Flatulence in Dogs

Flatulence occurs when gas builds up in your dog’s intestinal tract and colon. This is commonly caused by the dog eating something new – either a change in diet, or a food that they weren’t meant to eat. If your dog is eating food they can’t digest like dairy, soybeans, peas, or foods high in fat, they can experience chronic flatulence. Dog farts are typically not concerning, but if your dog’s gas becomes unbearable it may be time to make a change.

What Are Some Causes of Flatulence in Dogs?

Hard-to-digest foods like table scraps or spicy foods can give your dog an upset stomach, which can result in excessive gas or excessively smelly gas. Feeding them food or snacks with low-quality ingredients, fillers, or artificial preservatives can also give your dog gas.

If your dog is fed a high-quality diet and still has excessive gas, your veterinarian can test to see if they have poor digestion. They can also try to identify an intolerance or allergy your dog may have by eliminating ingredients from their diet and reintroducing them again.

Dogs who eat quickly will swallow more air while eating, which also leads to more flatulence.

Which Dogs Are Most at Risk?

If your dog is overweight, obese, or sedentary they are at a higher risk for chronic flatulence, regardless of diet. Short-nosed breeds like Pugs, Boston Terriers, Shih Tzus, and Lhasa Apsos tend to swallow a lot of air when they eat or drink, which causes excessive farting.

Could Flatulence Be a Symptom of Another Health Issue?

Once you’ve ruled out a food intolerance or digestive issue as the cause of your dog’s flatulence, you may need to visit your vet to identify a more serious cause. Persistent dog farts may be a side effect of the following health issues:

  • Inflammation of the large intestine or colon (canine colitis)

  • Irritable bowel syndrome (IBS)

  • Stomach infection

  • Intestinal parasites such as worms

  • Inflammatory bowel disease

  • Inflammation of the pancreas

  • Cancer

What Can I Do to Reduce My Dog’s Flatulence?

A healthy and consistent diet is the best way to reduce your dog’s farts.

You can also try the following:

  • Don’t give your dog table scraps. Dogs can’t easily digest scraps, including foods high in fats and sugars, which can cause bloating and discomfort.

  • Don’t give your dog dairy products. Most dogs are lactose intolerant, which means that milk, cream, or cheese can upset their stomachs.

  • Keep your dog out of the trash in your home and outside. Practice the command “leave it” when taking your curious dog on walks.

  • Avoid giving your dog fart-inducing foods. Steamed vegetables like broccoli, cauliflower, and Brussels sprouts can be healthy for your dog, but also produce more gas.

  • Slow down your speed-eater. Divide your dog’s food into smaller portions throughout the day or try a slow-feeding dish to make them slow down.

  • Keep your dog active. Make sure they get plenty of exercise and playtime.

  • Change your dog’s diet. If you switch your dog to a new food, gradually introduce the food with their current kibble over the course of a week or two.

If those tips don’t work, you may want to feed your dog a mix of dry and wet foods. Make sure they are getting the right amount of protein. You generally want to give your dog more protein than carbohydrates, but too much red meat can also be the cause of especially stinky farts. Introducing a probiotic diet or supplement will aid in healthy digestion. Ask your veterinarian first if you’re considering giving your dog over-the-counter anti-gas medication.

What Are Some General Tips for Choosing a Healthy Dog Food?

Foods with low-quality ingredients can cause gas in dogs, so make sure to look at the ingredients that are used in your dog’s food. Avoid feeding your dog food that contains fermentable fibers such as chicory, inulin, pectins, psyllium, plant gums, oats, barley, beet pulp, fruit, or legumes. High-quality foods will consist of the following:

  • One or more animal-based protein sources at the top of the ingredient list

  • The words “highly digestible” or “low residue” on the label

  • Minimal to no chemical preservatives

When Is It Time to See the Vet?

