Children will start losing their baby teeth around the age of 4 or 5, and that process can continue for several years. This process is usually smooth, with the baby teeth falling out with the permanent teeth then growing into those empty spaces.

However, one of the most common problems is when baby teeth are still in the mouth with permanent teeth growing behind baby teeth. This occurrence is sometimes called  “shark teeth” or “tooth behind the tooth” because there are now two rows of teeth instead of just one.

If this is happening to your child, here’s what to do.

Why Are Baby Teeth Important?

Even though baby teeth ultimately fall out, making sure they are healthy while they are intact is vital.

• Baby teeth provide a healthy start for the permanent teeth coming in after they fall out
• Permanent teeth grow into the empty space that the baby teeth provide

What is the Difference Between Baby Teeth and Permanent Teeth?

1. Baby teeth are usually whiter in color than permanent teeth, and the permanent teeth tend to be more ivory or yellow.
2. Baby teeth are smoother in appearance than permanent teeth. The permanent teeth have a more jagged edge along their top ridge, which helps them push through the gums’ surface.
3. The number of baby teeth that your child will have totals 20, whereas the permanent teeth will total 32, including the wisdom teeth (which will appear during the teenage years).

How Teeth Fall Out

Children typically lose their teeth in this order.

• The two center bottom teeth will fall out first
• The next teeth to fall out are the two central upper incisors
• The lateral incisors and first molars will fall out next
• The canine teeth will then fall out, and lastly, the second molars

Why Baby Teeth Might Not Fall Out

There are three main reasons baby teeth might not fall out.

1. When the permanent tooth starts pushing against the baby tooth’s roots, the roots begin to dissolve. Once enough of the root has dissolved away from the baby tooth, it becomes loose and should fall out. However, if the permanent teeth begin growing behind baby teeth, it can miss the baby tooth’s roots, which won’t trigger them to dissolve.
2. The second reason baby teeth don’t fall out can be due to moderate to severe crowding preventing the permanent tooth from growing correctly.
3. The last reason could be that your child’s permanent teeth aren’t coming in because the permanent tooth has not yet fully developed.

What Should you do When Baby Teeth Don’t Fall Out

If you notice permanent teeth growing behind baby teeth, first determine if the baby tooth is loose at all.

• If the baby tooth is even slightly loose, get your child to start wiggling it over the next few days to see if it will fall out naturally, and if it doesn’t fall out on its own, then contact your dentist for assistance.
• If the baby tooth is not loose whatsoever, contact your dentist for assistance. Your child may need dental x-rays to determine if extraction of the baby tooth will be necessary.

Will the Dentist Need to Extract the Baby Tooth?

• If your child has permanent teeth growing behind baby teeth and the baby tooth isn’t loose, the dentist may determine that the best course of action is to extract the baby tooth.
• If your child’s permanent tooth failed to develop, the baby tooth might be used as the permanent tooth as long as it can remain healthy.

How do Permanent Teeth Come in Behind Baby Teeth?

When a permanent tooth is growing behind baby teeth, it reabsorbs the baby tooth’s roots, which then causes it to become loose and ultimately fall out. The permanent tooth then takes the place of the baby tooth.

If permanent teeth aren’t growing behind baby teeth, the baby tooth’s root will remain intact and not get pushed out as it usually would. This occurrence causes the teeth to take on a “shark tooth” appearance. Shark teeth look a little frightening or strange, but they are actually quite common in children, and rarely do they cause dental problems.

Where Shark Teeth Usually Occur

The most common place to find permanent teeth growing behind baby teeth is at the lower incisors, but it could happen anywhere, including the upper incisors or even the primary molars.

If the “tooth behind the tooth” does involve the lower and upper front teeth, there is a good chance it will happen to the other tooth next to that one.

When do Shark Teeth Occur?

Although permanent teeth growing behind baby teeth can happen at any time, it is more common during two distinct phases of childhood development.

• The first phase is when the lower front teeth grow in around age 6
• The second phase is when the upper back molars appear around age 11

What Should you do if Permanent Teeth Start Growing Behind Baby Teeth?

First of all, don’t panic, as this is a common problem. There is no actual treatment for shark teeth because if the permanent tooth has not grown in all the way while at the same time, the baby tooth is getting looser, the situation will most likely resolve on its own.

However, if the permanent tooth continues to grow in and the baby tooth does not loosen, you should contact us to set up an appointment, as your child may need to have the baby tooth extracted.

What Happens if you do Nothing?

If your child has permanent teeth growing behind baby teeth, the teeth will start to deflect and move out of position, resulting in problems that will require a children’s orthodontist.

Call your Child’s Pediatric Dentist

To find out more and get much-needed answers, contact Children’s Dentistry of Las Vegas at any one of our many locations. Our dentists accept Medicaid and dental insurance and also offer special needs dentistry services for children needing accommodations.