So, your puppy has teeth in the wrong spot...

The most common orthodontic abnormality seen in dogs is base narrow canines. Otherwise known as Linguoverted Canines. In this condition the lower canine teeth are angled straight upward, instead of tipping outward. Some puppies or dogs may display only mild contact of the affected canines with the upper gums, requiring minimal intervention. Others may show direct traumatic contact with the tissue of the upper hard palate.


 
WHAT YOU NEED TO KNOW…

 

  • Can affect young puppies when the deciduous teeth erupt on a narrow angle and contact the palate.
  • Can occur in any breed but is more common in breeds with longer narrow facial structure such as Poodles, Collies, Labradors, and German Shepherds.

    Normal Alignment

    What is a normal bite? The way the teeth align with each other is referred to as the ‘occlusion’. Normally the upper incisors sit just in front of the lower incisors, this is called a ‘scissor bite’. The lower canines sit in the gap between the upper canines and corner (third) incisors, without rubbing against either of these teeth.

    Dental Milestones

    When a puppy is two or three weeks old, the baby teeth begin to erupt through the gums, starting with the incisors, followed by the canine teeth, and finally the premolars. All of the deciduous teeth should be in place by about eight weeks of age. 


    By eight to twelve weeks of age, the roots of the baby teeth are starting to resorb and the teeth begin to loosen and fall out. This makes room for the permanent teeth to erupt.  As with the deciduous teeth, the permanent incisors are the first to come in, followed by the canine teeth, and the premolars. The last teeth to erupt in the adult set are the molars. Puppies do not have molars. All of the permanent teeth should be present by about eight months of age.

     

    What causes Base Narrow Canine

    This problem arises a couple of different ways. One is where the lower jaw is the right length but the lower canines (or fangs) erupt too vertically, so they hit the upper gum tissue instead of clearing the upper jaw to the sides. The second way is that the lower jaw is too short, so the lower canines get caught between the upper canines as they erupt, and are forced to follow a narrow path up into the palate. 

    Treatment Options

    This condition can be addressed in a number of ways, with treatment being based on a number of factors including the  age of the puppy, the underlying cause and the position of the teeth.  Following is a general guideline of potential treatment options and when these may take place.

    6 - 12 weeks of age

    Massage

     

    For borderline cases or if the teeth have not fully erupted yet, it may be an option to  gently massage the puppy canines in an outward direction, 3 times a day for 15 minutes.Watch for the baby lower canines coming out. If the milk tooth starts to wobble and the adult tooth is a) coming up inside it or b) not directly underneath it then wobble the baby tooth until it comes out. Leaving both the baby tooth AND adult tooth side by side for any period of time can affect the way the adult tooth will grow in.
    Once the baby tooth is out and you see the tip of the adult canine coming through, massage it outwards daily. Get puppy relaxed (that can be hard!) on your knee and gently place you finger on the tooth and massage outwards, pushing ever so slightly, best to do when they are a bit sleepy.

     

    Extraction of the Canine Milk teeth

    “If the lower deciduous canines are traumatising the maxillary mucosa, further intervention is needed. Deciduous canine teeth are sharp and these puppies could be experiencing pain every time they close their mouths. Puppies that want to chew or mouth everything may be doing this to avoid the pain of having a closed mouth and the impact this has on their hard palate. 

    In some cases, deciduous canine extractions relieve ‘dental interlock’ allowing the mandible to ‘catch up’ to the maxilla and the permanent teeth to erupt in a normal position.  [Advanced Animal Dentistry]

    5 - 6 Months of Age

    At this age the permanent canine teeth should be erupting.  

