Introduction
Every dental procedure ends with a chart, and every chart depends on two skills: knowing the anatomy of the teeth and naming each tooth the same way every time. AAHA guidelines say that in the dental suite the credentialed technician should examine the mouth and dictate the charting to an assistant, so the technician has to name teeth and surfaces quickly and correctly.4
This guide covers the deciduous and permanent dental formulas of the dog and cat, when the teeth erupt, the parts of a tooth and its supporting tissues, the directional terms used on a chart, the modified Triadan numbering system (including the teeth a cat does not have), and the AVDC abbreviations you will write most often.
Key facts
- Dog: 42 permanent teeth, 2 x (I 3/3, C 1/1, P 4/4, M 2/3). Puppy: 28 deciduous teeth, 2 x (i 3/3, c 1/1, p 3/3).3
- Cat: 30 permanent teeth, 2 x (I 3/3, C 1/1, P 3/2, M 1/1). Kitten: 26 deciduous teeth, 2 x (i 3/3, c 1/1, p 3/2).3
- Triadan quadrants run clockwise as you face the patient: 100 right maxilla, 200 left maxilla, 300 left mandible, 400 right mandible. Deciduous quadrants are 500 to 800 in the same order.1
- Rule of 4 and 9: the canine is always 04 and the first molar is always 09.1
- Missing positions are skipped, never renumbered. The cat's first upper premolar is 106 or 206, and its two lower right premolars are 407 and 408.12
- Enamel covers the crown, cementum covers the root, dentin makes up most of the tooth, and the pulp sits in the center.3
- Mesial faces toward the first incisor along the arch, distal faces away. Lingual faces the tongue; palatal may be used for the tongue side of maxillary teeth.2
- The dental chart is part of the medical record and a legal document.13
How the VTNE tests this
- Name or number a tooth: convert an anatomical name to a Triadan number, or a number back to a name, for a dog, a cat or a young animal. Domain 3 Task A (use anatomy, physiology and pathophysiology as they apply to dentistry); K1 (anatomy).14
- Count teeth from a formula or spot the wrong formula for a species or age. K1.14
- Choose the right surface term (mesial, distal, buccal, lingual, palatal) for a finding. K5 (medical terminology).14
- Read and write chart abbreviations such as M2, F3 or T/FX/CCF during a COHAT (comprehensive oral health assessment and treatment). Domain 3 Task C; K21 (dental procedures, including charting).14
Core concepts
Dentition words you need
Dogs and cats are diphyodont (two generations of teeth), anelodont (the teeth do not grow continuously) and brachydont (short crowns fully covered by enamel, with roots longer than the crowns).3 Horses and ruminants are hypsodont: long crowns that keep erupting.1
Deciduous and permanent are the correct terms for the two generations. "Primary" is acceptable when you talk with clients. The mixed dentition period is the time when both deciduous and permanent teeth are in the mouth.2
There are four tooth classes: incisors, canines, premolars and molars.1 The carnassial teeth of the dog and cat are the maxillary fourth premolar and the mandibular first molar; in a normal bite the upper fourth premolar overlaps the lower first molar on the buccal side.11 The canine teeth of dogs and cats, and the carnassial teeth of dogs, are called strategic teeth, and root canal therapy is more often recommended for them than extraction.12
Parts of a tooth
Each tooth has a crown above the gum line and one or more roots below it.1 The AVDC separates two ways of drawing that line. The anatomical crown is everything coronal to the cementoenamel junction (CEJ), the place where enamel and cementum meet. The clinical crown is everything coronal to the gingival margin.2 A tooth with gingival recession therefore has a longer clinical crown, but its anatomical crown has not changed.
