Eruption of Permanent Teeth Behind Baby Teeth

Why Permanent Teeth Sometimes Erupt Behind Baby Teeth

It’s completely normal to feel concerned when you see a permanent tooth growing behind a baby tooth. Many parents worry that something is wrong, but in most cases, the eruption of permanent teeth behind baby teeth is nothing to be alarmed about. This happens most commonly in the lower front teeth (bottom middle ones) and is often called “shark teeth” because of the double row it creates.

The reason it happens is simple: permanent teeth naturally develop underneath the baby teeth, but sometimes, instead of pushing the baby tooth out from directly below, they come up behind it.

This occurs because the permanent teeth form on the tongue side (lingual side) of the jaw. Ideally, the roots of baby teeth dissolve as the permanent teeth push through.

Sometimes, the baby tooth’s root doesn’t dissolve quickly enough, so it stays in place while the new tooth emerges behind it.

How Do Baby Teeth Normally Fall Out?

Baby teeth fall out naturally through a process called exfoliation, which starts when permanent teeth develop underneath and push upward. As they grow, they dissolve the roots of baby teeth (resorption), causing them to loosen and eventually fall out, making space for adult teeth.

This process usually begins around age 6, starting with the lower front teeth, followed by the upper front teeth. Over the next few years, lateral incisors, molars, and canines replace baby teeth, with the full transition typically completed by age 12 or 13.

Typical Timeline of Permanent Teeth Eruption

By around age 8, most children have their permanent front teeth (incisors) and first permanent molars while they still keep their baby canines and molars on the sides. If one permanent tooth erupts on one side of the mouth but its matching tooth on the other side doesn’t appear after about six months, it’s a good idea to check with a dentist. 

Regular dental check-ups ensure everything is progressing on schedule.

Why Do Permanent Teeth Sometimes Come in Behind Baby Teeth?

Failure of Baby Tooth Root Resorption

Permanent teeth usually trigger the breakdown of baby tooth roots, allowing them to loosen and fall out. However, sometimes, the root does not dissolve as expected or dissolves too slowly. When this happens, the baby tooth stays in place while the permanent tooth takes an alternative path and erupts behind it. This is most commonly seen in the lower front teeth around the age of 6 or 7, creating a “shark tooth” appearance.

Lack of Space in the Mouth

If a child’s jaw is small or their baby teeth are crowded, there may not be enough room for the permanent teeth to push out the baby teeth properly. As a result, the new tooth emerges behind the baby tooth instead of in its correct position.

Palatal Eruption in Upper Front Teeth

Though less common, the same issue can happen in the upper front teeth, where permanent teeth erupt behind baby teeth towards the roof of the mouth (palatal eruption). In some cases, this corrects itself over time, but if the baby tooth does not loosen on its own, the dentist may need to remove it.

Will the Permanent Tooth Move Into Place?

In many cases, the tongue’s natural pressure and normal jaw growth help guide the permanent tooth forward into its proper position. However, if the baby tooth stays in place for too long or the adult tooth is growing at an extreme angle, a dentist may recommend removing the baby tooth to ensure correct alignment. Regular dental check-ups with your Brisbane dentist are essential to monitor this process and prevent complications.

Eruption of Permanent Teeth Behind Baby Teeth

Is It Normal? Should I Be Worried?

Yes, it’s completely normal, and in most cases, there’s nothing to worry about! This happens to lots of kids, and more often than not, the baby tooth will eventually fall out on its own. Once that happens, the permanent tooth usually shifts into place naturally, helped by the tongue and normal jaw growth. If the baby tooth stays put for too long, or if the new tooth is growing at an odd angle, it’s a good idea to see an experienced kids’ dentist. But in most cases, just a little patience (and maybe some gentle wiggling) is all it takes!

What Should I Do If My Child Has a Permanent Tooth Behind a Baby Tooth?

Encourage gentle wiggling – Ask your child to gently wiggle the baby tooth with a clean finger or their tongue. This can help loosen it and speed up the natural shedding process.

Maintain good oral hygiene – Brush and floss around the baby tooth to prevent food and plaque buildup, which can lead to cavities or gum irritation.

Let the tongue do its job – The tongue naturally pushes teeth forward, helping permanent teeth move into place over time. Encourage your child to move their tongue against the new tooth while talking and eating.

When Should You See a Dentist?

  • If the baby tooth isn’t loose at all.
  • If the baby tooth has been loose for weeks but still won’t come out.
  • If your child is in pain or the area looks swollen.
  • If the permanent tooth is growing in at a severe angle.
  • If one permanent tooth erupts on one side of the mouth but its matching tooth on the other side doesn’t appear after 6 months, check with a dentist.

