By Seahorse Kids Dental · Patient Education
Why You May See Two Rows
Children have baby teeth and adult teeth in their mouths at the same time for several years as their smiles change. The timing varies from child to child. At the lower front teeth, an adult tooth may begin to show on the tongue side of a baby tooth before that baby tooth has fallen out.
It can look like a second row, but appearance alone does not show whether the baby tooth should be removed. The tooth's looseness, the space available, and the way the adult tooth is developing all matter.
Why Can An Adult Tooth Come In Behind A Baby Tooth?
Adult teeth do not always emerge exactly where parents expect. A baby tooth may still be in place when its adult tooth begins to appear. Crowding or limited space can affect the path, and a past injury, decay, or dental treatment involving the baby tooth may also be relevant. Less commonly, another tooth may be affecting the eruption path.
Those are details the dentist can assess in person. A photo can help you keep track of what changed, but it cannot show everything about tooth position or available space.
Does The Baby Tooth Need To Be Removed?
Not necessarily. A baby tooth that is already loose is different from one that remains firm. The dentist may look at:
- which baby tooth and adult tooth are involved;
- how loose the baby tooth is;
- how much of the adult tooth has appeared;
- how much room is available and whether the area is crowded;
- whether the baby tooth was injured or treated before; and
- whether an X-ray would help clarify the tooth's position or development.
Depending on the exam, the plan may be to watch and wait, allow a loose baby tooth to come out naturally, or remove a baby tooth that is not coming out on its own. That is why the dentist looks at the available space and the child's bite before recommending removal—not just how the tooth looks.
What Can I Notice At Home?
You do not need to measure the gap or wiggle a firm tooth. Before the appointment, it may help to note:
- when you first saw the adult tooth;
- whether the baby tooth is loose and whether that has changed;
- whether your child has pain or avoids chewing in that area;
- whether the gum looks swollen or irritated; and
- whether the baby tooth had an earlier injury, filling, or other treatment.
A quick reference photo can help you describe what you noticed. The exam is what helps the dentist decide whether anything needs to be done.
What Might The Dentist Recommend?
Some children only need time and a follow-up check. If the baby tooth is loose, the dentist may suggest letting it come out naturally. If it remains firm or the adult tooth's position raises a concern, removal or another plan may be discussed.
An X-ray is not needed for every child. When the dentist recommends one, it can show the roots, the position of the adult tooth, and how much space is available—details that cannot always be seen by looking in the mouth.
When Should I Call?
Call sooner if your child has pain, swelling, pus, fever, an injury, or trouble eating. If there are no urgent symptoms, schedule a visit if the adult tooth is coming in and the baby tooth is still firm, the area looks crowded, or you are unsure what you are seeing.
Do not try to pull a firm baby tooth at home. If you would like the dentist to take a look, call Seahorse Kids Dental at (310) 596-1111.
This information is educational and does not replace individualized dental advice.
While baby and adult teeth share the mouth, keep up your child's cleaning routine. Our guide to when to start flossing your child's teeth explains cleaning between touching teeth. You can also use our questions to ask a pediatric dentist to prepare for the visit.
Sources
- American Academy of Pediatric Dentistry, Management of the Developing Dentition and Occlusion in Pediatric Dentistry.
- American Dental Association, MouthHealthy, Eruption Charts.
- American Dental Association, MouthHealthy, Healthy Habits for Babies and Kids.