If your dog still has excessive gas after you’ve changed their diet, it may be time to visit your vet. Not only is your dog’s gas uncomfortable for you, but flatulence can also cause your dog physical discomfort. If your dog has a medical problem or food sensitivity, their gas may be accompanied by the following symptoms:

  • Weight loss

  • Change in appetite

  • Vomiting

  • Diarrhea

Schedule a visit to your veterinarian if your dog shows any of those symptoms.


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Get to Know Your Dog’s Digestive System

A healthy digestive system is essential to your dog’s well-being. The digestive system serves many important functions: it takes in food, absorbs nutrients, maintains fluid and electrolyte balance, and gets rid of waste.

It also covers a lot of area. The digestive tract includes the oral cavity (salivary glands, tongue, teeth), esophagus, stomach, small and large intestine, liver, pancreas, rectum, and anus.

The canine digestive system isn’t the most glamorous topic, but understanding how it works puts you in a better position to determine if your dog is sick and needs to be seen by a vet. It can also guide you in making decisions that will enhance their health.

Here are 7 interesting facts about your dog's gastrointestinal tract and health!

1. Dogs Get Heartburn, Too

Dogs can get indigestion and heartburn just like humans.

In the fasted state, stomach acids are very similar in people and dogs. After eating, however, dogs produce more acid than we do.

Our similarities mean that dogs and people benefit from the same antacids. But before giving your dog an over-the-counter antacid, talk to your veterinarian. You will want to be sure you aren’t risking any potential drug interactions or side effects.

Veterinarians can also provide you with important usage guidance for antacids to ensure you are not putting your pet’s health at risk.

But more stomach acid doesn’t translate to letting your dog eat potentially contaminated foods. Dogs are no less sensitive to food poisoning (bacterial contamination) than are people. The practice of feeding raw meat to dogs carries a demonstrated risk of food poisoning.

2. Food Moves Through a Dog's GI Tract Three Times as Fast

Dogs have a small intestine that occupies about 25% of the total gastrointestinal volume, which is consistent with other omnivores, including people. The small intestine of a cat, a true carnivore, occupies only 15%.

On average, food moves through the canine stomach a bit slower than ours, but food movement through the intestines is a little faster. Gastrointestinal transit time is six to eight hours for dogs, while in people it’s between 20 and 30 hours.

3. Dogs Can’t Chew Side to Side

You’ve probably noticed that your dog can’t chew side to side. The dog’s jaw only allows for up and down motion when chewing, whereas people have side-to-side movement that allows more grinding of food.

The difference probably has to do with our historical diets. The wolf-like ancestors of dogs ate mostly meat that could be easily ripped and swallowed, but people also relied on gathering or farming plant material that required more chewing.

4. Most Dogs Can Digest and Absorb Carbs

But modern dogs are considered omnivores, just like we are. They originally ate a carnivorous diet in the wild, but since they have been domesticated, adaptions have been made that allow them to digest and utilize plant-based nutrients.

True carnivores, like cats, have a higher nutritional requirement for taurine, arachidonic acid and certain vitamins, which are available in animal fat and protein sources.

Omnivores don’t have a higher requirement for these and create their own arachidonic acid from vegetable oils. Most normal dogs have no difficulty digesting and absorbing carbohydrates. So, there is no benefit to feeding grain-free diets to normal dogs.

5. Cholesterol Doesn’t Impact a Dog’s Health

Your doctor may advise you to lower your cholesterol level, but you won’t hear the same concerns echoed at the vet’s office. Cholesterol does not have the same effect on your dog’s heart, and their digestive systems are designed to accommodate animal fat.

Dogs also don’t have the same issues with colon cancer, so the idea that eating foods high in soluble fiber or low in saturated or trans-fats will provide any health benefit is really unknown at this point.

Vets say one of the keys to health is keeping your dog at a healthy weight. Obesity is related to exacerbation of many health problems in dogs and is a vet’s number one battle. If it’s any one thing that we can do, it’s talk to our vets about how to curb obesity.