     

    Extract Retained Deciduous Dentition

    Firstly, it is ESSENTIAL that the deciduous canines (maxillary and mandibular) are not retained. Deciduous teeth are retained when they are present and the adult tooth is also present. If the deciduous tooth is firm and the adult tooth is just erupting, the deciduous tooth needs removal ASAP. In this situation the permanent tooth is in the WRONG position, often in a much worse position. If deciduous, canine mandible teeth are retained the permanent tooth will erupt inside the deciduous tooth, exacerbating the problem.  If the maxillary canine teeth are retained, the permanent tooth erupts in front of the deciduous tooth, narrowing the natural space between the teeth and blocking the ability of the mandibular canine teeth to erupt into a non-traumatic position.  Removal of the retained deciduous tooth will often allow the erupting tooth to move into the extraction site and a more appropriate position.  

    Ball Therapy

     

    Eruption of the lower canines is a time where they are not “set” in the bone. These erupting teeth are susceptible to external forces that can guide them into different positions. Some animals respond well to oral ball play. With appropriately sized firm rubber toys/balls and frequent play behaviour, a suitable object can apply enough lateral pressure to move some lower canines into a more normal position. This should be undertaken for 15 minutes three times a day during the eruption period.  Ball Therapy is used to attempt to correct base narrow canine. The concept is pretty simple – encourage your puppy to play with a rubber ball, three times a day for at least 15 minutes. Encourage your puppy to carry the ball in their mouth, in between their  canine teeth. The presence of the ball applies a gentle force to the canine teeth – training the teeth into a more appropriate position.  Kong has a range of balls that suit this purpose.  Another appropriate orthodontic toy is the puppy kong toys that you can fill with treats. To read more about the Ball Therapy Technique,  press on the following link  ,http://www.toothvet.ca/PDFfiles/ball_therapy.pdf

    Orthodontic Intervention

    In my experience, approximately 98% of puppies presenting with base narrow canine, do not need further intervention.  Some patients require a slightly more aggressive approach and are candidates for early orthodontic intervention including gingivoplasty procedure or placement of crown extensions.  This is not always a procedure that can be done, but if suitable is usually the last treatment required. 

     

    From 8 months

    If there has been no success with previous interventions, 7-8 months of age is the time where definitive treatment can take place.

    Height Reduction Dental Surgery

     

    A height reduction involves cutting the mandibular canines to approximately the height of the mandibular incisor teeth, physically stopping them from touching other tissue in the mouth. This exposes the pulp chamber of the tooth which must be protected with a series of restorations or fillings. This procedure requires periodic follow-up with dental radiographs over the patient’s lifetime.  

    Orthodontic Devices

    Other patients are candidates for an inclined plane. This is an orthodontic device that is made and attached to the dog’s upper jaw, between the upper canines and incisors. This acrylic device is shaped so the lower canines strike it, and over time are guided into their correct, non-painful, positions. When first placed, the dog cannot close their mouth, but over a short time, usually 4 weeks, the teeth move labially. This is a “better” procedure than a bilateral height reduction, as there is minimal risk of damaging the teeth and long term follow-up requirements are minimal.  

      Extraction of the Adult Canine Tooth

      Extraction of the lower canines is also an option for patients with linguoverted mandibular canine teeth, and does not result in a terrible or painful result for the animal. Removal of these teeth offers relief from discomfort and is far better than doing nothing. Extraction of the mandibular canine teeth requires no long-term follow-up but may result in changes to the appearance of the patient. These changes are generally of a cosmetic nature and not medical concerns and include: 

      • Tongue protrusion from the mouth 
      • Thinning of the front of the lower jaw 
      • Regression in length of the lower jaw (generally only if incisor teeth also extracted) 
      • Small risk of jaw fracture during extraction

      Summary

      Base Narrow Canine is a common dental problem seen in labradoodles due to the long snout that is both in the poodle and the labrador heritage. If your puppy has been diagnosed with base narrow canine, there is no cause for alarm. In almost all cases of base narrow canine it has been our experience at Burrinjuck that the problem has been rectified with minimal interventions, including extraction of the baby canines, ball therapy and massaging the emerging adult canines as they come through.  We recommend working with your vet to judge the appropriate interventions that will be the best fit for your puppy.