Traumatic Malocclusion in a Maltipoo Puppy: Orthodontic Correction of the Lower Canines
Persistent deciduous canines displaced the permanent teeth inward, causing the lower canines to traumatize the hard palate mucosa.
The owners of a 6.5-month-old Maltipoo puppy sought care because the deciduous teeth had not fallen out on time and the canines appeared in two rows.
During the occlusal assessment, more than persistent deciduous canines were found. The lower permanent canines had erupted inward and, on jaw closure, were traumatizing the hard palate mucosa, creating painful traumatic lesions.
To resolve the traumatic contact, extraction of the deciduous canines and placement of a custom orthodontic appliance were planned. After approximately 1.5 months the position of the permanent canines had changed, the appliance was removed, and the teeth no longer traumatized the palatal mucosa.
- Maltipoo
- 6.5 months
- Persistent deciduous canines
- Traumatic malocclusion
- Orthodontic appliance
- Correction in 1.5 months
- Patient
- Maltipoo puppy, 6.5 months old.
- Reason for visit
- Deciduous teeth failed to fall out on time, and the canines appeared in two rows.
- Key finding
- Persistent deciduous canines and malpositioned lower permanent canines.
- Consequence
- The permanent canines traumatized the hard palate mucosa and caused painful traumatic lesions.
- Treatment
- Extraction of the persistent deciduous canines and placement of a custom orthodontic appliance.
- Correction duration
- Approximately 1.5 months.
- Result
- The position of the permanent canines changed, traumatic contact was resolved, and the appliance was removed.
- Further care
- Home oral hygiene and occlusion monitoring per individual recommendations.
The video contains footage from a dental procedure. Some viewers may find this content sensitive.
Reason for the Visit
The owners of a 6.5-month-old Maltipoo puppy sought care because the deciduous teeth had not fallen out on time and the canines appeared in two rows.
This appearance is often described as "double teeth." In reality, these are persistent deciduous teeth that remained in the mouth after the corresponding permanent teeth began erupting.
This is not merely a cosmetic feature. Persistent deciduous teeth can contribute to crowding, plaque accumulation, and displacement of the permanent teeth.
Findings on Occlusal Assessment
The examination revealed:
- Persistent deciduous canines
- Permanent canines erupting alongside them
- Malpositioned lower permanent canines
- Traumatic contact between the mandibular canines and the hard palate mucosa
The lower permanent canines were angled inward. On jaw closure, their crowns contacted the palatal mucosa and were continuously traumatizing it.
Painful traumatic lesions of the mucosa had already formed at the contact sites.
Why This Malocclusion Required Treatment
An orthodontic problem in animals is not evaluated by how straight the teeth look.
The key question is whether the occlusion is functional and whether the teeth are traumatizing soft tissue or other teeth.
In this case, contact between the lower canines and the hard palate:
- Traumatized the mucosa
- Sustained a local inflammatory process
- Caused pain
- Could lead to deepening of the traumatic lesions
- Prevented the formation of a comfortable, functional bite
The hard palate mucosa was undergoing continuous mechanical trauma.
Leaving the situation untreated was therefore not advisable.
Why the Deciduous Canines Had to Be Extracted
When a permanent tooth is already erupting while the corresponding deciduous tooth remains in place, there isn't enough normal space for both teeth.
A persistent deciduous tooth can affect the eruption path of the permanent tooth and contribute to its displacement.
In this clinical case, the deciduous canines needed to be extracted to remove the mechanical obstruction and free up space for further correction of the permanent canines' position.
Why Extraction Alone Was Not Enough
By the time of presentation, the lower permanent canines had already erupted in a malpositioned orientation and were traumatizing the palate.
Extracting the deciduous teeth removed one cause of crowding, but it did not guarantee that the permanent canines would spontaneously settle into a functional position.
Orthodontic treatment was planned to redirect their position.
Why Treatment Timing Matters
In puppies, occlusion and tooth position change together with jaw growth and permanent tooth eruption.
In some cases, early intervention allows the growth period to be used to reposition teeth and prevent further trauma.
However, there is no single universal "window" that applies to all dogs.
Timing depends on:
- The puppy's age
- The stage of permanent tooth eruption
- The type of malocclusion
- Tooth position
- The nature of the trauma
- Growth rate
- Individual response to treatment
In this case, the puppy presented at 6.5 months of age, when orthodontic correction was still clinically feasible.
Timing of orthodontic treatment is especially important in puppies. While the jaws are still growing and the permanent teeth are settling into position, it is sometimes still possible to redirect their eruption path or position. The exact "window of opportunity" is determined individually, depending on age, type of malocclusion, stage of tooth eruption, and nature of the trauma.
Treatment Plan
The plan included two main stages:
- Extraction of the persistent deciduous canines
- Placement of a custom orthodontic appliance to gradually reposition the lower permanent canines
Before treatment, the owners were informed of the procedure's goal, the expected direction of tooth movement, the need to monitor the mucosa, possible risks and limitations, the importance of home care, and the need to remove the appliance once the desired clinical result was achieved.
Placement of the Orthodontic Appliance
After the deciduous canines were extracted, a custom veterinary orthodontic appliance was placed.
Its purpose was to gradually reposition the lower permanent canines so that, on jaw closure, they would no longer contact the hard palate mucosa.
The orthodontic appliance was not used for cosmetic tooth alignment.
The primary goal was to create a more functional, non-traumatic bite.
Outcome at 1.5 Months
After approximately 1.5 months, the position of the lower canines had changed.
The occlusal assessment confirmed that the canines were no longer traumatizing the palatal mucosa.
Once the desired clinical result was achieved, the orthodontic appliance was removed.
What Changed After Treatment
The main outcome was resolution of the traumatic contact.
After correction:
- The lower canines settled into a more functional position
- The crowns no longer traumatized the hard palate mucosa
- A persistent source of painful mechanical irritation was eliminated
- The puppy could close its mouth more comfortably
Veterinary orthodontics in this case was aimed not at the teeth's appearance, but at comfort and function.
Further Home Care
After orthodontic treatment was completed, the owners were given recommendations for home oral hygiene.
Regular care is especially important for small-breed dogs, in which crowding can cause plaque to accumulate faster.
Home care is tailored individually, taking into account age, gum condition, tooth position, and how calmly the animal tolerates the procedures.
Key Takeaway
Teeth in two rows in a puppy are more than just an unusual appearance.
Persistent deciduous teeth can affect the position of the permanent teeth, and an abnormal bite sometimes leads to ongoing mucosal trauma and pain.
In this case, timely extraction of the deciduous canines and orthodontic correction made it possible to:
- Reposition the lower permanent canines
- Resolve the hard palate trauma
- Preserve the permanent teeth
- Achieve a functional, comfortable bite
It's best to assess a puppy's occlusion during the transition from deciduous to permanent teeth, rather than waiting for traumatic contact to cause significant mucosal damage.
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Does your puppy need an occlusal assessment?
During a consultation, the transition from deciduous to permanent teeth, canine position, and the presence of traumatic contact can be assessed. Treatment options and optimal timing are determined individually after examining the specific patient.
Every clinical case is individual. Orthodontic treatment strategy is determined after assessing age, jaw growth, tooth position, the nature of the malocclusion, and the presence of soft tissue trauma.