# Signs of Dog Dental Pain and Teething Symptoms Dog teething symptoms in puppies include chewing, drooling, and mild gum soreness that fades as adult teeth arrive. In adult dogs, the same behaviors often point to dental pain instead. This article is educational and is not a substitute for veterinary diagnosis or treatment. ## Quick Answer - Puppies typically have 28 baby teeth that start erupting at 3 to 5 weeks of age, with permanent teeth appearing around 4 to 5 months and all adult teeth in place by about 7 months [1]. - Normal teething causes chewing, drooling, and slightly red gums. It should not cause fever, swelling of the face, or refusal to eat for more than a day. - Dental pain in dogs is often hidden. Pets feel pain the same way people do, but they cannot tell you about it, so owners must watch for behavior changes [2]. - Bad breath, tartar, red gums, and dropping food are signs of dental disease, not teething, in dogs older than about 6 months. - Any facial swelling, bleeding from the mouth, or a tooth that looks broken or discolored needs a veterinary visit. ## What Normal Teething Looks Like in Puppies Puppies go through two sets of teeth, just like people. The baby teeth, called deciduous teeth, begin to erupt at 3 to 5 weeks of age. Most dogs have 28 of them. Permanent teeth usually start coming in around 4 to 5 months, and all 42 adult teeth are typically present by 7 months of age [1]. During this window, you may notice: - More chewing on fingers, toys, furniture, and shoes - Drooling or a slightly wet chin - Gums that look pink, puffy, or a little tender - A mild drop in appetite for a day or two - Occasional small spots of blood on a chew toy These are common dog teething symptoms and usually do not need treatment. The timeline varies with body size. In a study of Yorkshire Terriers, puppies weighing 3 kg (about 6.6 pounds) or less lost baby teeth and grew adult teeth later than puppies over 5 kg (about 11 pounds) [3]. Small breeds may still be teething at 6 or 7 months. One thing to watch: baby teeth that do not fall out. Persistent deciduous teeth are a known problem in small breeds and can crowd the adult teeth [3]. Your veterinarian should check for this at the 6-month visit. ## Signs of Dog Mouth Pain You Might Be Missing Dogs are good at hiding oral pain. A 2025 review in the Journal of Veterinary Dentistry notes that dental pain is often overlooked or unseen in pets because they cannot communicate it [2]. That does not mean the pain is not real. Watch for these signs of dog mouth pain: - Chewing on one side of the mouth only - Dropping food or chewing more slowly - Pawing at the face or rubbing the muzzle on the floor - Flinching when you touch the head or open the lips - Grinding the teeth (bruxism) - Bad breath that has gotten worse - Drooling more than usual, sometimes with blood - Reluctance to play with hard toys or chew bones - Weight loss or a messy, food-covered face after meals Some of these overlap with other problems. Teeth grinding, for example, can be linked to dental pain or to nausea and stomach upset. If your dog grinds their teeth, it helps to look at the whole picture. You can read more about that in [Why Is My Dog grinding teeth? Bruxism Dental Pain and GI Nausea](/knowledge/veterinary-medicine/symptom-guides/why-is-my-dog-grinding-teeth-bruxism-dental-pain-and-gi-nausea). Drooling and bad breath together deserve a closer look. When these appear suddenly, they can point to a dental emergency. See [Dog Bad Breath and Drooling: When It's a Dental Emergency](/knowledge/veterinary-medicine/vet-visit-decisions/dog-bad-breath-drooling) for guidance on when to call right away. ## Common Causes of Dental Pain in Dogs Not every mouth problem is teething. The table below separates the usual causes and how quickly each one needs attention. | Cause | Typical clues | How urgent | |---|---|---| | Normal puppy teething | Chewing, mild drooling, red gums, age 3 to 7 months | Routine, monitor at home | | Gingivitis | Red gum line, bad breath, bleeding when brushing, usually first seen around 2 years of age [4] | Routine visit within weeks | | Periodontitis | Bad breath, loose teeth, gum recession, usually begins at 4 to 6 years of age [4] | Vet visit soon, damage is irreversible [4] | | Broken or fractured tooth | Visible crack, pain when chewing, avoids hard food | Same-day or next-day visit | | Nonvital (dead) tooth | Discolored tooth, often gray or pink, may look normal otherwise | Vet visit soon, infection and pain can follow if untreated [5] | | Persistent baby teeth | Two teeth in the same spot, common in small breeds [3] | Address at the 6-month visit | | Malocclusion (bad bite) | Crowded or misaligned teeth, mouth trauma, trouble chewing | Vet visit, may need dental radiographs [6] | | Oral injury or foreign object | Sudden drooling, pawing at mouth, bleeding, a bone or stick stuck | Emergency if bleeding or choking | Gum disease is the most common oral problem in dogs [7]. It starts with plaque and