When to Consider Removing the Baby Tooth

  • If the baby tooth isn’t loosening – If the baby tooth is still firmly in place and not wiggling at all, even though the permanent tooth has already erupted, it may need to be removed.
  • If the “double row” remains past age 7½ – By this age, most lower front baby teeth should have fallen out. If they haven’t and the permanent teeth are fully visible behind them, removal might be necessary.
  • If the permanent tooth is growing at an angle – A misaligned eruption can lead to crowding or spacing issues. If the new tooth is struggling to move into the right position, a dentist may recommend extracting the baby tooth to create space.
  • If there’s discomfort or difficulty chewing – Sometimes, a retained baby tooth can cause mild pain or make it harder for a child to bite and chew properly. If it’s interfering with daily function, it’s best to have it assessed.
  • Avoid unnecessary extractions – Dentists usually remove only the baby tooth that’s causing an issue. Extracting multiple teeth too early can create unnecessary gaps, which may lead to alignment problems later on.

If you’re unsure, a quick visit to the dentist can help determine whether removal is needed or if the tooth will fall out naturally in time!

Can This Affect My Child’s Teeth Alignment in the Future?

Most permanent teeth shift into place naturally – In many cases, once the baby tooth falls out, the tongue and normal jaw growth help guide the permanent tooth into its correct position over time.

Orthodontic treatment may be needed in some cases – If the permanent tooth is erupting at an odd angle or there isn’t enough space for it to align properly, braces or other orthodontic treatments may be recommended later.

Crowding can be a concern – Permanent teeth are larger than baby teeth, so if baby teeth were tightly spaced, there might not be enough room for the new teeth to come in straight. This can cause overlapping or misalignment.

Early dental visits can help detect issues – A dentist can monitor your child’s tooth alignment as they grow and catch potential problems early. If needed, space maintainers or early orthodontic intervention can help prevent future crowding.

Regular check-ups are key – Routine dental visits allow for ongoing assessment of your child’s teeth, ensuring they develop in the right position and avoiding bigger alignment issues down the track.

Avoid Placing a Lingual Arch Too Early

A lingual arch is a dental appliance used to hold space in the mouth, often to prevent crowding or alignment issues. However, placing it too early—before the lower front permanent teeth (incisors) have fully erupted—can actually cause more problems. If the arch is placed too soon, it may push these teeth too far back, affecting their natural positioning and overall bite alignment.

Dentists typically wait until the lower incisors have fully come in before considering a lingual arch.

This ensures that the teeth have enough room to erupt properly without being forced into an unnatural position. Every child’s dental development is different, so regular check-ups allow the dentist to determine the right timing for any orthodontic intervention, ensuring the best long-term results.

Other Teeth Can Also Erupt in the Wrong Place

While permanent teeth erupting behind baby teeth is most common in the lower front teeth, it can also happen in the upper front teeth. In these cases, the new teeth may emerge behind the baby teeth towards the roof of the mouth, known as palatal eruption. This is less common but can sometimes require intervention if the baby tooth doesn’t fall out naturally.

In some cases, baby teeth don’t fall out at all, which can cause permanent teeth to erupt in unusual positions, leading to crowding or misalignment. Regular dental check-ups allow dentists to monitor your child’s dental development and step in early if needed. Early detection helps prevent bigger alignment issues and ensures that permanent teeth have the best chance of moving into the correct position.

Eruption of Permanent Teeth Behind Baby Teeth

How to Prevent Problems with Permanent Teeth Erupting

Schedule regular dental check-ups – Routine visits to the dentist help detect any issues early, ensuring baby teeth fall out on time and permanent teeth erupt correctly.

Encourage good oral hygiene – Brushing twice a day, flossing, and maintaining a healthy diet help keep teeth and gums strong, reducing the risk of infections or delays in tooth eruption.

Avoid habits that cause misalignment – Thumb sucking, prolonged dummy use, or tongue thrusting may put pressure on baby teeth and affect how permanent teeth come in. Helping your child break these habits early can prevent misalignment.

Monitor baby teeth loss – If a baby tooth isn’t loosening when expected or if a permanent tooth is erupting in the wrong place, see a dentist to determine if intervention is needed.

Ensure enough space for adult teeth – If baby teeth are tightly packed, permanent teeth may struggle to come in properly. A dentist can monitor your child’s jaw growth and suggest space maintainers or early orthodontic treatment if necessary.

Conclusion: In most cases, permanent teeth erupting behind baby teeth is completely normal and nothing to worry about. The baby tooth usually falls out on its own, and the new tooth moves into place naturally. However, it’s important to keep an eye on the situation and see a dentist if the baby tooth isn’t loosening or if the permanent tooth is growing at an unusual angle. Regular dental check-ups help monitor your child’s oral development, ensuring their teeth align properly and any potential issues are addressed early.

Frequently Asked Questions

Will My Child Be in Pain If Their Permanent Teeth Erupt Behind Baby Teeth?

