How to Help a Teething Puppy With Pain

Name: How to Help a Teething Puppy With Pain
Creator: Dr. Zubair Khalid

By Dr. Zubair Khalid, DVM, MS, PhD · 2026-10-02

Teething can make a puppy uncomfortable, but you can ease most of it at home with cold items, safe chews, and a little patience. Knowing how to help a puppy with teething also means knowing when sore gums are normal and when a mouth problem needs a vet. Most puppies chew, drool, and nip their way through it, and most of that is expected.

This article is educational and is not a substitute for veterinary diagnosis or treatment.

Quick Answer

Puppies usually get their baby teeth between about 3 and 6 weeks of age, and those teeth start falling out around 3 to 4 months as adult teeth come in.
Cold is the safest home comfort tool. Chill a damp washcloth or a puppy chew in the fridge, never freeze it rock hard.
Offer appropriate chew toys and supervise every chew session. Discard anything a puppy can break off and swallow.
Never give human pain relievers. Ibuprofen, Aleve, and Tylenol can poison dogs and harm the stomach, liver, kidneys, and red blood cells [1].
Call your vet if you see a double tooth, a broken tooth, swelling, bleeding that will not stop, or a puppy who stops eating.

Puppy Teething Timeline: What to Expect Month by Month

Puppies are born without teeth. The baby teeth, also called deciduous teeth, start pushing through in the first weeks of life. A large study of over 1,000 puppies across 53 breeds found that the timing and order of baby tooth emergence varies with breed size and skull shape [2]. Small breeds and flat-faced breeds tend to be later and more variable than large breeds [2]. That means two puppies of the same age can have very different mouths, and that is normal.

Here is a general schedule owners can use as a guide.

Age	What is happening	What you may notice
3 to 6 weeks	Baby teeth emerge	Nursing, tiny teeth visible
6 to 8 weeks	Most baby teeth are in	Nipping, mouthing, early chewing
3 to 4 months	Baby teeth loosen and fall out	Drooling, chewing, occasional blood on toys
4 to 6 months	Adult teeth come in	More chewing, possible gum soreness
6 to 7 months	Most adult teeth are in	Chewing usually settles down

Permanent canine teeth are a useful marker of development. In male dogs, canine eruption tracks closely with pubertal maturation and is a strong indicator of physical maturity [3]. This is one reason your vet checks the mouth at every puppy visit.

Dental examination is also the most common way vets estimate a puppy's age, though it is not perfectly precise [4]. If you adopted a puppy with no birth date, your vet can give you a reasonable age range based on which teeth are present.

How to Help a Teething Puppy in Pain: Step by Step

Step 1: Check the mouth gently

Lift your puppy's lip and look at the gums and teeth. You are looking for symmetry, missing teeth, double teeth, broken teeth, and any swelling. Keep sessions short and reward calm behavior. If your puppy growls or pulls away when you touch the mouth, stop and read Dog Growling When Touched: Pain or Behavior Problem?. Mouth pain is one possible reason for that reaction.

Step 2: Use cold therapy

Cold numbs sore gums and reduces swelling. Soak a clean washcloth in water, wring it out, and freeze it for about 30 minutes so it is cold and firm but not solid ice. Let your puppy chew on it while you hold one end. You can also refrigerate rubber chew toys. Avoid fully frozen hard toys, which can crack baby teeth.

Step 3: Offer safe chews

Choose chews sized for your puppy's mouth so they cannot swallow them whole. Rubber teething toys, rope toys under supervision, and veterinary dental chews made for puppies are good options. Check the toy after each session and throw it away once it is torn.

Step 4: Rotate toys

Keep three or four chews in rotation and swap them every day. Novelty keeps a puppy interested and reduces chewing on furniture. If your puppy is destroying items when left alone, that may be more than teething. See Destructive Chewing in Puppies: Teething Relief vs Separation Anxiety.

Step 5: Redirect biting

When your puppy nips your hands, replace your hand with a toy and praise the swap. Consistent redirection teaches what is okay to chew. For more on this, read Puppy Training Tips Biting.

Step 6: Keep the mouth clean

Start brushing your puppy's teeth now with a soft finger brush and dog-safe toothpaste. This builds a habit that protects adult teeth for life. Gum disease is common in dogs, and early prevention matters. Learn more in How To Treat Gum Disease In Dogs.

Step 7: Watch eating and drinking

Mild gum soreness may make a puppy chew more slowly, but a puppy should still eat and drink normally. If your puppy refuses food, drops food, or cries while eating, call your vet.

What Do Puppies Do When Teething?

Teething puppies chew almost constantly. They mouth hands, furniture, shoes, and leashes. They may drool more than usual. Some puppies have looser stools or a slightly reduced appetite for a day or two. You may find tiny teeth on the floor or in bedding.

Chewing is not misbehavior during this stage. It is how puppies relieve pressure on sore gums and explore the world. Your job is to make the right things easy to chew and the wrong things boring or out of reach.

How to Help a Puppy Lose a Tooth

Most baby teeth fall out on their own while the puppy chews. You usually will not see it happen, and the puppy may swallow the tooth. That is fine.

Here is what you can do to help the process along safely.

Give appropriate chew toys daily so teeth work loose naturally.
Do not pull a loose tooth. Pulling can break the root and cause infection.
Do not wiggle teeth with your fingers.
Check the mouth weekly for retained baby teeth, which look like a second tooth sitting beside the adult tooth.
Keep up with vet visits so your veterinarian can catch problems early.

If a baby tooth is still firmly in place when the adult tooth comes in beside it, that is a retained tooth. Retained teeth trap food and plaque and can push adult teeth out of alignment. Your vet may recommend removal, often during the spay or neuter procedure.

