Malocclusion in puppieswhen it's a problem and what to do

What is a normal bite in a dog

For most breeds the normal bite is the scissor bite. The nomenclature of the American Veterinary Dental College (AVDC) describes it by the position of several groups of teeth:

• Incisors: the upper ones sit slightly in front of the lower ones, and the lower incisors touch them from the inside — like the blades of scissors.
• Canines: the lower canine sits in the gap between the upper third (corner) incisor and the upper canine without pressing on either of them.
• Premolars: the upper and lower premolars alternate like the teeth of pinking shears and do not press into each other.
• Carnassial teeth: with the mouth closed, the upper fourth premolar sits on the outside of the lower first molar.

In a puppy, the deciduous teeth normally meet in the same way. So the bite can be assessed even before the teeth change, and then checked again as the permanent incisors and canines come through.

Some breed standards allow a different bite — for example, a protruding lower jaw in many short-nosed dogs. In that case I assess not whether the bite matches the standard but whether the teeth injure the gums, lips or other teeth. More on these breeds in the article on teeth in brachycephalic breeds.

Types of malocclusion: the AVDC classes in plain words

The AVDC nomenclature divides malocclusions into classes depending on where the problem lies: in the relationship between the jaws or in the position of individual teeth. In brackets are the terms owners and breeders often use.

• Class 1 — the jaws relate normally, but individual teeth are out of position. A tooth may be tilted inwards, outwards, forwards or backwards. This includes lower canines that point inwards, an incisor crossbite (one or more upper incisors sitting behind the lower ones), upper canines tilted forwards, and crowded teeth.
• Class 2 — the lower jaw is shorter than the upper jaw (“overshot” or “overbite”). The lower teeth meet behind their normal position, so the lower canines and incisors may press into the palate and the gum behind the upper teeth.
• Class 3 — the lower jaw is longer than the upper jaw (“undershot” or “underbite”). The lower incisors sit in front of the upper ones. The lower canines may hit the upper corner incisors, and the incisors may injure the gum opposite.
• Class 4 — jaw asymmetry. One side of the jaw is longer or shorter than the other, or the jaw is shifted sideways or vertically; the midlines of the upper and lower incisors do not line up. This used to be called a “wry bite”.

An open bite is described separately — when some of the upper and lower teeth do not meet with the mouth closed. If you can see that the teeth are growing crooked or do not meet, start with the page on teeth growing incorrectly or not meeting.

A class is a description, not a verdict. What matters more for a treatment decision is whether there is traumatic contact and whether the bite interferes with the normal change of teeth.

Lower canine hitting the palate: base-narrow canines

Now a closer look at lower canines tilted inwards (linguoversion in professional terms, often called base-narrow canines). When the jaws close, the tips of these canines miss their gap and land on the palate or the gum just inside the upper canines. The puppy injures itself every time it closes its mouth.

Sores appear on the palate, followed by pits where the teeth press in. Over time a deep defect can form next to the upper canine, and in severe cases a communication with the nasal cavity. This can happen with a class 1 malocclusion and with a short lower jaw (class 2).

This was the situation in a Maltipoo puppy with a traumatic bite: the deciduous canines had not fallen out, and the permanent lower canines erupted inwards and injured the lining of the palate. After the deciduous canines were extracted, the position of the permanent ones was corrected with a custom orthodontic appliance, which was removed after about 1.5 months.

Persistent deciduous teeth push permanent teeth out of place

A deciduous tooth should make room when the permanent tooth erupts next to it. If it stays put, the permanent tooth has to go around it and comes through in the wrong place:

• the permanent lower canine erupts on the inner side of the deciduous one, so a persistent deciduous canine deflects it inwards — towards the palate;
• the permanent upper canine erupts in front of the deciduous one and may shift forwards, narrowing the gap where the lower canine should sit;
• the incisors may end up in two rows or form a crossbite.

Plaque quickly builds up between the deciduous and the permanent tooth, so the gums suffer too. This happens most often with the canines — there is a separate article on double canines in puppies. The main rule: there should never be two of the same tooth in one place at the same time.

When a bite is just a feature and when it hurts and causes injury

Orthodontics in animals does not aim for a “show” bite but for one in which the teeth do not injure tissues and the animal can pick up and bite through food comfortably. That is why I always separate two situations.

A puppy with a traumatic bite usually keeps eating and playing, so the pain is easy to miss. Watch for caution while eating, food or toys dropping from the mouth, rubbing the face with a paw, blood on toys or bad breath.

A feature that you decide to monitor should still be rechecked over time: while the jaws are growing and the teeth are changing, the picture may change.

Why timing matters in puppies

Puppies change their deciduous teeth for permanent ones at about 4 to 7 months — a month-by-month timeline is in the article when do puppies lose their baby teeth. This period and jaw growth offer options that an adult dog no longer has.