6. Diarrhea and Vomiting May Be Bigger Problems Than You Thought

Gastrointestinal diseases account for about 10% of veterinary visits. Diarrhea is one of the most frequent clinical signs. Abnormal stool may also be a first symptom of a more systemic disease process, such as kidney, liver, and some endocrine disorders.

Vomiting is also a common symptom. An acute bout may resolve itself over a day or two—vets will often recommend a short, 12-hour period of fasting to “rest” the GI tract, followed by a bland diet of chicken and rice. But when the clinical signs continue or are especially severe, testing is often recommended to attempt to find out what may be causing the distress.

Imbalances with other organs, such as the kidneys, can also cause gastrointestinal signs. It is important to see your vet to determine the best treatment for your dog.

7. Your Dog’s Poop Tells a Lot About Their Health

You can learn a lot about your dog’s health by studying her poop (an unpleasant, but necessary task).

There are a variety of causes for abnormal stool. Most episodes of acute onset diarrhea are typically self-limiting within a few days, as dietary indiscretions are a frequent cause.

Parasites, bacteria, and viruses may also cause diarrhea. Depending on the underlying cause, the animal may or may not need appropriate treatment for the infectious agent. If diarrhea persists for several days, and/or there is blood in the stool, the animal should be examined by a veterinarian who can determine the most appropriate course of treatment.

On the other hand, if your dog isn’t pooping and is straining to defecate, they may be constipated, which if prolonged, may cause serious health issues.

One important takeaway is to contact your vet if you notice anything suspicious. Even short episodes of diarrhea or constipation that occur periodically, especially in combination with other signs, like weight loss and loss of appetite, may indicate a more complicated disease process.

Another key point is that you regularly monitor your dog’s poop habits. It is important for the owner to daily monitor how often the animal defecates and the consistency of the stool. There is some variation between animals and also variation from day-to-day, with some animals having consistently softer stools or harder stools than others. But generally, with time, the owners should be able to establish what’s normal for their animal.


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Encephalitis: Brain Inflammation in Dogs

Encephalitis in Dogs

The term encephalitis refers to an inflammation of the brain. However, it also may be accompanied by the inflammation of spinal cord (myelitis), and/or the inflammation of the meninges (meningitis), membranes which cover the brain and spinal cord.

German short-haired pointers, Maltese, and Yorkshire terriers are all found to be predisposed to encephalitis.

Symptoms of Encephalitis

Although symptoms may vary depending on the portion of brain affected, they typically appear suddenly and are rapidly progressive. Such symptoms include:

  • Fever

  • Seizures

  • Behavioral changes (e.g., depression)

  • Decreased responsiveness

  • Head tilt to either side

  • Paralysis of face

  • Uncoordinated movements or circling

  • Unequal size of pupils (anisocoria)

  • Smaller sized pinpoint pupils

  • Decreased consciousness, which may worsen as disease progresses

Causes of Encephalitis

  • Idiopathic (unknown cause)

  • Immune-mediated disorders

  • Post-vaccination complications

  • Viral infections (e.g., canine distemper, rabies, parvovirus)

  • Bacterial infections (anaerobic and aerobic)

  • Fungal infections (e.g., aspergillosis, histoplasmosis, blastomycosis)

  • Parasitic infections (e.g., Rocky Mountain spotted fever, ehrlichiosis)

  • Foreign bodies

Diagnosis of Encephalitis

You will need to give your veterinarian a thorough history of your dog’s health, including the onset and nature of the symptoms, and possible incidents that might have precipitated the unusual behaviors or complications. Your veterinarian may then perform a complete physical examination as well as a biochemistry profile, urinalysis, and complete blood count (the results of which will depend on the underlying cause of the encephalitis).

If your dog has an infection, the complete blood count may show an increased number of white blood cells. Viral infections, meanwhile, may decrease the number of lymphocytes, a type of white cells (also known as lymphopenia). And abnormal reduction in platelets (small cells used in blood clotting) is a good indicator of thrombocytopenia.