- Enamel: the hardest and most mineralized tissue in the body. Ameloblasts form it only before the tooth erupts, so lost enamel is not replaced. It is 0.1 to 1 mm thick in dogs and cats.3
- Dentin: makes up most of the adult tooth and is formed by odontoblasts at the edge of the pulp. Primary dentin forms during development, secondary dentin is laid down after the root is complete (normal aging), and tertiary dentin forms as a repair response.3
- Pulp: nerves, blood and lymphatic vessels, connective tissue and odontoblasts in the center of the tooth.1 The pulp chamber is the space in the crown, the root canal is the space in the root, and the apical foramen is the opening at the root tip.2 In adult dogs and cats the pulp communicates with the periodontal ligament through the apical delta, a branching set of small openings, and through lateral canals. In young animals the apical opening is still large.23
- Cementum: mineralized connective tissue, similar to bone, that covers the root. Cementoblasts form it.3
The periodontium is the tooth's supporting apparatus: gingiva, periodontal ligament, cementum and alveolar bone. The periodontal ligament is anchored in the cementum on one side and the alveolar bone on the other, holding the tooth in its socket (alveolus). The gingival sulcus, the shallow groove between the tooth and the free gingiva, is normally 0 to 3 mm deep in dogs and 0 to 1 mm in cats.3
Roots worth memorizing
In the dog the incisors and canines have one root. In the maxilla, the first premolars have 1 root, the second and third premolars 2, and the fourth premolar and both molars 3. In the mandible, the first premolar has 1 root, the second to fourth premolars and the first and second molars have 2, and the third molar has 1.1 In the cat the maxillary second premolar is small and single-rooted, the maxillary fourth premolar has three roots, the two mandibular premolars have two roots each, and the large mandibular first molar has two.3 Root counts matter on the chart because furcation findings apply only to multirooted teeth.2
Directional terms on a chart
- Vestibular: the surface facing the lips or cheeks (the vestibule). Buccal and labial are acceptable alternatives.2
- Lingual: the surface of any maxillary or mandibular tooth that faces the tongue. Palatal can be used for the lingual surface of maxillary teeth only.2
- Mesial: for the first incisor, the surface next to the midline; for every other tooth, the surface facing toward the first incisor. Distal is the opposite surface.2
- Rostral and caudal: toward the front of the head and toward the tail. Anterior and posterior are the human dentistry equivalents.2
- Coronal refers to the crown portion of the tooth, and apical to the apex, the end of the root.2
Formulas and eruption times
A dental formula lists the teeth on one side, upper jaw over lower jaw, and is multiplied by 2. The WSAVA guidelines write permanent teeth in capital letters and deciduous teeth in lower case.3 The first premolar and the molars have no deciduous predecessors; they develop directly from the dental lamina at the back of the arch.5 That is why the puppy formula has no molars and only three premolars per quadrant.
| Species | Deciduous formula | Permanent formula | Eruption |
|---|---|---|---|
| Dog | 2 x (i 3/3, c 1/1, p 3/3) = 28 | 2 x (I 3/3, C 1/1, P 4/4, M 2/3) = 42 | Deciduous teeth start at 3 to 6 weeks and are usually complete by 12 weeks. Permanent teeth start at about 3 to 5 months and are all present by about 7 months. |
| Cat | 2 x (i 3/3, c 1/1, p 3/2) = 26 | 2 x (I 3/3, C 1/1, P 3/2, M 1/1) = 30 | Deciduous incisors erupt at 2 to 4 weeks and deciduous premolars at 5 to 6 weeks. Permanent teeth start at about 4 to 7 months. |
Sources: WSAVA Global Dental Guidelines (formulas); Merck Veterinary Manual pet owner pages on dental development of dogs and cats; Wallis et al. 2023 (dog eruption ages).3678
Published ages vary by source and by breed. In a study of 61 Yorkshire terrier puppies, dogs under 3 kg lost deciduous teeth and gained permanent ones later than heavier dogs, and 69% of the puppies had at least one persistent deciduous tooth.8 A persistent deciduous tooth is one still present when it should have been shed (AVDC abbreviation DT/P).2
Procedure or technique
Numbering a tooth with the modified Triadan system
The modified Triadan system is the tooth numbering system of choice in veterinary dentistry, and both Triadan numbers and full anatomical names are acceptable in the record.2 Each tooth gets three digits. The first digit is the quadrant; the last two give the tooth's position counted from the midline.1
- Find the quadrant while facing the patient. Go clockwise: right maxilla 1, left maxilla 2, left mandible 3, right mandible 4. For a deciduous tooth use 5, 6, 7 or 8 in the same order.1 The patient's right side is on your left, which is where most mistakes start.
- Count from the midline. The central incisor is 01, then 02 and 03.1
- Anchor on 04 and 09. The canine is always 04 and the first molar is always 09.1 Premolars fill the positions between them, 05 to 08, so the fourth premolar is always 08.
