? Bad breath. Bad breath or especially a sudden worsening of the breath is often associated with worsening of gum disease.

Gum disease is usually caused not by problems with the gums, but by bacteria on the teeth. So to take care of the gums, brush your dog's teeth. The best and most common way to prevent gum disease is to brush their teeth every day using a soft-bristle toothbrush. Brushing aside, you also can use products approved by your vet, such as dental-maintenance chews (we sell OrvoVet Dental Chews—just ask our receptionists!).

Periodontal disease is the most common cause of unhealthy gums, but other diseases such as immune-mediated inflammatory disease, bleeding disorders, gingival enlargements, and even oral cancers can also cause unhealthy gums. Periodontal disease is most common in dogs under 30 pounds. This is due to crowding—small dogs tend to have large teeth in a relatively small mouth.

Read more: Periodontal Disease and Treatment: Dental Scaling

Additionally, breeds like boxers can be prone to gum overgrowth, a benign condition that is genetic in nature. Although the condition itself is benign, it can result in an almost tumor-like overgrowths of gum tissue which can cause pseudopockets in the dog’s gums.

If you can imagine gum tissue growing up and around the tooth, you can imagine it forming this little nook, cranny or pocket between the overgrown gum and the tooth where fur and debris and food can get stuck and subsequently cause bad breath and infection.

Additional Gum Issues to Watch Out For

Younger dogs, and puppies especially, can come down with papillomatosis, or warts of the gums. Signs include the appearance of solitary, clusters, or even hundreds of warts. If you see one or two warts, don’t worry. Those will usually fall off in one to two months. Dogs with an abundance of warts, however, may need to have surgery to remove them.

Over time, the texture of an older dog’s gums can become more cobbled looking. A cobbled texture in and of itself is nothing to fret about, but cobbled gums can be a sign of cancer. Depending on the type of cancer, if the cobbled gums are accompanied by bad breath, oral pain, reluctance or difficulty chewing, and oral bleeding, seek out a vet to examine your pet.

However, rather than fret over textural changes, it's the color of the gums or if they are bleeding or look like they are going to bleed easily to be more concerned about.

Additionally, rough or intense chewing on a toy or a bone can cause gums to bleed. Sharp pieces of the chew toy could temporarily roughen up the gum. If this is the case, this gum condition normally is not a serious issue, unless the bleeding doesn’t stop. If bleeding lasts more than 10 minutes, it is advised to seek emergency treatment.

Bleeding gums could be a sign of oral cancer, kidney failure (high levels of ammonia can accumulate causing ulcerations and gum bleeding), or idiopathic thrombocytopenic purpura (or ITP)—when the immune system destroys platelets so blood doesn’t clot. If a dog consumes rat poison, it also could cause their gums to bleed,

How Can Gum Problems Be Treated?

If you suspect your dog has gum problems, head to the vet. Your veterinarian will perform a complete dental exam under general anesthesia and take dental X-rays to determine the appropriate treatment.

Treatment is based on the results of the exam and X-rays, and may include anything from a good cleaning of the plaque and tartar on the tooth surface to periodontal surgery or even tooth extraction. If other diseases are suspected (like an immune disease or cancer), a gum biopsy can be obtained and observed.

If you suspect your dog already has a dental disease, it’s best to have a vet treat the condition first and then start an at-home gum-care program.

If your pet has a preexisting dental problem that could be associated with oral sensitivity, it may be beyond the point where tooth brushing is going to do any help. It’s just going to irritate the dog. When your pet has a mouthful of healthy teeth left, then is the time to start on a home-care program with tooth brushing!

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