It is so exciting when your child gets their first loose tooth. They wiggle and play with the loose tooth, talk about it all the time, and get excited about a possible visit from the tooth fairy. This is just the beginning of a long process of all their baby teeth being replaced by permanent teeth. What if something happens and a permanent tooth grows in wrong? What if the incisors come in before their baby teeth come out? Or, what happens when the canine teeth stick out, or don’t grow long enough? What needs to be done when your child’s dentist explains that their permanent molars are growing in the wrong direction? All these situations are common and can be fixed.
When a tooth grows in the wrong place, it is considered an ectopic tooth and ectopic simply means an object or organ situated in an unusual place, away from its normal location. An ectopic tooth can erupt in an abnormal location, but it can also just mean a tooth that grew in at the correct place but is misaligned, such as a canine tooth that sits too high in the gumline or points out towards the lip. Ectopic teeth are found with or without crowding, and x-rays can show when a tooth is growing in wrong, long before it even begins to surface.
Some ectopic teeth will not cause problems and can be left alone. Others simply need to be watched as they grow in, as it is possible that their misalignment will self-correct. However, they often need treatment as an ectopic tooth can lead to problems such as tooth decay, gum disease, poor bite and misalignment of other teeth. Other important reasons to consult your child’s dentist about treatment are if the tooth is causing physical pain or emotional distress. As with many other dental problems, the earlier ectopic teeth are treated, the simpler treatment will be.
One of the most interesting types of ectopic teeth is called shark teeth. Occasionally, the permanent teeth will grow in before the primary teeth fall out, creating a double row of teeth like that of a shark. This situation is most common with the incisors, but also happens regularly with molars. Usually, the permanent tooth starts growing in under the primary tooth and dissolves the roots of the baby tooth. As this happens, the baby tooth becomes loose and eventually falls out. Unfortunately, with shark teeth the new teeth grow in at an angle which does not dissolve the roots of the primary teeth quickly enough for them to fall out before the permanent teeth grow in.
Shark teeth may not need to be treated. If the baby tooth is loose and continues to get looser, the permanent tooth is likely to move to the correct position on its own after the primary tooth comes out. However, if the permanent tooth has completely erupted and the primary tooth is still not loose, treatment will likely be required. Aside from cosmetic reasons for treatment, a double layer of teeth leads to increased risk of cavities and gum disease, as well as crowding of the other permanent teeth.
This situation is usually resolved by pulling the primary tooth in the way. After the baby tooth is removed, the permanent tooth often moves into the correct position within a few weeks or months. Typically, if one incisor erupts as a shark tooth, the incisor next to it will do the same, so your child’s dentist may recommend waiting to see if that happens and treating both teeth at the same time to make it easier for your child.
Ectopic Canine Teeth
Canine teeth play two important roles in the mouth. They help guide your bite and are the cornerstone of your smile and the dental arch. Interestingly, canine teeth take 10-12 years to completely form and erupt, which means there is a huge window for something to go wrong in their final position. In addition to increased risk of gum disease and cavities, poorly positioned canine teeth contribute to malocclusion, which is poor dental alignment. Malocclusion may cause many problems, including grinding, difficulty with biting and chewing, and even headaches.
Some of the most common types of ectopic canines are canine teeth which grow above the other teeth, are properly positioned but sit too high in the gum, or even point out toward the lip. Since canine teeth play such an important role in the mouth, ectopic canines frequently require treatment. Braces and even palatal spacers may be needed to correct ectopic canine teeth. Depending on the severity of the problem, treatment may take months or years. As the positioning of canine teeth impacts the other teeth and jaw, early treatment is vital, and is a key reason that an early visit to the orthodontist is recommended. When treatment is started early, it is far easier to correctly position the tooth, and negative effects of an ectopic canine on the rest of the mouth can be greatly minimized. Early treatment also shortens the time needed to correct the issue and helps your child be more confident of their smile during their school years.
Sometimes, at a routine dental checkup, the dentist may tell you that your child’s molars are growing in wrong. How can this happen if your child has not even gotten their first loose tooth? As you can see from the chart below, the first set of permanent molars generally arrive in the same year as the two lower central incisors, and usually appear first.
There are many signs that tell a dentist when molars are growing in wrong, and it is more common than you would think. Somewhere between three quarters of a percent and six percent of the population is affected by this issue. One thing a dentist looks for is incisors that are loose, with no sign of a molar yet, or even loose primary molars years ahead of schedule. This may mean that the molar is trying to come in below the baby molars. Dental x-rays will also catch this problem, allowing for early treatment to reduce treatment times and lessen the harm caused to the mouth. Approximately two-thirds of ectopic molars growing in this way will self-correct within three to six months, but the other one-third require treatment. Untreated, ectopic molars that do not self-correct may cause permanent damage to the adjacent premolar and can create crowding of the rest of the teeth.
Treatment depends on the severity of the problem. Many cases are easily corrected by orthodontic separators, but severe cases may require extraction of a tooth or surgical treatment. As with many other dental problems, early diagnosis and intervention are critical to reduce treatment times and prevent secondary problems from arising.
It is common to have problems with wisdom teeth. When wisdom teeth grow in wrong, they almost always create other issues. Most often, an ectopic wisdom tooth will be removed. As they are not necessary, frequently crowd the other teeth, and lead to increased risk of cavities and gum disease, any complication with wisdom teeth usually results in extraction, rather than spending the time and effort to correct the problem.
Ectopic teeth are a fairly common dental issue. While some will self-correct, others require treatment and the earlier the problem is diagnosed, the easier it is to treat. That is another reason why it is important to bring your child in for regular checkups. If your child has a dental home where they are comfortable, and a dental team familiar with your child’s dental development, ectopic teeth will be detected earlier, and you will be able to work out a treatment plan before further harm is caused to the mouth.
At Jungle Roots Children’s Dentistry, we focus on preventative dentistry. If your child is diagnosed with ectopic teeth, we will often wait and see if the problem self-corrects. When treatment is required, our excellent dental team, including an orthodontist and a sedation specialist, along with our state-of-the art facilities will provide your child with the best treatment possible. To be sure that we catch any potential problems early, don’t forget to schedule your child’s regular dental checkup.
At Jungle Roots Children’s Dentistry, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist. At Jungle Roots Children’s Dentistry, we aim to turn every visit to our office into a fun-filled educational safari for all.
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