Puppy Dental Care: Teething, Tooth Brushing, and Long-Term Oral Health

Dental disease affects over 80% of dogs by age three, making it the most common health condition in adult dogs. The foundation for lifelong oral health starts during puppyhood — both by managing the teething process correctly and by establishing a tooth-brushing routine before adult teeth are even in place.

Understanding Puppy Teeth

Puppies are born without teeth. Their 28 baby teeth (deciduous teeth) begin erupting around 3 weeks of age and are fully in by 6–8 weeks. These needle-sharp teeth are temporary — they will be replaced by 42 permanent adult teeth between 3 and 7 months of age.

The teething timeline:

• 3–4 months: Incisors begin falling out and adult incisors emerge
• 4–5 months: Premolars and canines loosen
• 5–7 months: Molars erupt; all adult teeth should be in place by 7 months

You may find baby teeth on the floor, in toys, or swallowed (harmless). If a baby tooth has not fallen out by the time the adult tooth is emerging alongside it (retained deciduous tooth), consult your veterinarian — retained teeth can cause misalignment and infection.

Teething Relief

Teething is uncomfortable. Your puppy's increased chewing during this period is not misbehavior — it is pain management. Provide appropriate relief:

• Frozen chew toys: Rubber toys filled with peanut butter and frozen provide cold relief and mental enrichment
• Frozen washcloths: Wet a washcloth, twist it, freeze it, and let your puppy gnaw on it (supervised)
• Rubber teething toys: Purpose-made puppy teething toys with varied textures soothe sore gums
• Avoid hard chews: Antlers, bones, and hard nylon toys can fracture baby teeth and damage emerging adult teeth

Redirect chewing away from furniture, shoes, and hands by keeping appropriate chew options accessible in every room.

Starting a Tooth-Brushing Routine

The best time to start brushing your puppy's teeth is before they need it. Building comfort with mouth handling now means a cooperative adult dog later.

Phase 1: Mouth Handling (Week 1)

Touch your puppy's muzzle, lift their lips, and gently rub their gums with your finger. Pair every touch with a treat. Keep sessions under 30 seconds. The goal is positive association, not thorough cleaning.

Phase 2: Finger Brushing (Week 2–3)

Wrap gauze around your finger or use a silicone finger brush. Apply a small amount of dog-specific toothpaste (never human toothpaste — fluoride and xylitol are toxic to dogs). Gently rub the outer surfaces of the teeth. Reward generously.

Phase 3: Toothbrush Introduction (Week 4+)

Transition to a soft-bristled dog toothbrush or a small children's toothbrush. Brush the outer surfaces of all teeth using gentle circular motions. Focus especially on the back molars and upper teeth where plaque accumulates fastest. Aim for 30–60 seconds initially, building to 2 minutes over time.

Brushing 3–4 times per week is the minimum for meaningful plaque prevention. Daily brushing is ideal.

Dental Health Beyond Brushing

• Dental chews: VOHC-accepted dental chews (look for the Veterinary Oral Health Council seal) provide supplementary cleaning through mechanical abrasion
• Water additives: Some enzymatic water additives reduce bacterial load, though they do not replace brushing
• Professional cleanings: Your veterinarian will assess dental health at each visit and recommend professional cleaning under anesthesia when needed
• Diet: Dry kibble provides slightly more mechanical cleaning than wet food, but diet alone does not prevent dental disease

Warning Signs

Schedule a veterinary dental exam if you notice:

• Persistent bad breath (not normal "puppy breath")
• Red, swollen, or bleeding gums
• Difficulty eating or dropping food
• Excessive drooling
• Loose adult teeth or visible tartar buildup
• Pawing at the mouth

The Long View

Two minutes of tooth brushing a few times per week prevents the pain, infection, and expense of advanced dental disease. It also prevents systemic health problems — bacteria from periodontal disease can enter the bloodstream and affect the heart, liver, and kidneys. Start the habit now, and your puppy's smile stays healthy for life.