tartar, moves to gingivitis, and can progress to periodontitis, where the gums, ligaments, and bone are damaged. That damage is irreversible and leads to permanent loss of tooth support [4]. Small-breed dogs tend to have more periodontitis than large-breed dogs, and back teeth are affected more often than front teeth [4]. Bite problems are also more common than many owners realize. In one CT-based study of 92 dogs, malocclusions were found in 46.7% of them, with the highest rate in Shiba Inus and the lowest in Golden Retrievers and Akitas [6]. Malocclusion can cause oral trauma, trouble chewing, and periodontal disease [6]. ## Red Flags That Mean Emergency Call an emergency clinic right away if you see: - Facial or jaw swelling, especially under the eye - Bleeding from the mouth that does not stop - A tooth that is hanging loose after trauma - Trouble breathing, gagging, or choking - A foreign object lodged in the mouth or throat - Refusing all food and water for more than 24 hours - Severe pain, crying out, or not letting you near the face Swelling around the eye or cheek can mean an abscess or infection spreading beyond the tooth root. This is not something to watch at home. ## What You Can Safely Do at Home While You Wait You cannot treat dental disease at home, but you can keep your dog comfortable and avoid making things worse. **Do:** - Offer soft food or moistened kibble if chewing is painful - Provide cool, firm chew toys made for teething puppies - Rinse the mouth gently with plain water if your dog allows it - Keep the face clean and dry if your dog is drooling - Take a photo of anything unusual in the mouth to show your vet **Do not:** - Give human pain relievers. Many are toxic to dogs, and the dose depends on your dog's weight and health. Your veterinarian will calculate the right medication and amount. - Try to pull a loose or broken tooth yourself - Use sharp or hard chews that could crack a tooth - Delay a vet visit because your dog is still eating. Dogs often eat through significant pain [2]. A regular diet of hard kibble may help reduce dental problems because chewing provides a mechanical cleaning effect on the teeth [4]. That said, kibble alone does not replace brushing or professional cleanings. ## What Your Veterinarian Will Check A complete oral exam should be part of every physical examination, because oral disease is treated most effectively when caught early [7]. Many problems stay hidden in the mouth and progress to an advanced stage before owners notice [7]. At your visit, expect: - A full mouth exam, including the back teeth and under the tongue - Checking for persistent baby teeth, especially in small breeds [3] - Probing the gum line for pockets and checking for loose teeth - Dental radiographs (X-rays) to look at tooth roots and bone - A discussion of anesthesia and cleaning if disease is found Radiographs matter more than most owners expect. In a study of 287 small-breed dogs, nonvital incisor teeth were common, and factors like a higher body condition score and class 3 malocclusion raised the risk. Age, sex, and body weight did not have a significant impact [5]. Nonvital teeth can look normal from the outside, and if they are left untreated, infection and pain may follow [5]. Your vet may also find something unusual, such as a baby tooth root displaced into a developing adult tooth. That is rare but has been documented in a Cavalier King Charles Spaniel whose adult canine stopped developing after the baby tooth was extracted [8]. This is one reason extractions are done carefully and followed up. ## Preventing Dental Problems and Monitoring at Home Prevention is simpler than treatment, and it starts early. **Start brushing young.** Get your puppy used to a finger brush and dog-safe toothpaste during the teething months. Daily brushing is the single best home habit. **Check the mouth weekly.** Lift the lips and look at the gum line, the back teeth, and the front incisors. Note any redness, tartar, or bad smell. **Watch the calendar.** Gingivitis is often first noticed at about 2 years of age and improves with treatment. Periodontitis usually begins at 4 to 6 years of age and progresses to tooth loss if untreated [4]. Knowing these windows helps you plan checkups. **Keep routine dental cleanings.** Your vet can spot problems before they become painful. For a deeper look at stages and treatment, see [Dog Dental Disease: Signs, Stages, and What You Can Do](/knowledge/veterinary-medicine/preventive-and-routine-care/dog-dental-disease-signs-stages-and-what-you-can-do). **Track behavior changes.** A dog who stops chewing on a favorite toy or starts eating more slowly is telling you something. Write down what you see and when it started. **Know your breed's risk.