- Skip positions that the species does not have. Missing teeth are skipped in the sequence, never renumbered.1
- Join the digits. Left maxilla (2) plus fourth premolar (08) is 208. The deciduous teeth follow the same rule: a puppy's deciduous upper canines are 504 and 604, and its deciduous second premolars are 506, 606, 706 and 806.8
| Quadrant (facing the patient) | Permanent | Deciduous | Adult dog | Adult cat |
|---|---|---|---|---|
| Right maxilla (upper right) | 100 | 500 | 101 to 110 | 101 to 104, 106 to 109 |
| Left maxilla (upper left) | 200 | 600 | 201 to 210 | 201 to 204, 206 to 209 |
| Left mandible (lower left) | 300 | 700 | 301 to 311 | 301 to 304, 307 to 309 |
| Right mandible (lower right) | 400 | 800 | 401 to 411 | 401 to 404, 407 to 409 |
Sources: Merck Veterinary Manual, Dentition and Dental Nomenclature of Animals; AVDC Nomenclature (tooth numbering).12
Charting the mouth: the technician's role
AAHA's 2019 guidelines say a credentialed technician in the dental suite should perform both the conscious and the anesthetized initial oral exam, dictate the charting to an assistant, take the radiographs and perform the cleaning.4 A charting routine used at the Ohio State University teaching hospital works like this:9
- Check the facial bones, tongue, sublingual area, buccal folds, retropharyngeal area, tonsils and local lymph nodes before looking at individual teeth.
- Note how the patient is lying so you start in the correct quadrant. Using the explorer end of the instrument (a Shepherd's hook), count the teeth from 101 to 110. Circle any missing tooth on the chart.
- As you count, check each tooth for mobility and record it as M1, M2 or M3.
- Turn the instrument to the periodontal probe end and probe the sulcus around each tooth on the way back from 110 to 101. Call out only the abnormal depths, in millimeters.
- Look for crowding (CWD), furcation exposure (F1 to F3), gingival or oral masses (OM, with the surface named, such as distal palatal) and abrasion (AB).
- Drag the explorer across any fractured surface. If the tip enters or catches in the pulp cavity, the fracture is complicated. If it moves across the whole surface without catching (the surface may feel rough from tertiary dentin), it is uncomplicated.
- Repeat in the 200, 300 and 400 quadrants.
The explorer detects calculus, caries and exposed pulp. The periodontal probe measures pocket depth and the size of lesions; a notched probe has marks at 1, 2, 3, 5, 7, 8, 9 and 10 mm.10 Abnormal radiographic findings belong on the chart as well.15
| Abbreviation | Meaning |
|---|---|
| DT/P | Persistent deciduous tooth: present when it should have exfoliated |
| T/SN | Supernumerary (extra) tooth |
| AB / AT | Abrasion (wear from a non-dental object) / attrition (wear from tooth-to-tooth contact) |
| T/FX/EF | Enamel fracture: loss of crown substance confined to the enamel |
| T/FX/UCF | Uncomplicated crown fracture: the pulp is not exposed |
| T/FX/CCF | Complicated crown fracture: the pulp is exposed |
| T/FX/RF | Root fracture |
| TR 1 to TR 5 | Tooth resorption, stages 1 to 5 |
| GR | Gingival recession |
| M0 to M3 | Mobility: M0 physiologic up to 0.2 mm; M1 over 0.2 to 0.5 mm; M2 over 0.5 to 1.0 mm; M3 over 1.0 mm or any axial movement |
| F1 to F3 | Furcation: F1 probe less than halfway under the crown; F2 more than halfway but not through; F3 through and through |
| X / XS / XSS | Closed extraction without sectioning / closed extraction with sectioning / open extraction (after flap creation and alveolectomy) |
| RTR | Retained root (or reserve crown) remnant |
Source: AVDC Nomenclature (tooth abnormalities, periodontal indices and extraction terms).2
Flowchart
Species differences
- Dog: 42 permanent teeth, with 10 positions in each upper quadrant and 11 in each lower quadrant.1 The puppy has no deciduous first premolars or molars.5
- Cat: 30 permanent teeth with one molar per quadrant (09). The tooth just behind the upper canine is the second premolar, and the tooth just behind the lower canine is the third premolar.12 There is no 105, 205, 305, 306, 405 or 406.
- Horse: equine practice uses the same Triadan system. A horse with full permanent dentition has 11 teeth or potential teeth in each arcade, because the canine (04) and wolf tooth positions are counted even when the tooth is absent; the wolf tooth is the small upper first premolar, for example tooth 205. Clinicians drop the first digit to mean the same position in several arcades, as in "the upper 07s".16 Canine teeth usually appear only in male horses, and wolf teeth are small premolars found mostly in the upper jaw.1
- Ruminants: the canine tooth of cattle, sheep and goats has commonly been counted as a fourth incisor.1 Their teeth, like the horse's, are hypsodont.1
Calculation
Worked example: total teeth from a formula. Add the numbers on one side, then multiply by 2 for the two sides of the head.