To confirm lung involvement and related complications, your veterinarian may require chest X-rays, while MRIs and CT-scans are used to evaluate the brain involvement in detail. Your veterinarian may also collect a sample of cerebrospinal fluid (CSF), which is then sent to a laboratory for cultures. This is necessary for definitive diagnosis and to determine the severity of the problem. If culture assays are unsuccessful, a brain tissue sample may be necessary to confirm the diagnosis, but this is an expensive procedure.

Treatment of Encephalitis

Your veterinarian will focus on reducing the severity of the symptoms, such as brain edema and seizures, and halt the progression of the disease. Severe forms of encephalitis require immediate hospitalization and intensive care. For instance, those suspected of having bacterial infections will be given broad spectrum antibiotics, which can reach the brain and spinal cord.

Living and Management

With proper treatment and care, symptoms gradually improve within two to eight weeks; however, the overall prognosis depends on the underlying cause of the condition. For example, in some dogs, symptoms may reappear once treatment is discontinued. In such instances, a second round of treatment (or long-term treatment) may be required to save the dog's life.

Your veterinarian will schedule regular follow-up exams to evaluate the effectiveness of the treatment and the dog's state of health. Your vet may even recommend a new diet for the dog, especially if it is frequently vomiting or severely depressed.


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Canine Dental Health: Top 10 Questions and Answers

Dogs are remarkable creatures. From the tip of their cold noses to the ends of their wagging tails, canine anatomy is as beautiful and graceful as it is unique and fascinating. The mouth, teeth, and skull of dogs are incredibly well adapted to meet the needs of one of nature’s most perfectly designed scavengers. The oral cavity of the dog is also the source of many myths and misunderstandings that lead to some potentially serious problems. Here are some of the most common, interesting and important dental questions regularly asked.

1. How many teeth do dogs have?

The average adult dog has about a third more teeth than his human counterpart. Adult dogs have 42 permanent teeth compared to a measly 32 average human teeth (not counting any wisdom teeth. Those are "bonus."). Puppies possess 28 baby teeth while human babies will have 20 deciduous or “baby” teeth.

2. When do dogs begin to lose their baby teeth?

Puppies begin losing baby teeth around 12 to 16 weeks of age. By four months of age, almost all of a pup’s deciduous teeth have been shed and many of the permanent teeth have already erupted and are in place.

3. Can you tell how old a dog is by looking at their teeth?

The answer is—it depends. When dogs are young, you can estimate their age by observing which teeth have erupted. For example, a puppy’s deciduous incisors typically erupt between 4 to 6 weeks of age and the permanent incisors are in place by 12 to 16 weeks. The canines or “fang teeth” emerge at 3 to 5 weeks and the permanent canines by 12 to 16 weeks. By the time the permanent molars are present, the dog is 4 to 6 months old. In general, once a dog reaches six months of age, all or least most of their permanent teeth are visible.

Once the adult teeth are in place by about 6 months, it’s anyone’s guess. Some veterinarians claim to determine a dog’s age by gauging the amount of wear on the teeth. Maybe. What if a young dog chews on hard things? That could lead to a three-year old stray dog mistakenly being categorized as a senior dog on the basis of worn teeth, resulting in a lower chance of adoption. The myth of aging dogs by their teeth started with horses. Horses’ teeth erupt over a five-year period ("full mouth at five"), wear at somewhat established rates and you can get a ballpark guess of the age of a horse by careful examination of teeth. The same isn’t true for man’s best friend. Or man. Guessing a dog’s age must include much more than simply the current state of their teeth.

4. Can dogs regrow adult teeth if they lose them?

This is a common myth asked about by many dog owners. Unlike species such as sharks, dogs can’t regrow lost or damaged teeth. If they lose an adult tooth, they lose it forever, just as in humans. This is why it’s so important to take good care of your pets' teeth. They’ve got to last a lifetime.

