Dental problems in small dog breeds:Yorkie, Russian Toy, Pomeranian, Chihuahua

Why small dog breeds develop dental problems earlier

A 2 kg dog and a 30 kg dog have the same number of permanent teeth — 42. The jaws of a small dog are many times smaller, but the teeth are reduced far less. That is why in Yorkies, Russian Toys, Pomeranians, Chihuahuas, Maltese, toy poodles and other toy breeds several features work against oral health at once:

• crowding — the teeth stand close together, premolars may be rotated, and plaque and food debris get trapped between them;
• relatively large roots — they take up a bigger share of the bone than in large dogs, especially in the lower jaw;
• thin bone — there is little bone around the roots, so even a small loss of it is critical for the tooth;
• retained deciduous teeth — in toy breeds the deciduous teeth, especially the canines, often do not fall out on their own.

As a result, plaque and tartar build up faster, inflammation spreads from the gums to the bone earlier, and the consequences of periodontitis are more serious for a small jaw. Breed is not a sentence, but it is a reason to start prevention early.

Retained deciduous teeth and double canines

In puppies the change of teeth is usually complete by 7 months. If the permanent tooth has already erupted and the deciduous one is still in place, there are two teeth where there should be one. Most often these are “double canines”, but deciduous incisors and premolars can be retained too.

Plaque gets trapped between the two teeth, so periodontitis can start in that area while the dog is still young, and the permanent canine may erupt in the wrong position and injure the gums or palate. That is why I advise showing your puppy to a veterinary dentist as soon as you notice double canines in a puppy, rather than waiting for the tooth to “fall out by itself”. More about this situation on the symptom page retained temporary teeth.

The root of a deciduous canine is long, thin and fragile, and the permanent tooth sits right next to it. So a dental radiograph is taken before extraction, and the tooth is removed under anaesthesia gently and completely: a root fragment left in the bone can become inflamed later.

The opposite also happens: a tooth is missing from the row. It may be a tooth that never developed or an unerupted tooth in the bone, around which a cyst sometimes forms — only a radiograph can tell them apart. An example is the case retained teeth in a Chihuahua: in a 5-year-old dog, retained deciduous teeth were combined with unerupted teeth that only dental radiography revealed.

Early periodontitis: why Yorkie and Pomeranian teeth fall out early

Periodontitis is inflammation of the tissues that hold the tooth in place: the gums, the periodontal ligament and the bone. It starts with plaque and gingivitis, then the inflammation quietly spreads below the gum line and destroys the bone around the roots. In small breeds this process often begins at a young age.

Because the bone is thin, a small dog's tooth starts to loosen after losing only a small part of its support. The incisors, premolars and upper canines are often the first to suffer. Stages and treatment are covered in detail in the article on periodontal disease in dogs.

Chihuahua teeth falling out is not normal ageing

Owners often assume that small dogs simply have “weak teeth” that fall out with age. But permanent teeth should not fall out because of age: in an adult dog a tooth usually falls out when periodontitis has destroyed the bone around the root. The neighbouring teeth may be at the same stage, and root fragments or foci of inflammation sometimes remain under the gums.

That was the situation in the case periodontal disease in a Yorkie: an 8-year-old Yorkshire terrier had bad breath, loose teeth, crowding in the upper jaw and teeth that were already falling out. Dental radiographs showed which teeth had to be extracted, and after treatment the dog could eat comfortably again.

A thin jaw: why severe periodontitis is dangerous for a small dog

In a toy-breed dog the roots of the lower first molar — the largest tooth in the lower jaw — occupy a large part of the height of the bone. When periodontitis destroys the bone around these roots, only a thin strip of jaw is left at that point. It can break under normal load: during play, a jump off the sofa or even while eating. This is called a pathological fracture.

For the same reason, extractions in a small dog with severe periodontitis need careful planning:

• dental radiography before surgery — shows how much bone is left, the shape of the roots and whether there is already a crack;
• careful surgical technique — multi-rooted teeth are sectioned and removed root by root, without excessive force on the jaw; when clinically indicated, I use piezosurgery;
• a check radiograph after extraction — to make sure the roots have been removed completely and the bone is intact;
• a plan for very thin bone — I discuss the approach and feeding after surgery with the owner in advance; if a fracture has already happened, the jaw needs to be stabilised.

The earlier periodontitis is treated, the more bone can be preserved and the simpler the procedure will be.

Oronasal fistula: when periodontitis reaches the nose

In a toy-breed dog only a thin plate of bone separates the root of the upper canine from the nasal cavity. A deep periodontal pocket on the palatal side can destroy it, creating a communication between the mouth and the nose — an oronasal fistula. From the outside the canine may still look almost normal.

