Retained Deciduous Teeth in Puppies: Symptoms, Causes, Diagnosis, Treatment, and Care Essentials

Oral HealthDiseasesMeongsiljang Veterinary Advisory Board

Retained deciduous teeth in puppies occur when baby teeth fail to fall out as they should, which can lead to bite misalignment and increase the risk of infection. Early diagnosis and appropriate treatment are essential.

Retained Deciduous Teeth in Puppies Occur When Baby Teeth Fail to Fall Out Normally

The inside of a puppy's mouth with retained baby teeth

Retained deciduous teeth in puppies occur when baby teeth fail to fall out even after the corresponding permanent teeth have started to erupt. Normally, baby teeth should loosen and fall out as the permanent teeth begin to grow, but if this process doesn’t happen correctly, it can lead to problems. This condition is most commonly seen in the canine and incisor areas, and can cause teeth to grow in overlapping positions or result in malocclusion. If left untreated, it may lead to misaligned teeth, inflammation around the gums, periodontal disease, and even infections. That’s why early detection and timely treatment are so important.

The Main Causes of Retained Deciduous Teeth Are Genetics, Tooth Size Mismatch, and Delayed Development

Genetic factors are considered the most important cause of retained deciduous teeth in puppies. It is well known that a significant number of malocclusions are related to genetic predispositions, and some breeds are genetically more prone to this condition. When permanent teeth begin to erupt but the baby teeth do not fall out on time, both teeth remain in the same space, resulting in a retained state. In addition to genetics, factors such as severe systemic diseases, nutritional imbalances, and endocrine (hormonal) disorders can affect tooth development and eruption timing. Retained baby teeth can disrupt proper tooth alignment and allow food debris to accumulate between teeth, increasing the risk of infection.

Oral structure in which baby teeth interfere with the growth of permanent teeth

Main Symptoms of Retained Deciduous Teeth Include Overlapping Teeth, Bad Breath, and Decreased Appetite

Retained baby teeth in puppies can lead to several noticeable changes, such as overlapping teeth, bad breath, and pain or discomfort. When baby teeth don’t fall out, the permanent teeth may not grow in properly, which can cause misalignment or crooked teeth. Bad breath often occurs when food gets trapped between teeth, allowing bacteria to multiply and potentially leading to gum inflammation and periodontal disease. If your puppy is experiencing pain or discomfort, they may show reluctance to eat or have difficulty during meals. If you notice any of these signs, it’s a good idea to have your veterinarian perform an oral examination.

A dog showing signs of discomfort while eating

Retained Deciduous Teeth Can Lead to Bite Abnormalities and Increased Risk of Infection

Retained baby teeth can significantly disrupt proper tooth alignment. As permanent teeth grow in crooked or overlapping, it can lead to bite abnormalities, while food debris trapped between teeth may cause periodontal disease or infections around the teeth. In fact, periodontal disease is one of the most commonly diagnosed conditions in veterinary medicine. If left untreated for too long, this condition can result in tooth loss or chronic pain. Certain breeds are genetically predisposed to this issue, so it’s important to seek veterinary care as soon as possible to begin treatment.

Diagnosis of Retained Deciduous Teeth Is Confirmed Through Oral Examination and X-rays

Retained baby teeth in puppies can usually be easily identified through a veterinarian’s oral examination. However, since some cases aren’t visible to the naked eye, X-rays are used to accurately assess the position and development of the permanent teeth. X-rays are essential for determining whether baby teeth remain, if permanent teeth are erupting properly, and if there are any abnormalities between the teeth. In particular, X-ray examinations are recommended for early diagnosis in breeds prone to retained baby teeth or when symptoms are present. An accurate diagnosis forms the foundation for developing an effective treatment plan.

Treatment Involves Extraction of Deciduous Teeth, Performed Immediately After Anesthesia

Treatment for retained baby teeth in puppies involves extracting the remaining deciduous teeth. After administering anesthesia, the veterinarian safely removes the baby teeth to allow the permanent teeth to erupt in their correct positions. Because baby teeth often have long roots that can make extraction challenging, intraoral X-rays are taken before and after the procedure to ensure no root fragments remain. Extraction is recommended as soon as the permanent teeth begin to erupt, and unless the baby teeth are extremely loose, it is best not to leave them in place. Some temporary discomfort may occur after surgery. The veterinarian will prescribe pain relief and provide guidance on oral hygiene care and careful post-operative monitoring. Early treatment plays a crucial role in preventing dental alignment issues.

A veterinarian performing a surgical extraction of deciduous teeth under anesthesia

Home Care Focuses on Tooth Cleaning and Regular Check-ups

After treatment for retained deciduous teeth, home care focuses on regular tooth brushing and routine oral exams. Brushing your pet’s teeth once or twice daily with a pet toothbrush helps prevent periodontal disease. You can also support dental health by appropriately using dental treats and products, preferably those recommended by your veterinarian. Regular oral check-ups and ongoing monitoring of your pet’s teeth are essential. Early detection and consistent care help maintain long-term oral health.

Small Breeds Are at Higher Risk for Retained Deciduous Teeth and Require Attention

Retained baby teeth are more common in certain breeds due to genetics. When permanent teeth start coming in but the baby teeth don’t fall out on time, both sets of teeth remain in the same space, leading to a retained tooth condition. This can cause misalignment and increase the risk of gum and periodontal infections. Early diagnosis and treatment are crucial. Regular dental check-ups with your veterinarian are important, along with closely monitoring whether permanent teeth are erupting properly and baby teeth are falling out as expected.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

How long should I wait for baby teeth to fall out?

The key factor isn’t just age, but the eruption of permanent teeth. If a baby tooth hasn’t fallen out on its own even after the corresponding permanent tooth has started to come in, it’s best to have your vet examine your pet at that point. Once permanent teeth begin to erupt, it’s recommended to remove any remaining baby teeth as soon as possible. The longer you wait, the greater the risk of misaligned teeth and infections.

Is the surgery to remove baby teeth very painful?

Since anesthesia is used, your pet won’t feel any pain during the surgery. There may be some temporary discomfort afterward, but your veterinarian will prescribe pain relief medication and guide you through the recovery process.

What problems can occur if baby teeth are not removed?

If baby teeth don’t fall out on their own, the adult teeth may grow in crooked or overlap, trapping food particles between them and leading to gum disease or infections. Over time, this can even result in tooth loss.

Is there a genetic component to retained baby teeth?

Yes, certain breeds are genetically more prone to retained deciduous teeth. It is well established that a significant number of malocclusions are linked to genetic predisposition. Keeping track of dental history within the same family can be helpful for management.

Will the teeth automatically align properly after the baby teeth are removed?

In most cases, permanent teeth naturally grow into the correct position after baby teeth are removed. However, in some instances, the teeth may not align perfectly. If this happens, your veterinarian may recommend orthodontic treatment if necessary.

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References

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[3] Plumb's Veterinary Drug Handbook, 9th ed. Wiley-Blackwell, 2021.