Puppy Teething: Timeline, Symptoms & How to Help

Most puppies follow a fairly predictable dental schedule, though small variations happen. Baby teeth usually erupt between 3 and 6 weeks of age. By 6 to 8 weeks, most puppies have all 28 baby teeth. Adult teeth usually begin replacing them around 3.5 to 4 months, and most dogs have all 42 permanent teeth by 6 to 7 months.

In general, incisors are replaced first, then canines and premolars, with molars appearing later because puppies do not have baby molars. Large- and giant-breed puppies may finish a bit earlier than some small-breed puppies. If your puppy still has obvious retained baby teeth after about 7 months, it is reasonable to ask your vet for an oral exam.

Normal teething signs can include increased chewing, mild drooling, tender gums, a little blood on a toy, temporary reluctance to chew hard kibble, and mild irritability. Some puppies become more mouthy with hands, clothing, or furniture during this stage. You may also notice a distinct teething-related breath odor.

These signs should stay mild and temporary. Your puppy should still be bright, interested in food, and able to settle with redirection. Severe pain, marked swelling, pus, heavy bleeding, or refusal to eat are not typical teething signs and deserve a call to your vet.

Offer several safe chewing options and rotate them so your puppy stays interested. Soft rubber toys, puppy-specific teething toys, and food-stuffed toys that have been chilled can help soothe sore gums. Some puppies also like a clean damp washcloth that has been cooled, but it should only be offered under supervision so pieces are not swallowed.

Management matters too. Keep shoes, cords, children's toys, and other tempting items out of reach. Redirect biting to an approved toy, then praise calm chewing. If your puppy seems sore, ask your vet whether a temporary diet adjustment, such as softened kibble, makes sense. Do not give human pain medication unless your vet specifically tells you to.

A good rule is that if a chew is hard enough that you would not want it tapped against your kneecap, it may be hard enough to damage teeth. Bones, antlers, hooves, hard nylon chews, rigid plastic toys, and ice cubes can all be risky for developing teeth. Toys that splinter, shred easily, or have small parts can also create choking or intestinal blockage concerns.

Always supervise chewing, especially with a young puppy. Choose toys sized for your puppy's mouth and chewing style. If your puppy can tear off chunks, retire that toy and switch to a safer option.

Sometimes a baby tooth stays in place while the adult tooth erupts beside it. This is called a retained or persistent deciduous tooth. It is seen often enough in puppies, especially with canine teeth, and can lead to crowding, trapped debris, tartar buildup, gum inflammation, and abnormal bite alignment.

If you see two teeth occupying the same spot, do not try to pull the baby tooth at home. Your vet can examine the mouth and decide whether monitoring, timing with a spay or neuter procedure, or a separate anesthetized extraction is the best option. Early attention can help prevent longer-term dental problems.

Call your vet if your puppy has a retained baby tooth, persistent bad breath, trouble picking up food, marked drooling, facial swelling, bleeding that does not stop quickly, a broken tooth, or obvious pain when the mouth is touched. You should also reach out if your puppy is older than about 7 months and does not seem to have finished teething.

An oral exam is usually straightforward and can catch problems before they become more uncomfortable or more costly to treat. Early dental guidance also helps pet parents build a home care routine that fits their puppy and budget.

For uncomplicated teething, many puppies only need home care and routine wellness guidance. In the U.S. in 2025-2026, a general exam for mouth discomfort or suspected retained baby teeth often falls around $65 to $120, depending on region and clinic type. Puppy-safe teething toys and dental supplies may add about $10 to $40.

If your vet recommends dental X-rays, sedation, or extraction of retained deciduous teeth, the cost range can rise meaningfully. A focused retained baby tooth extraction procedure may run roughly $300 to $900+, while more complex dental work with anesthesia, imaging, multiple extractions, or specialty care can exceed $1,000. Exact cost range depends on your puppy's size, the number of teeth involved, monitoring needs, and whether a general practice or dental specialist is providing care.