What to Do When Puppy Baby Teeth Don’t Fall Out

Oral HealthQ&AMeongsiljang Veterinary Advisory Board

We’ve compiled the causes, potential issues, recommended timing for extraction, and home care tips for when a puppy’s baby teeth don’t fall out after seven months of age.

When Do Retained Puppy Baby Teeth Become a Problem?

A retained baby tooth visible alongside the permanent tooth in your puppy’s canine area, creating a double row of teeth.

Puppy baby teeth begin to emerge at 3–4 weeks of age and are replaced by permanent teeth between 6–7 months of age. In veterinary medicine, "persistent deciduous teeth" refers to the condition in which baby teeth remain in the mouth even after the corresponding permanent teeth have started to erupt. In other words, the medical criterion is not how many months old the puppy is, but whether baby teeth are present alongside already erupting permanent teeth. Veterinary dental textbooks recommend that once permanent teeth begin to erupt, the baby teeth should be extracted as soon as possible unless they are extremely loose and about to fall out on their own. If baby teeth remain alongside erupted permanent teeth beyond 7 months of age, promptly consult your veterinarian to plan for extraction. When permanent and baby teeth occupy the same space, it can lead to malocclusion and accelerate the progression of periodontal disease. This condition is common in breeds with genetic predispositions, so be sure to schedule regular oral examinations at 6–7 months of age.

Why Don’t Baby Teeth Fall Out?

Normally, as permanent teeth erupt, they dissolve the roots of the baby teeth, causing them to fall out naturally. However, if the permanent tooth grows in beside the baby tooth rather than directly beneath it, the baby tooth’s root won’t dissolve, leaving it in place. This is mostly due to genetic factors and is especially common in small breeds like Yorkies, Maltese, Pomeranians, and Toy Poodles. Rarely, systemic diseases or nutritional issues can also be the cause, but please don’t blame yourself—this isn’t due to any mistake on your part.

Puppy Tooth Replacement Timeline at a Glance

Puppies have 28 deciduous (baby) teeth and 42 permanent (adult) teeth. A difference of one to two weeks from the schedule below is normal depending on breed and size, but if the timing deviates significantly, a veterinary examination is recommended.

Age	Dental Status	Key Points to Check
3–4 weeks	Baby teeth begin to erupt	Gums may itch, leading to chewing behavior
6–8 weeks	All 28 baby teeth present	Check oral health before adoption
3–4 months	Incisors begin to be replaced	You may find loose baby teeth at home
4–6 months	Canines and molars are replaced	Bad breath or bleeding may occur
6–7 months	All 42 adult teeth present	Check for any retained baby teeth
7+ months	Diagnosis of retained baby teeth	Consult your vet about extraction timing

Problems Caused by Leaving Persistent Deciduous Teeth

Malocclusion: Permanent teeth may erupt at incorrect angles, leading to a traumatic bite where the lower canine teeth pierce the upper gum tissue.

Rapid progression of tartar and periodontitis: Food debris becomes trapped in the narrow spaces between deciduous and permanent teeth, causing rapid tartar accumulation and accelerating periodontal disease.

Alveolar bone damage and premature tooth extraction: Persistent periodontal inflammation can damage the alveolar bone surrounding permanent teeth, increasing the risk of losing them at a young age.

Pain and reduced appetite: Gum irritation can make it difficult for pets to eat their food and may cause them to become irritable. Veterinary dentistry textbooks explicitly state that "once permanent teeth begin to erupt, retained deciduous teeth should be extracted as soon as possible, unless they are severely loose."

A puppy's teeth misaligned and gums inflamed due to retained baby teeth

See a Vet Immediately If You Notice These Signs

If your puppy is over seven months old and still has baby teeth, or if you notice any of the following signs, it’s time for a dental checkup: - Two rows of canine teeth are visible side by side - A sudden, foul odor from the mouth - Swollen gums and drooling with blood - Chewing food on only one side or avoiding hard treats - Showing particular discomfort when the face is touched Since this often coincides with the timing of spaying or neutering, it’s common to perform tooth extractions under the same anesthesia.

Never Try to Pull Baby Teeth Out at Home

When you see your pet’s baby teeth wobbling, it might be tempting to pull them out yourself, but this is actually quite dangerous. Baby tooth roots are longer and more curved than permanent tooth roots, so if pulled incorrectly, the root tip can break off and remain embedded in the gums. This leftover root fragment can lead to chronic abscesses and may require additional surgery. There’s also an increased risk of bleeding and infection. Even if a baby tooth is loose, if the permanent tooth has already started coming in, it’s safer to have a vet take an X-ray to check the root condition before deciding whether extraction is necessary. The extent and method of extraction depend on whether any root fragments remain and their condition, so don’t assume everything is fine just because the tooth is loose—early veterinary examination is highly recommended.

The guardian carefully checks the puppy’s teeth at home.

Timing for Extraction and Concurrent Spaying or Neutering

Retained baby teeth require general anesthesia for extraction, so the procedure is most commonly performed on the same day as spaying or neutering. Since sterilization is generally recommended between 6 and 8 months of age, scheduling a dental examination at this time to remove any necessary retained deciduous teeth in one session places the least stress on your dog. However, if the permanent teeth are already severely misaligned, orthodontic treatment or additional extractions may be required. Your veterinarian will determine the appropriate anesthesia protocol and scope of extraction based on your dog’s weight and oral health status.

How to Care for Your Puppy at Home After Extraction

Same-day feeding: Once the anesthesia has fully worn off, offer small amounts of soft or soaked food.

3–5 days of care: Avoid hard chews and bone treats to minimize gum irritation.

Pain management: Administer the prescribed anti-inflammatory pain medication exactly as directed.

Checking for bleeding: A slight pink tint in the saliva is normal, but contact us immediately if bright red bleeding persists.

Long-term care: Starting 2–3 days later, gently brush with a silicone toothbrush to establish a routine that helps prevent tartar buildup on permanent teeth.

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

If baby teeth don’t fall out on their own, do they always need to be extracted?

Yes, extraction is generally recommended. Retained deciduous teeth alongside permanent teeth can lead to periodontal disease and malocclusion, so early extraction is the standard treatment unless the baby teeth are severely loose and about to fall out on their own.

Is it possible to extract baby teeth without anesthesia?

No. To safely remove the teeth down to the roots, X-ray imaging and general anesthesia are essential. We do not recommend non-anesthetic scaling or tooth extraction, as they carry a high risk of leaving root fragments behind and damaging the jawbone.

Why do small-breed dogs tend to retain more baby teeth?

Retained baby teeth are mostly linked to genetic factors. It's important to have regular dental check-ups to see if any baby teeth are still present once the permanent teeth start coming in, regardless of breed.

Can I keep the lost baby tooth?

While you may keep them as keepsakes, please wash them thoroughly and store them in an airtight container for hygiene reasons. However, do not attempt to forcibly pull out loose baby teeth, as this can be dangerous; please only collect those that fall out naturally.

Will having fewer teeth after an extraction cause any problems?

If only the retained baby teeth are removed, the permanent teeth remain in place, so there are usually no functional issues. However, if the permanent teeth are also extracted, proper care of the opposing teeth becomes even more important.