It is suspicious if your dog sneezes during or after eating or drinking, or has discharge from one nostril, sometimes with blood. Extracting the diseased canine does not always close an established communication, so surgical closure may be needed. More in the article on oronasal fistula in dogs.

Signs owners of small dogs often miss

Small dogs adapt to pain well, and their tiny teeth are hidden behind the lips, so tartar on the back teeth is easy to miss. Pay attention if you notice:

• bad breath — it is not “just the breed”;
• a red line along the gum margin or blood on toys;
• yellow or brown tartar, especially on the upper canines and back teeth — lift the lip at the side;
• loose incisors or teeth that have already fallen out;
• your dog crunches food on one side only, swallows kibble whole, drops food or refuses hard treats;
• rubbing the face with a paw, not letting you touch the head, becoming irritable;
• sneezing or nasal discharge, swelling under the eye.

Home dental care for a small dog

Daily toothbrushing is the most effective home prevention: plaque starts to form again within hours, which is why guidelines recommend brushing every day. What matters for a small mouth:

• a small brush — a brush for small dogs, a soft child's toothbrush or a finger brush that fits in the mouth without forcing the jaws open;
• veterinary toothpaste — human toothpaste is not meant to be swallowed, and a dog swallows it;
• outer surfaces first — most plaque collects on the canines and back teeth on the cheek side; use gentle strokes along the gum line;
• go gradually — start with a few seconds and a reward, and never hold your dog down;
• chews are only an add-on — choose ones with the VOHC seal, sized for your dog, and count their calories;
• nothing hard — bones, antlers and hard nylon toys can break small teeth.

Brushing slows plaque formation, but it does not remove tartar below the gums or treat periodontitis. If there is already tartar or the teeth are loose, the mouth needs professional treatment first, and daily brushing then helps maintain the result.

How often a small dog needs a dental check-up

There is no universal schedule. I set the interval between check-ups individually: based on age, the condition of the mouth, how quickly tartar builds up and how regularly you manage to brush. Many small dogs need closer monitoring than large dogs. More in the article on how often a dog needs a dental check-up.

It is worth planning the first check-up while the teeth are still changing. At a consultation without anaesthesia I can see the gums, tartar, bite and loose teeth, but most periodontitis is hidden below the gum line. The full picture comes from COHAT under inhalational anaesthesia with dental radiography of every tooth.

1. 01

   Consultation

   I assess the gums, tartar, bite and loose teeth, and explain what can be seen now and what cannot be seen without radiographs.

2. 02

   Pre-anaesthetic work-up

   Blood tests and, when clinically indicated, echocardiography and other tests; together with the anaesthetist we assess the risks.

3. 03

   COHAT with dental radiography

   Probing of every tooth, radiographs of all teeth, professional cleaning and treatment according to the agreed plan.

4. 04

   Follow-up and home care

   I explain aftercare, and together we set the interval for the next check-up.

Anaesthesia in very small dogs

What owners of small dogs fear most is anaesthesia: “but she only weighs one and a half kilos”. Low body weight does not make anaesthesia impossible — it determines how it is prepared and delivered. No anaesthesia is entirely free of risk, so the risk is assessed individually and weighed against the risk of living with chronic infection and pain.

Anaesthesia is given and monitored by a separate veterinary anaesthetist, while I focus on the teeth. For very small dogs the following are especially important:

• precise dosing — based on body weight measured on the day of the procedure;
• warming — a small body loses heat quickly, so the dog is kept warm until fully awake and its temperature is monitored continuously;
• monitoring — breathing, heart rhythm, blood oxygen saturation, blood pressure and temperature throughout the procedure;
• individual fasting — long fasting does not suit very small dogs because of the risk of low blood sugar;
• the airway — tracheal collapse can occur in toy breeds, so mention any cough in advance;
• duration — treatment is sometimes split into stages so that anaesthesia is not prolonged.

Blood tests are needed before anaesthesia. Heart disease is not uncommon in older small-breed dogs, so echocardiography is arranged when clinically indicated.

When not to wait for a routine check-up

In a small dog, these situations should not be put off even for a few days:

• the mouth will not close, the jaw is shifted or there is bleeding from the mouth — same-day examination;
• swelling under the eye or on the cheek, a draining tract on the skin;
• sneezing with blood or discharge from one nostril;
• refusing food, whimpering or jerking the head away while eating;
• a puppy's permanent canine has erupted but the deciduous one is still in place.

Bad breath, tartar or red gums are a reason to book a consultation soon. If you are not in Kyiv, start with an online consultation based on photos. How I work with dogs of different breeds is described on the page veterinary dentist for dogs.

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