Signs That Something Is Wrong

Normal teething is mild and self-limiting. Call your vet if you see any of these.

A double tooth, also called a retained deciduous tooth
A broken or discolored tooth
Swelling of the face or jaw
Bleeding from the mouth that does not stop
Dropping food, chewing on one side, or refusing to eat
Bad breath that is new or severe
Excessive drooling that soaks the chest
Crying when the mouth is touched
Weight loss or poor growth

Pain in animals can show up in ways owners miss. Pets may hide, pace, pant, or become quiet and withdrawn [5]. Some become irritable or avoid being handled. If your puppy seems painful, do not wait to see if it passes. A veterinarian can examine the mouth and decide whether treatment is needed.

Common Mistakes to Avoid

Giving human pain medicine

This is the most dangerous mistake. Over-the-counter pain medicines like ibuprofen, Aleve, and Tylenol can cause toxicity in pets and damage the gastrointestinal tract, liver, kidneys, and red blood cell production [1]. Never give these to a puppy. Never give leftover prescription pain medicine either, because opioids not prescribed for your pet can affect the cardiovascular and central nervous systems [1].

Freezing chews rock hard

Ice-hard chews can fracture baby teeth. Chill items in the refrigerator instead, or freeze a damp cloth briefly so it stays soft.

Using chews that are too small

A chew that fits entirely in the mouth can be swallowed. Choose a size larger than your puppy's throat and supervise every session.

Ignoring a retained tooth

A retained baby tooth is not cosmetic. It traps debris and can damage the adult tooth. Ask your vet to check at each visit.

Assuming all chewing is teething

Chewing that happens only when you leave, along with barking, pacing, or house soiling, may point to separation distress instead. That needs a different plan.

Skipping dental care

Teething is the best time to start brushing. Puppies who learn to accept a toothbrush now are easier to care for later.

Supplies and Setup That Matter

You do not need much, but the right items make teething easier.

Two or three puppy-safe rubber chews in different shapes
One or two rope toys for supervised tug and chew
A few clean washcloths for cold therapy
A finger brush and dog-safe toothpaste
A shallow water bowl so a sore puppy can drink easily
A safe puppy pen or crate so your puppy cannot chew dangerous items when unsupervised

Set up a chew station in the room where you spend the most time. Keep one chew within reach so you can redirect quickly. Puppies repeat what gets rewarded, so fast redirection works better than punishment.

Watch for non-food items your puppy might swallow, including socks, hair ties, and electrical cords. Swallowed objects can cause a blockage, which is an emergency.

If your puppy also has loose stools during this stage, mild digestive upset is common, but ongoing diarrhea needs a vet. See How To Help Puppy With Diarrhea At Home.

Limitations and When to Contact a Veterinarian

Teething is normal, but some mouth problems are not. Contact your veterinarian the same day if your puppy has a broken tooth with a visible pink or red center, facial swelling, bleeding that will not stop, refusal to eat for more than 12 hours, or a fever. Go to an emergency clinic now if your puppy has trouble breathing, cannot close the mouth, has a swollen eye with jaw swelling, or has swallowed a toy or bone fragment.

Call your vet for a routine visit if you see a retained baby tooth, persistent bad breath, tartar buildup, or a bite that looks uneven. Puppies should have their mouth checked at every wellness exam, and most vets will address retained teeth at the time of spay or neuter.

Pain medicine choices differ between animals, and a drug that is safe for one pet may be dangerous for another [5]. Even some human medicines sold without a prescription can make pets very sick or cause death [5]. Your veterinarian will calculate any dose from your puppy's weight and health history.

Every puppy is different, and individual cases need a veterinarian's assessment. When in doubt, call your clinic. If you suspect your puppy ate a human medication, call your veterinarian or a pet poison hotline right away.

Frequently Asked Questions

How long does puppy teething last?

Most puppies finish teething by about 6 to 7 months of age. Baby teeth typically start falling out around 3 to 4 months, and adult teeth come in over the next few months. Small and flat-faced breeds may run a little later.

Do puppies get pain relief from cold chew toys?

Yes, cold items numb sore gums and reduce swelling. Use a damp washcloth chilled in the refrigerator or a refrigerated rubber chew. Avoid rock-hard frozen items that could crack a baby tooth.

Should I pull my puppy's loose baby tooth?

No. Let the tooth fall out on its own while your puppy chews safe toys. Pulling can break the root and lead to infection. If a baby tooth stays in place while the adult tooth comes in, ask your vet about removal.

Can I give my puppy ibuprofen or Tylenol for teething?

No. These medicines can cause serious toxicity in dogs and harm the stomach, liver, kidneys, and red blood cells. Never give any human pain medicine to a puppy unless your veterinarian prescribes it specifically for your pet.

When should I worry about my puppy's teething?

Worry if you see a double tooth, a broken tooth, facial swelling, bleeding that will not stop, or a puppy who stops eating or cries when the mouth is touched. These signs point to a problem that needs a veterinary exam instead of home care.

References

Pet in Pain What Do I Do. Pet Poison Helpline.
Time and sequence of emergence of the deciduous dentition in dogs and its applicability for age estimation. Anatomia, histologia, embryologia, 2022.
Linking Canine Teeth Eruption, Testicular Histology and Testosterone Levels as Indicators of Pubertal Maturation in Male Dogs. Anatomia, histologia, embryologia, 2026.
Age determination in dog puppies by teeth examination: legal, health and welfare implications, review of the literature and practical considerations. Veterinaria italiana, 2020.
Pain and Pain Management in Pets - Special Pet Topics. Merck Veterinary Manual.