Do Puppies Need Orthodontic Treatment? — Signs of Malocclusion and Criteria for Assessment

Oral HealthQ&AMeongsiljang Veterinary Advisory Board

We’ve put together a clear, easy-to-understand guide for pet parents on when orthodontic treatment is needed for dogs, including the ideal timing, costs, and important precautions. We’ll also walk you through key cases such as malocclusion and retained deciduous teeth.

What Is Puppy Orthodontic Treatment?

A young puppy undergoing a dental alignment examination.

Puppy teeth alignment is a veterinary dental treatment that corrects tooth positioning to prevent pain and complications when malocclusion causes gum or palate injuries or impairs proper chewing. The key point is that this procedure is performed for functional and pain-relief reasons, not for cosmetic purposes. While malocclusion may sometimes be merely a cosmetic issue, it can cause oral trauma or hinder proper jaw growth, requiring early and proactive intervention in such cases. If a canine tooth pierces the palate or if retained baby teeth cause permanent teeth to erupt crookedly, it is best to have your puppy examined as soon as possible during the early stage when permanent teeth begin to emerge.

Common Cases Requiring Orthodontic Treatment

Unlike in humans, orthodontic treatment for dogs is only performed when medically necessary, not for cosmetic reasons. The most common cases include: 1) lower canines piercing the roof of the mouth (lingual version), 2) malocclusion caused by a length discrepancy between the upper and lower jaws, 3) retained deciduous teeth where permanent teeth erupt alongside baby teeth, and 4) misaligned teeth due to trauma. These conditions can lead to pain, stomatitis, and periodontal disease, making early intervention essential.

Comparison of Malocclusion Types

Item	Type 1 (linguoversion)	Type 2 (overbite)	Type 3 (underbite)	Type 4 (unilateral difference)
Characteristics	Lower canine teeth point inward	Upper jaw long and lower jaw short	Lower jaw longer than upper jaw	Left-right asymmetry
Common breeds	All breeds	Some breeds with a genetic predisposition	Bulldog, Shih Tzu, Pekingese	All breeds
Correction recommendation	High (pain)	Medium	Low (breed standard)	Case-by-case judgment
Recommended timing	Early, around the start of permanent tooth eruption	Early intervention recommended	When a functional problem occurs	Early examination

In breeds such as Bulldogs and Shih Tzus, underbite is the breed standard, so it is often not a candidate for correction

Retained Deciduous Teeth: The Most Common Reason for Orthodontic Treatment

Retained deciduous teeth are a dental issue that can occur in various dog breeds. This condition, known as "retained baby teeth," happens when a permanent tooth has started to erupt but the corresponding baby tooth hasn't fallen out. If the baby tooth remains while the permanent tooth begins to grow, it can cause the permanent tooth to develop at an angle. In particular, if you notice two canines in the same spot, it's important to visit a veterinary clinic right away. It's recommended to remove retained baby teeth as soon as possible once the permanent teeth start coming in. Leaving them in place can lead to food getting trapped, causing gum inflammation and periodontal disease, and may permanently misalign the permanent teeth.

A puppy’s canine tooth with both baby and permanent teeth growing together

See a Vet Immediately If You Notice These Signs

If you notice any of the following signs, your dog may have a malocclusion or dental issue: ① Frequently opening the mouth or chewing on only one side; ② Dropping food or refusing to eat; ③ Bleeding, pus, or a foul odor coming from the mouth; ④ Canine teeth piercing the upper gum or palate; ⑤ Retained baby teeth in the same position even after adult teeth have erupted. Many dogs endure dental pain silently, so it’s important for owners to regularly check their mouths.

Orthodontic Methods and Treatment Process

Dental correction for dogs generally falls into three main categories. First, deciduous tooth extraction is the simplest approach; removing the baby teeth allows the permanent teeth to settle into their proper positions. Second, an inclined plane device is attached to the roof of the mouth to gently push the canine teeth outward. Third, crown reduction involves reshaping the tip of the problematic canine tooth followed by root canal therapy. All procedures are performed under general anesthesia, and it is safest to refer your pet to a veterinary dental specialist.

A veterinary dental specialist treating a dog's teeth

Costs and Recovery Period

While the approach and costs vary significantly depending on the clinic, extracting deciduous teeth is relatively straightforward when performed alongside anesthesia and dental scaling. More complex procedures, such as using inclined-plane devices or crown reduction, are only available at veterinary dental specialty hospitals and tend to be more expensive. Be sure to obtain an accurate estimate after consulting with a dental specialist. Recovery time depends on the treatment method and your pet’s individual condition; during this period, it’s important to follow your veterinarian’s instructions, which typically include feeding soft food and avoiding hard toys or bone treats.

General Anesthesia Risks and Pre-Anesthetic Examinations

Dental correction for dogs is performed under general anesthesia. Since young puppies, senior dogs, and small-breed dogs may face higher anesthesia risks, pre-anesthetic physical examinations and blood tests (including complete blood count, total protein, BUN, etc.) are essential. Additionally, if regular oral care (such as brushing and professional cleanings) is not maintained after the procedure, periodontal disease can recur. Establishing a daily tooth-brushing routine is the best preventive measure.

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

At what age should a puppy receive orthodontic treatment?

It’s best to diagnose and treat retained baby teeth or canine tooth issues early, when the permanent teeth begin to emerge. The ideal time for intervention is before the permanent teeth fully settle into place, right as they start to erupt.

How long does my pet need to wear the orthodontic appliance?

The duration of wearing the inclined plane device varies depending on the case, and the veterinarian will remove it once they confirm that the canine teeth have been properly aligned. The length of time may differ based on the severity of symptoms and individual response.

Should underbites in Bulldogs and Shih Tzus also be corrected?

For these breeds, an underbite is considered a breed standard, so correction is not necessary unless it causes pain or functional issues. Cosmetic correction is not recommended.

What happens if it’s not corrected?

If malocclusion is left untreated, it can cause persistent oral trauma to the roof of the mouth or gums, leading to chronic pain and worsening periodontal disease. It’s important to consult with a veterinary dental specialist early on, before complications become severe.

Can pets wear orthodontic appliances for a long time, just like people?

Dogs have difficulty tolerating orthodontic appliances for long periods, so we rarely use the same correction methods as in humans. Instead, we opt for shorter, more effective approaches.

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References

[1] Clinical Medicine of the Dog and Cat, 4th Ed - Chapter 5: Oral Cavity and Dentition

[2] Wiggs's Veterinary Dentistry: Principles and Practice, 2nd Ed - Orthodontics Chapter

[3] The Dog Care Handbook, Things I Wish My Vet Had Told Me - Dental Care Section