In most cases, children do not experience pain due to the eruption of permanent teeth behind baby teeth. This situation, often referred to as “shark teeth,” is common and usually painless. However, if your child complains of discomfort or if you notice swelling, it’s advisable to consult your dentist to rule out any complications.

What Happens If My Child’s Baby Tooth Falls Out but the Permanent Tooth Still Looks Out of Place?

After a baby tooth falls out, the permanent tooth may initially appear misaligned or out of place. Over time, natural forces like the tongue and lips, along with normal jaw growth, often help guide the tooth into its correct position. If the tooth remains misaligned after a few months, or if you’re concerned about its position, it’s best to consult your dentist for an evaluation.

How Long Does It Take for the Baby Tooth to Fall Out Once the Permanent Tooth Starts Coming In?

Once a permanent tooth begins to erupt, it typically takes a few weeks for the corresponding baby tooth to become loose and fall out. Encouraging your child to gently wiggle the loose baby tooth can help expedite this process. If the baby tooth remains firmly in place for more than a few weeks after the permanent tooth has emerged, it’s advisable to consult your dentist for guidance.

Can This Condition Cause Speech Problems?

In most cases, when a permanent tooth erupts behind a baby tooth, it doesn’t lead to speech issues. However, if the misalignment is significant or if multiple teeth are affected, it could potentially interfere with proper speech development. If you notice any speech difficulties in your child, it’s advisable to consult a dentist for an evaluation.

Should I Be Concerned If My Child’s Teeth Look Crooked After This Happens?

It’s common for teeth to appear crooked when a permanent tooth erupts behind a retained baby tooth. Often, once the baby tooth falls out, the permanent tooth moves into its correct position naturally. However, if the tooth remains misaligned after a few months, or if multiple teeth are affected, it’s best to schedule an appointment with our professional Brisbane paediatric dentist so that they can evaluate the situation. Early evaluation can help determine if orthodontic treatment might be necessary to correct the alignment.

Could This Be a Sign of an Underlying Dental Problem?

While a permanent tooth erupting behind a baby tooth is usually a common developmental occurrence, in some cases, it may indicate underlying issues such as crowding or delayed exfoliation of baby teeth. Regular dental check-ups are essential to monitor your child’s oral development and address any potential problems early on. If you have concerns, it’s advisable to consult your dentist for a thorough evaluation.

Will This Happen to All of My Child’s Teeth or Just Some?

This situation, often called “shark teeth,” typically occurs with the lower front teeth and sometimes the upper front teeth. It’s less common in other areas of the mouth. If you notice this happening with multiple teeth or in different regions, it’s a good idea to consult your dentist for an evaluation.

Can Diet or Nutrition Affect How Permanent Teeth Erupt?

Nutrition plays a significant role in tooth development. Malnutrition or deficiencies in essential nutrients can lead to delayed eruption of both primary and permanent teeth. Ensuring your child has a balanced diet rich in vitamins and minerals supports healthy tooth development and timely eruption.

If My Child Needs the Baby Tooth Removed, Is It a Complicated Procedure?

Removing a baby tooth is generally a straightforward and routine procedure. Dentists perform this with minimal discomfort to the child. After removal, the permanent tooth usually moves into its correct position naturally. Your dentist will guide you through the process and provide aftercare instructions to ensure a smooth recovery.

What If My Child Has Dental Anxiety?

It’s normal for children to experience dental anxiety. At Pure Dentistry, we offer options like laughing gas (nitrous oxide) and sleep dentistry through general anaesthesia to help your child feel comfortable during dental procedures. Laughing gas is a mild sedative that helps children relax while remaining awake, and its effects wear off quickly after the procedure. For more extensive treatments or higher anxiety levels, Brisbane Dental Sleep Clinic points out that sleep dentistry Brisbane under general anaesthesia ensures your child is completely asleep and unaware during the procedure. Our team will discuss these options with you to determine the best approach for your child’s needs.

Does This Increase the Chances of My Child Needing Braces?

Not necessarily. In many cases, once the baby tooth is removed or falls out naturally, the permanent tooth aligns correctly on its own. However, if there are underlying issues like crowding or misalignment, orthodontic treatment might be needed in the future.

Eruption of Permanent Teeth Behind Baby Teeth

Ensure Your Child’s Smile Grows Healthy and Strong

Seeing a permanent tooth erupt behind a baby tooth can be concerning, but early dental care ensures everything develops properly. If your child’s baby tooth isn’t loosening, or the new tooth is growing at an angle, professional guidance can help prevent future alignment issues. Our experienced team provides gentle, expert care to keep your child’s smile on track. We also offer flexible payment options through Humm and Supercare for your convenience. Schedule an appointment today—call 07 3343 4869.