General guidance — not a diagnosis. When in doubt, call your vet.
The short answer on teething
Puppies replace their baby teeth over several months, and the schedule is a guide rather than a deadline. Mild gum sensitivity and extra chewing can accompany the change, but a permanent tooth erupting beside a baby tooth, an abnormal bite, a broken tooth, or trouble eating deserves a veterinary oral exam.
Your puppy's routine appointments are useful checkpoints. Ask for the mouth to be examined during the puppy first vet visit and at later vaccine visits, because the teeth and bite can change quickly during growth.
Puppy tooth timeline by stage
Merck's professional eruption table labels its figures as average data subject to considerable variation.[1] Its canine values are best used as a sequence:
| Stage | What the Merck table shows for dogs |
|---|---|
| Early baby teeth | Third incisors and deciduous canines erupt at 3–4 weeks; first and second incisors at 4–5 weeks |
| Baby premolars | Deciduous premolars erupt at 4–6 weeks |
| First permanent teeth | First incisors erupt at 4 months; first premolars and first molars at 4–5 months |
| Main replacement period | Second incisors erupt at 4½ months, third incisors at 5 months, and canines at 5–6 months |
| Later permanent teeth | Second through fourth premolars and second molars erupt at 5–6 months; third molars at 6–7 months |
A longitudinal study with some cross-sectional observations followed 440 puppies from 82 breeds. Breed size and skull type significantly affected timing: appearance and completion of eruption were considerably later in small or toy breeds and brachycephalic breeds.[3] This is why a single calendar cannot decide whether an individual puppy is normal.
Normal changes versus warning clues
Expected changes can include more interest in chewing, brief reluctance to have the mouth handled, and gaps where a baby tooth has fallen out. You may never find the shed tooth. Focus on comfort, eating, and whether the adult teeth are entering a sensible position rather than counting every lost tooth.
Play biting and tooth replacement can overlap, but they are not the same problem. A puppy biting guide is more useful when the main issue is teeth on hands or clothing; teething assessment is about the mouth itself.
Check the lips and front of the mouth gently when your puppy is relaxed. Do not force the jaws open. Look for:
- Two teeth occupying the same position, especially two canines
- A tooth pressing into the palate, gum, lip, or another tooth
- A visibly fractured, loose, or discolored permanent tooth
- Swelling, persistent bleeding, foul odor, or discharge
- Dropping food, chewing only on one side, or avoiding normal meals
AAHA advises addressing persistent deciduous teeth as permanent teeth begin to erupt. Immediate veterinary extraction can help prevent displacement of the permanent tooth, malocclusion, and crowding-related periodontal disease.[2] Never pull a baby tooth at home; its root and the nearby developing tooth cannot be assessed from the visible crown.
Keeping the mouth comfortable
Offer size-appropriate chew toys that flex slightly and cannot be swallowed whole. Avoid objects that splinter or are so hard that they could damage a tooth. Supervise new chews, remove damaged pieces, and use the destructive chewing guide for household management rather than treating every chewing episode as dental pain.
Do not give human pain medicines or apply numbing gels. AAHA notes that juveniles actively shedding deciduous teeth may be uncomfortable with home dental care and recommends avoiding negative experiences.[2] Keep mouth handling brief and positive; pause if it hurts. Once permanent teeth are erupted and comfortable, build a gradual routine with this guide to brushing a dog's teeth.
When to See a Vet
- A permanent tooth is erupting while the matching baby tooth remains in place
- Your puppy cannot eat normally, cries when chewing, or has facial or gum swelling
- A tooth is broken, displaced, discolored, or contacting the palate or other soft tissue
- Bleeding does not stop promptly, or there is foul odor, pus, marked lethargy, or facial trauma
For dog owners
An article can't ask about your dog.
Describe what you're seeing. You'll get a few follow-up questions about your dog, then where it lands — vet today, watch closely, or no visit needed — and what to do at home meanwhile.
Frequently Asked Questions
When do a puppy's permanent teeth start appearing?
Merck's professional eruption table starts the dog schedule with first incisors at 4 months and first premolars and first molars at 4–5 months, while noting that the figures are averages subject to considerable variation.[1]
Should every adult tooth be in by 6 months?
No. Merck lists third molars at 6–7 months, and its table warns that eruption data vary.[1] Breed size and skull type also affected timing in a study of 440 puppies from 82 breeds.[3]
Is a double row of teeth normal?
It can mean a deciduous tooth has persisted while its permanent replacement erupts. AAHA recommends addressing persistent deciduous teeth promptly because they can displace the permanent tooth, contribute to malocclusion, and worsen crowding.[2]
Should I pull a loose baby tooth?
No. Let it fall naturally unless your veterinarian recommends treatment. Pulling can cause pain, fracture a root, or injure nearby tissue, and the permanent tooth's position cannot be assessed safely at home.
Should I brush during active teething?
Do not force brushing over a sore area. AAHA notes that juveniles actively shedding deciduous teeth may experience discomfort with home dental care and advises avoiding negative experiences.[2] Keep handling gentle and resume gradual training when the mouth is comfortable.
What if a permanent tooth seems missing?
Book an oral examination rather than assuming it never formed. AAHA recommends intraoral dental radiographs for missing permanent teeth to confirm absence because an unerupted tooth can be problematic.[2]
Do small-breed puppies teethe later?
They can. In the study of 440 puppies from 82 breeds, appearance and completion of permanent tooth eruption occurred considerably later in small or toy breeds and in brachycephalic breeds.[3]
References
- Soltero-Rivera, Merck Veterinary Manual Professional, 2021 — Estimation of Age by Examination of the Teeth in Animals. https://www.merckvetmanual.com/digestive-system/dental-development-and-anatomy/estimation-of-age-by-examination-of-the-teeth-in-animals
- American Animal Hospital Association, 2019 — Preventing Periodontal Disease. https://www.aaha.org/wp-content/uploads/globalassets/02-guidelines/dental/aaha_dental_guidelines.pdf
- Van den Broeck et al., Anatomy, Histology, Embryology, 2023 — Replacement of Deciduous by Permanent Dentition in Dogs. https://pubmed.ncbi.nlm.nih.gov/36692220/