Adult dog, 2 x (I 3/3, C 1/1, P 4/4, M 2/3):3
Upper teeth per side = 3 + 1 + 4 + 2 = 10 teeth/side
Lower teeth per side = 3 + 1 + 4 + 3 = 11 teeth/side
Total = (10 + 11) teeth/side x 2 sides = 42 teeth
Adult cat, 2 x (I 3/3, C 1/1, P 3/2, M 1/1): (8 + 7) teeth/side x 2 sides = 30 teeth.3
Check against the chart: the upper count per side should match the number of filled cells in that quadrant, so a dog has 10 teeth from 101 to 110, and a cat has 8 teeth in the 100 quadrant even though the highest number is 109.
Safety, legal and client education
- The chart is a legal record. A completed dental chart becomes part of the medical record. Canine and feline charts are different and cannot be swapped.13
- Record everything AAHA lists: signalment, history and exam findings, abnormal probing depths for each affected tooth, missing, malpositioned, supernumerary or fractured teeth, tooth resorption, furcation exposure, masses, radiographic findings, the treatment plan, home care advice and any recommendation the client declined.4
- Know the scope of practice. AAHA states that nonsurgical dental procedures must be performed by a veterinarian, a credentialed technician or a trained assistant under veterinary supervision, as the state or provincial practice act allows. Because extractions are oral surgery, AAHA says technicians should not perform them.4
- Do not touch an oral mass with the probe or explorer. If you do, change to another sterile instrument before you continue, so you do not spread tumor cells around the mouth.9
- Kitten and puppy visits: the FelineVMA guidelines ask the team to explain the change from deciduous to permanent teeth and the expected age for it.15 The same talk suits puppies. Small-breed puppies, such as Yorkshire terriers, need regular checks while the teeth are changing, because persistent deciduous teeth are common in them.8
- Words for clients: "primary" or "baby" teeth is fine with owners; "deciduous" belongs in the record.26
Common mistakes and exam traps
- Reading the quadrant from your own side. Quadrant 100 is the patient's right maxilla, which is on your left when you face the patient.1
- Renumbering a cat. The first upper premolar of a cat is 106 or 206, not 105 or 205, and the lower right premolars are 407 and 408, not 405 and 406.12
- Giving a puppy molars. Deciduous formulas have no molars, and the dog has no deciduous first premolar, so 505 or 509 should never appear on a puppy chart.5
- Mixing up lingual and palatal. Lingual works on both jaws; palatal is only for maxillary teeth. A mass on the tongue side of 404 is lingual, not palatal.2
- Misreading mesial. Mesial is toward the first incisor along the arch, so on a premolar it points forward, not toward the midline of the palate.2
- Calling every fracture complicated. Complicated means the pulp is exposed (T/FX/CCF). A fracture through enamel and dentin that leaves the pulp covered is uncomplicated (T/FX/UCF).2
Quick review
- Dog: 42 permanent, 28 deciduous. Cat: 30 permanent, 26 deciduous.
- Dog formula 2 x (I 3/3, C 1/1, P 4/4, M 2/3); cat formula 2 x (I 3/3, C 1/1, P 3/2, M 1/1).
- Puppy teeth start at 3 to 6 weeks; adult dog teeth are all in by about 7 months.
- Kitten deciduous incisors erupt at 2 to 4 weeks; permanent cat teeth start at about 4 to 7 months.
- Enamel on the crown, cementum on the root, dentin in between, pulp in the center.
- Periodontium: gingiva, periodontal ligament, cementum and alveolar bone.
- Quadrants clockwise facing the patient: 1 right maxilla, 2 left maxilla, 3 left mandible, 4 right mandible; deciduous 5 to 8.
- Canine 04, first molar 09, fourth premolar 08.
- Cat: no 05 in any quadrant and no 06 in the mandible; one molar (09) per quadrant.
- Mesial toward the first incisor, distal away; lingual toward the tongue, palatal for maxillary teeth only.
- Complicated fracture means pulp exposure; mobility runs M0 to M3 and furcation F1 to F3.
- The dental chart is part of the legal medical record.