In keeping with our last dental article, this is a question related to teething that arises often in the dental office, and causes many parents a great deal of concern. What happens when there are permanent teeth coming in while the baby teeth are still present?

The switch from baby teeth to permanent teeth is a process that has a few stages. The first stage happens between 6 and 8 years old when the front teeth change over and the 6 year permanent molars erupt. The second stage is between 8 and 10 years old when very little changes from a teething standpoint, but there is much growth. The final stage is between 10 and 12 years old when the primary molars and canines fall out and the permanent canine and premolars come in.

Very often, the first teeth to come in are the first to fall out. The lower front incisors start to loosen anywhere between 5 and 7 years old, on average. As the permanent teeth that follow begin to erupt, often they will break the surface behind the baby teeth that are still present. As the permanent teeth erupt, you will notice some obvious differences between the baby teeth and the permanent teeth.

The new teeth coming in are much larger, generally much more yellow in colour, and have “bumps” on the top/edge of the teeth. Permanent teeth, like primary or baby teeth, are full size when they erupt, which is to say they donʼt grow over time. This means that when your childʼs new front teeth come in, they are the same size, or very close, to yours! This is why kids have the “awkward” appearance as the front teeth come in. It also means that since their mouth is smaller than an adult, at this stage of development, children will often display a degree of crowding of the front teeth, especially in the bottom. Often this crowding will resolve over time as the baby teeth further back start to fall out later, between 10 and 12 years old.

Permanent teeth are also different from primary teeth with regards to composition. These new teeth have thicker enamel, and dentin that is more yellow than baby teeth. The result is that permanent teeth are more yellow in appearance than baby teeth, rest assured, this is normal. The bumps, or “mamelons” are normal and are generally worn off within the first few years of the tooth being present in the mouth.

In some cases, the permanent teeth will erupt quite a bit before the baby teeth fall out, giving the “shark teeth” appearance where there are two rows of teeth present at the same time. The great majority of the time this situation will resolve itself without the need for professional assistance. Occasionally, however, the baby teeth will need help coming out, a scenario familiar to your dentist, and one he or she would be happy to discuss with you.

These are only a few of the more common teething issues seen in our office. If you have any questions or concerns related to these or any other dental issues, feel free to contact your family dentist, or our office for advice. Just as an aside, halfway through writing this article my 6 year old son lost his second baby tooth. A proud, yet strangely ironic, moment…and yes, he had shark teeth.