Deciduous teeth can “lock” the jaws. The upper and lower jaws do not grow fully in step. If, with a short lower jaw, the deciduous lower canines press into the palate, they can hold the lower jaw back and stop it growing forwards. Extracting these teeth when clinically indicated (called interceptive extraction in the professional literature) removes this mechanical obstacle. It does not “lengthen” the jaw: the lower jaw simply gets a chance to grow as far as its genetics allow, and the result cannot be predicted in advance.

Persistent deciduous teeth are best extracted as soon as it is clear that the permanent tooth is erupting next to them: the longer they stay, the more they can displace the permanent tooth. Deciduous teeth have long, thin roots, and the permanent tooth is developing right next to them, so they are extracted carefully, under anaesthesia and after a dental radiograph.

Once the permanent teeth have erupted and jaw growth slows down, the choice narrows to orthodontic correction, crown reduction or extraction. That is why it is worth assessing the bite while the puppy still has its deciduous teeth and again at 4–6 months, when the incisors and canines change.

How I assess the bite: examination and dental radiography

A treatment plan for a bite cannot be made from a photo: it shows the crowns but not the roots of the deciduous teeth, the developing permanent teeth or the width of the pulp. So the assessment has several stages.

What radiographs show and why they are essential is explained on the dental radiography page. Radiographs, extractions, impressions and fitting an appliance are done under anaesthesia; the anaesthetic plan is made individually after pre-anaesthetic tests.

1. 01

   Consultation

   Without anaesthesia I assess how the teeth meet from the front and the sides, the position of the canines, the palate and gums, and any traumatic contacts. We discuss whether treatment is needed now.

2. 02

   Dental radiography

   Under inhalational anaesthesia I take radiographs: the roots of the deciduous teeth, unerupted teeth, how far the permanent teeth have developed and the width of the pulp. Anaesthesia is given and monitored by a separate veterinary anaesthetist.

3. 03

   Treatment plan

   I explain the options, their limitations, and the number of stages and check-ups. If an orthodontic appliance is needed, impressions of the jaws are taken.

4. 04

   Follow-up

   Check-up examinations and, after some procedures, follow-up radiographs to assess the position of the teeth and the health of the pulp.

Treatment options: how the approach is chosen

There is no one-size-fits-all solution. The choice depends on the puppy's age, the type of malocclusion, the stage of tooth change and the radiographs, as well as on whether the puppy can tolerate an appliance and whether you can come for check-ups. Options that may be considered:

• Extraction of interfering deciduous teeth. When clinically indicated, after a radiograph, taking care not to damage the developing permanent teeth. Sometimes this is enough for the permanent teeth to erupt in a better position; sometimes it is only the first step.
• Orthodontic correction. A custom appliance — for example, an inclined plane that gradually guides the lower canines outwards as the jaws close. While the appliance is in the mouth, check-ups and careful hygiene are needed. In mild cases, exercises with a rubber ball or toy whose size is chosen by the vet are sometimes enough. More on the orthodontics and bite correction page.
• Crown reduction with vital pulp therapy. The canine is shortened just enough to stop it injuring the palate. The living pulp exposed in the process is protected (vital pulpotomy) and sealed with a filling. The tooth stays in the mouth and keeps working, but follow-up radiographs are needed to confirm that the pulp remains alive.
• Extraction of a permanent tooth. Considered when other options are not suitable or the tooth is damaged. The lower canine is a large tooth with a long root, so this is a surgical extraction, and the decision is made carefully.

A canine must not be filed down without protecting the pulp: in a young tooth the pulp is wide, and exposed pulp is a route for infection.

Bite and breeding: is malocclusion inherited

The professional literature considers that many malocclusions, especially those related to jaw length, have a hereditary component. But not every malocclusion is inherited: teeth can also be displaced by persistent deciduous teeth or by trauma. In an individual puppy it is not always possible to tell which.

What you can check at home

Once a week, at a calm moment, gently lift your puppy's lips and look:

• from the front — the upper incisors sit slightly in front of the lower ones, and the midlines of the upper and lower rows line up;
• from the side — the lower canine sits in the gap between the upper corner incisor and the upper canine rather than pressing on them;
• at the palate just inside the upper canines — there are no sores, pits or tooth marks;
• for two teeth in one place — a deciduous and a permanent tooth side by side;
• at how your puppy eats — whether it eats cautiously, drops food or rubs its face with a paw.

Photograph the bite from the front and from both sides in good light — it makes changes easier to spot. If you are not in Kyiv, start with an online consultation: from the photos I can tell you how urgent an examination is, although photos do not replace an in-person bite assessment.

How much does bite treatment for a puppy cost

The cost depends on the type of malocclusion, the number of stages and what the radiographs show, so I calculate it after diagnostics. Guide prices for an in-clinic consultation, an online consultation and anaesthesia are below.

Frequently asked questions