Is your child's permanent teeth coming in without the milk teeth falling out? It's more common than you think, stay with me and I'll explain it to you.

Sometimes, when we are eagerly waiting for the first baby tooth to fall out and the tooth fairy to come, not only does it not fall out, but the permanent tooth appears from behind, reminding us of the multiple rows of teeth that sharks have. 

It is called Ectopic eruption and is quite common. In this process the permanent tooth appears in a different place than it should, so the baby tooth still has some root that has not resorbed and does not fall out. 

The reason is usually a lack of space in the jaws, a dental trauma so frequent when children are learning to walk or play, although it can also be due to genetic factors, the difference in size of the permanent and temporary teeth or simply a deviation of a permanent tooth.

We will then observe two rows of teeth in our child's mouth, one being the primary teeth that have not been exfoliated and the other the permanent teeth that have just erupted and are clearly differentiated by colour, shape and size. 

Depending on the type of tooth that is not exfoliated in time, we will treat it differently.

When this happens in the lower incisorsTry to move it at home, always with clean hands as if you were holding a pair of tweezers, moving it forwards and backwards, or turning it sideways. Eating hard things such as apples, carrots, sandwiches or toasted bread will also help it to fall. 

Although these tips will only help if the tooth is already moving a little. If not, the baby tooth probably still has a root and needs help from the paediatric dentist, who will extract it, but don't worry, it will be quick, with a little anaesthetic and the gum will heal quickly.

In these cases, the permanent teeth will have been left far behind, but there is no need to be alarmed, as they will gradually move forward, thanks to the push of the tongue.

As for the upper incisors The most frequent cause is trauma to the baby teeth. The trauma causes a deviation in the trajectory, and despite the fact that several years have passed, the permanent teeth can appear through the palate, through the front and even rotated. 

If this happens, the paediatric dentist should be consulted as soon as possible, as the permanent tooth will not be in the correct position and the tongue will not help as in the case of the lower teeth. The extraction of the temporary tooth will be essential, as it will make it easier for the tooth to come down. If we do not get it back into position in time, orthodontic treatment will be necessary to correct it.

In the case of canines, the most common cause is a lack of space, and as this tooth erupts at the age of 12 or 13, the orthodontist will be responsible for aligning and creating space for this tooth.

By way of summary, we recommend:

  • Do not wait more than 1 or 2 months if the permanent tooth appears in the background.
  • Check that they brush well to maintain very good hygiene despite any discomfort they may have.
  • If in doubt, see your paediatric dentist for an assessment.