** Small breeds have more periodontitis [4], and flat-faced breeds have more malocclusions [6]. Yorkshire Terriers may teethe later than larger puppies [3]. These patterns do not predict your individual dog's future, but they help you know what to watch. ## Limitations and When to Contact a Veterinarian This article covers common patterns, but every dog is different. Only a veterinarian who examines your dog can diagnose the cause of mouth pain. **Contact a veterinarian the same day if:** - Your dog has facial swelling, a broken tooth, or bleeding from the mouth - Your dog is drooling heavily or pawing at the face - Your dog has stopped eating or is dropping food - You see a gray, pink, or dark tooth **Go to an emergency clinic now if:** - Your dog is having trouble breathing or swallowing - There is heavy bleeding that will not stop - Your dog is in severe pain or collapses **Schedule a routine visit if:** - Your puppy is around 6 months old and still has baby teeth - You notice bad breath, tartar, or red gums - Your dog is due for a dental cleaning - You have any question about whether a behavior is normal teething or something more ## Frequently Asked Questions ### How long does puppy teething last? Teething usually runs from about 3 to 5 weeks of age, when baby teeth erupt, until around 7 months, when all adult teeth are in place [1]. Small breeds may finish later, sometimes past 7 months [3]. If your puppy still has double teeth after 6 months, ask your vet about persistent baby teeth. ### Can I give my dog anything for dental pain at home? No. Human pain medications can be toxic to dogs, and safe veterinary drugs are dosed by weight and health status. Your veterinarian will choose the right medication and calculate the amount. Until then, offer soft food and avoid hard chews. ### Is it normal for my puppy to bleed while teething? A small amount of blood on a chew toy can be normal when a baby tooth loosens. Bleeding that continues, comes from the gums, or happens in an adult dog is not normal. Call your vet if bleeding does not stop within a few minutes. ### How can I tell if my dog has a dead tooth? A nonvital tooth often looks gray, pink, or darker than the teeth beside it. Sometimes it looks completely normal, which is why dental radiographs are needed. Nonvital incisors are common in small-breed dogs, and untreated teeth can lead to infection and pain [5]. ### Does chewing hard kibble keep my dog's teeth clean? Chewing hard kibble provides some mechanical cleaning and is linked to fewer dental problems [4]. It is not a substitute for brushing or professional cleanings. Daily brushing and regular veterinary exams do far more to protect your dog's teeth. ## Related Articles - [Dog Dental Disease: Signs, Stages, and What You Can Do](/knowledge/veterinary-medicine/preventive-and-routine-care/dog-dental-disease-signs-stages-and-what-you-can-do) - [Why Is My Dog grinding teeth? Bruxism Dental Pain and GI Nausea](/knowledge/veterinary-medicine/symptom-guides/why-is-my-dog-grinding-teeth-bruxism-dental-pain-and-gi-nausea) - [Dog Bad Breath and Drooling: When It's a Dental Emergency](/knowledge/veterinary-medicine/vet-visit-decisions/dog-bad-breath-drooling) - [Signs Of Arthritis Pain In Dogs](/knowledge/veterinary-medicine/veterinary-technology/signs-of-arthritis-pain-in-dogs) - [Dental Disease In Dogs And Cats](/knowledge/veterinary-medicine/dental-care/dental-disease-in-dogs-and-cats) - [Dog Growling When Touched: Pain or Behavior Problem?](/knowledge/veterinary-medicine/anxiety-and-behavior-support/dog-growling-when-touched-pain-behavior) ## References 1. [Dental Development of Dogs - Dog Owners](https://www.merckvetmanual.com/dog-owners/digestive-disorders-of-dogs/dental-development-of-dogs). Merck Veterinary Manual. 2. [Oral and Dental Pain Management](https://pubmed.ncbi.nlm.nih.gov/39311042/). Journal of veterinary dentistry, 2025. 3. [Development of Yorkshire Terrier Dentition](https://pubmed.ncbi.nlm.nih.gov/37505812/). Veterinary sciences, 2023. 4. [Dental Disorders of Dogs - Dog Owners](https://www.merckvetmanual.com/dog-owners/digestive-disorders-of-dogs/dental-disorders-of-dogs). Merck Veterinary Manual. 5. [Radiographic Prevalence of Nonvital Incisor Teeth in Small Breed Dogs: A Retrospective Study (2017-2021)](https://pubmed.ncbi.nlm.nih.gov/42206998/). Journal of veterinary dentistry, 2026. 6. [Breed-Specific Dental Variations in Dogs Assessing Malocclusions Using Computed Tomography (CT)](https://pubmed.ncbi.nlm.nih.gov/42188950/). Veterinary sciences, 2026. 7. [Disorders of the Mouth in Dogs - Dog Owners](https://www.merckvetmanual.com/dog-owners/digestive-disorders-of-dogs/disorders-of-the-mouth-in-dogs). Merck Veterinary Manual. 8. [Intradental Displacement of a Deciduous Tooth Root in a Dog](https://pubmed.ncbi.nlm.nih.gov/38374661/). Journal of veterinary dentistry, 2024. ## Further Reading - [Merck Veterinary Manual: Dog Owners](https://www.merckvetmanual.com/dog-owners) - [Cornell Richard P. Riney Canine Health Center: Canine Health Information](https://www.vet.cornell.edu/departments-centers-and-institutes/riney-canine-health-center/canine-health-information) - [American Veterinary Medical Association: Pet Care](https://www.avma.org/resources-tools/pet-owners/petcare)