If you notice that a permanent tooth is starting to come in behind a baby tooth that hasn't fallen out yet, it isn't necessarily an emergency. This situation occurs quite frequently during the period when a child begins to lose their baby teeth.
Sometimes a baby tooth starts to wiggle and falls out on its own, and the permanent tooth gradually moves into the correct position. Other times, the baby tooth remains too firmly anchored, and an evaluation by a pediatric dentist is necessary.
It's important not to try to force the extraction at home if the baby tooth isn't loose enough.
Why does a permanent tooth grow in behind a baby tooth?
Normally, when a permanent tooth begins to erupt, the root of the baby tooth gradually resorbs. The baby tooth becomes increasingly loose and eventually falls out.
However, the process does not unfold in exactly the same way for every child.
Sometimes a permanent tooth finds a slightly different path to erupt and comes in behind the baby tooth before it falls out.
With the lower incisors, it may seem as though the child has two rows of teeth for a while.
This may worry parents, but it doesn't automatically mean there's a serious problem.
What should you do if your child develops two rows of teeth?
The first thing to do is check to see if the baby tooth is loose.
If it is already quite mobile, the doctor may sometimes recommend monitoring it for a while, as it may fall out on its own.
However, if the baby tooth is still firmly in place and the permanent tooth continues to erupt behind it, it is a good idea to see a dentist.
The doctor will check:
- how loose the baby tooth is;
- how much the permanent tooth has erupted;
- if there is enough space on the arch;
- the position of the permanent tooth;
- stage of dental development;
- whether the baby tooth needs to be extracted.
The decision is made on a case-by-case basis. Not every situation involving two rows of teeth requires immediate extraction.
Will the permanent tooth move into the correct position on its own?
In many cases, after a baby tooth falls out, the tongue and natural forces within the oral cavity can help guide the permanent tooth into its normal position.
However, this also depends on the available space.
If the teeth are crowded or the dental arch is too small, the permanent tooth may remain in an incorrect position.
That is why it is helpful for the dentist to evaluate not only the tooth that is erupting, but also how the entire set of teeth is developing.
When should a baby tooth be removed?
Extraction may be considered when the baby tooth does not become loose enough, even though the permanent tooth has already begun to erupt.
However, there is no universal rule such as „if a permanent tooth comes in, the baby tooth must be pulled immediately.”.
The pediatric dentist makes the decision after examining the child.
At SmileCity, a baby tooth can be extracted using topical anesthesia or, when necessary, local anesthesia via infiltration.
The goal is to make the procedure as easy as possible for the child to tolerate.
Can we pull the tooth at home?
If a baby tooth is very loose and about to fall out, it may fall out naturally while eating or brushing.
However, we do not recommend forcibly extracting a tooth that is still firmly anchored.
Pushing him too hard can cause:
- pain;
- bleeding;
- gum damage;
- unnecessary anxiety for the child;
- a piece of a tooth breaking off.
If you're not sure, a quick consultation can quickly clarify whether action is needed or if you should just monitor the situation.
Is this a dental emergency?
Most of the time, no.
However, it’s a good idea to schedule an appointment if you notice that the permanent tooth has erupted significantly and the baby tooth isn’t moving.
You should see a doctor sooner if you also experience:
- pain;
- very inflamed gums;
- swelling;
- discharge or pus;
- persistent bleeding;
- difficulty chewing.
Where can you take your child to the dentist in Sector 6?
At SmileCity, children can be seen for tooth replacement, baby tooth extractions, cavities, sealants, and other issues specific to childhood.
The SmileCity Clinic is located in Bucharest at 158 Ghencea Boulevard, Sector 6, and is accessible from Ghencea, Drumul Taberei, and Prelungirea Ghencea.
If you've noticed that a permanent tooth is coming in behind a baby tooth, you can schedule an appointment to find out whether treatment is needed or if monitoring is sufficient.
How can you monitor progress at home without putting pressure on the tooth?
In the coming days, parents can simply observe whether the baby tooth becomes looser and whether the permanent tooth continues to erupt. There’s no need to check it obsessively or pull on it several times a day. The child can gently wiggle the tooth with their tongue, and brushing should continue as normal, taking care around that area. If the tooth becomes more loose, it may fall out on its own. If there is no change after a reasonable amount of time or if the permanent tooth is visibly coming in, a dental visit is the best way to decide whether to wait longer or if extraction is necessary.
What is the role of the available space on the arch?
The fact that a permanent tooth erupts further back does not automatically mean it will remain there. After the loss of a baby tooth, the tongue and natural forces can contribute to the tooth’s movement toward the dental arch. However, if there is significant crowding or insufficient space, this movement may be limited. That is why the dentist evaluates not only a single tooth but also its relationship with neighboring teeth, the shape of the dental arch, and the stage of development. Sometimes monitoring is sufficient; other times, a later orthodontic evaluation may be helpful.
Why is it important to get checked even if there is no pain?
Many teething problems do not cause pain. A child may eat normally, yet the permanent tooth may erupt in a position that warrants monitoring. A timely checkup can prevent both an unnecessary extraction and waiting too long when the baby tooth is actually blocking the eruption. In addition, the dentist can check for cavities, gum inflammation, or other changes that may not be obvious to the parent.
Frequently Asked Questions
Is it normal for a child to have two sets of teeth?
This can occur during the transition from baby teeth to permanent teeth, when a permanent tooth erupts before the baby tooth falls out. The situation should be evaluated based on the mobility of the baby tooth and the available space.
If a baby tooth doesn't fall out, does it absolutely have to be extracted?
Not always. If the baby tooth is loose and is about to fall out on its own, the dentist may recommend monitoring it. If it remains firmly in place while the permanent tooth erupts, extraction may be recommended.
Will the permanent tooth remain crooked?
Not necessarily. After a baby tooth falls out, the permanent tooth may shift. If there isn't enough space, orthodontic monitoring may be necessary.
Can the child eat normally?
Generally, yes. If there is pain, inflammation, or the child avoids chewing on that side, a consultation is recommended.
Which doctor should we see?
In this situation, you can see a doctor who treats children—specifically, a pediatric dentist.