5. Do dogs get cavities?

Dental caries or “cavities” as they’re more commonly known, are rare in dogs. This is due to many factors including a relatively low-sugar diet, differences in mouth bacteria, and the shape of the teeth. When cavities do occur, they can be treated the same way as human cavities: drill out the damaged part of the tooth and fill it with a special dental compound. In severe cases involving tooth root exposure, endodontic procedures will be performed such as root canal and capping. Extraction of the affected tooth is required in certain cases. Another good reason to provide dental care for your dog.

6. Do small or large dogs have more problems with their teeth?

Dogs both large and small can develop serious oral and periodontal problems. In small dogs with short snouts and cramped jaws, we tend to see more issues with plaque, tartar, and dental calculus buildup. This leads to gum and periodontal disease and eventually painful loose teeth. Small dogs may chip and break tiny teeth if permitted to gnaw on hard toys. Larger breeds tend to experience more traumatic injuries to teeth and gums such as fractured tooth tips, broken jaws, and worn tooth surfaces. If the tooth root becomes exposed, this results in severe pain and death of the tooth. Larger dogs can also develop the same plaque and tartar buildup as well as the gum and periodontal disease of their smaller siblings.

7. How can I tell if my dog has gum disease?

Start by lifting your dog’s lips. If you see dirty or discolored teeth, typically an ugly brownish-greenish color, see your veterinarian. This is likely tartar or plaque and is an early sign of imminent gum or periodontal disease. Next examine the gums for any swelling or redness. If you brush your fingertip along the gum line and observe the tissues become angry and inflamed or even bleed, this indicates more serious gum infection and disease. Finally, take a whiff. If your dog’s breath is foul, this is usually associated with bacterial infection. “Doggie breath” shouldn’t be a reason to avoid your dog. Remember that sweet smelling “puppy breath?” A dog with a healthy mouth should have pleasant or at least neutral odor. If your dog exhibits any of these signs, see your veterinarian for help.

8. What’s that really big tooth in the middle of my dog’s upper jaw?

The largest tooth in a dog’s mouth is the upper fourth premolar also known as the carnassial tooth. Its special shape and tooth surface is designed to help shear, crush, and hold. This is why you see dogs grasp chew toys with the side of their mouth, chomping feverishly. This is also why you have to replace so many chew toys. Next time blame the carnassial teeth instead of your dog.

9. I heard that dogs could get mouth cancer. Is that true?

Unfortunately oral tumors are diagnosed in many dogs. In fact, it’s estimated that one in four dogs will die of some form of cancer. Malignant oral tumors in dogs can be very aggressive and quickly spread throughout the body if untreated. If you observe any swelling, lumps, or dark and unusual colored tissue in your dog’s mouth, have it examined immediately. If diagnosed early, many oral cancers have a relatively good prognosis.

10. I’ve tried many times to brush my dog’s teeth with no success. They seem to hate it. Is there anything else I can do to take better care of my dog’s teeth?

You’re not alone. It's quite common for a busy pet owner to not brush their dog’s teeth every day, either. So what can be done? First, have all your pets’ teeth professionally cleaned under anesthesia once a year at your vet. This is perhaps the single most important thing a pet parent can do for their pet when they can’t brush the teeth daily. While they’re under, your vet will take oral x-rays to make sure there are no hidden problems lurking out of sight underneath the gums. Next, provide your dogs with chew treats approved by the Veterinary Oral Health Council (VOHC) to help remove plaque and tartar. Many have special ingredients embedded in them that help reduce harmful mouth bacteria. You can also regularly rinse your dogs’ mouths with an antimicrobial rinse designed to kill pathogenic bacteria that can cause gum infection. This also helps leave their breath highly kissable. Finally, at least once a week, take a peek inside your dogs’ mouths to make sure everything looks, and smells, healthy. See, taking care of your dog's mouth isn’t so hard after all!


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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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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