A child has grown a tooth above a tooth: what to do? Solving the second line problem in a painless way.

The first reaction of parents who notice that their child is growing a second row of teeth is natural fear. In dentistry, it is generally accepted that there are two causes of pathology:

abnormal growth of molars;
polyodontia or supernumerary teeth.

Normally, permanent teeth replace baby teeth only after the latter fall out. The germ of the molar tooth stretches upward, thereby contributing to the destruction of the roots. With some features of jaw development, this does not happen, which is why the second row appears.

Reasons for the growth of the second dentition in a child

Double or “shark” teeth in children appear when the baby tooth and the rudiment of the molar are located at different points in the oral cavity. When a new set erupts, the baby tooth remains in place. A tooth grows above a tooth, which not only does not look aesthetically pleasing, but also interferes with the development of the rest of the row.

The most common reason why teeth do not change is improper breathing. A lot depends on how a child breathes. Breathing disorders lead to problems with bite, deterioration of posture and changes in facial shape.

A child’s jaw develops correctly only when he breathes correctly through his nose. The tongue in this position presses on the palate from the inside. A natural semicircular shape of the jaw is formed, in which there is enough space for all the molars. This is why it is so important to teach your child to breathe through his nose to prevent the growth of the second row of teeth.

Symptoms

During the period when a child’s primary incisors appear and they are replaced by root units, parents should regularly examine the baby’s oral cavity. If you are alarmed by any manifestations, you must make an appointment with a pediatric dentist.

Symptomatic manifestations
Name	Description
Painful sensations	They are most often experienced when pressing on the mucous membrane or while eating. The soft tissue around the incisor may become inflamed.
Swelling of the gums	Pathological processes - tissue reaction, which manifests itself in the form of swelling.
Physical weakness, fever (up to 38-39 degrees)	During the inflammatory process, the temperature often rises and weakness in the muscle tissue is felt.
The baby tooth is loose but does not fall out	The symptom indicates a lack of solid food or pathology in the development of the jaw system.
Excessive salivation	When the nasopharynx is swollen, the nose becomes clogged, and as a result of breathing through the mouth, the mucous membrane dries out. Excessive salivation is a protective function of the body, preventing the penetration of germs and infections through the oral cavity.
Development of rhinitis	This process develops against the background of swelling of the nasopharyngeal mucosa.
No interdental gaps	From about 4 years of age, children develop large gaps between their teeth. If such a sign is not observed, then, most likely, a narrowing of the rows is developing. This leads to the growth of a second row of teeth.

Supernumerary teeth in children

The appearance of additional tooth buds is rare, occurring in only 2% of cases. The anomaly is associated with a disorder of embryonic development. A tooth that appears above a child's tooth is usually removed. But this does not always happen: if the tooth does not disturb the shape and aesthetics of the dentition, the dentist can leave it.

Sometimes supernumerary teeth are located outside the dental arch. The appearance of a tooth on the palate of a child is rare, however, this is no exception. There is no need to be afraid of this: it does not affect your health in any way. The Natadent clinic has a pediatric orthodontist who will help solve this problem quickly and painlessly.

How is the treatment carried out?

When choosing treatment tactics, the dentist takes into account:

how old is the patient;
how long ago the permanent unit emerged;
how much the molar crown appeared;
what condition is the milk unit in;
does the child have any complaints;
general condition of the dentition;
the patient has a predisposition to dental anomalies.

After conducting an in-person examination, the dentist decides whether to pull out the interfering tooth or leave it and wait until its roots resolve on their own. In the first case, local anesthesia is administered and removal is carried out; in the second, the doctor tells you when the baby needs to come for a second examination. Thus, if you deal with the problem of a “shark” smile in a timely manner, it will not cause negative consequences.

What to do if the child’s teeth grow in the second row?

When a doctor sees a tooth above a patient’s tooth, he immediately understands what’s wrong. First, the orthodontist removes the baby tooth. After this, the permanent tooth will move into place on its own under the action of the tongue muscle, if there is enough space. But what to do if a child has a lack of space for molars?

The primary task of the dentist and parents will be to restore normal breathing. At this stage, it is necessary to “retrain” the muscles of the mouth to work differently. This is where trainers or mouthguards come to the aid of specialists.

Orthodontic appliances solve several important problems:

train the muscles of the oral cavity, stimulating their natural development;
correct the direction of development of the child’s jaws;
correct the position of the tongue in the oral cavity;
teach the child to breathe through the nose;
get rid of bad habits.

Wearing trainers is most often considered as a preparatory stage. After this, more serious orthodontic treatment begins with the use of braces. However, here the first step is the most important, since the effectiveness of further work depends on it.

Consequences

Even one molar that grows behind a baby tooth causes a lot of trouble. Ignoring the problem and lack of treatment leads to the following consequences:

the child’s diction is impaired;
the process of chewing food occurs poorly, the food is not crushed to the desired consistency;
additional load on other teeth provokes displacement of healthy units, this provokes intense curvature of the bite;
diastemas and trema (gaps) form between the chewing teeth and the front permanent teeth;
the roots of healthy incisors and molars become bent.

How to understand that a child is at risk of growing teeth in two rows?

Attentive parents should monitor the process of teeth growth and loss. The change of dentition begins at 6-8 years: the first to fall out are the central and lateral incisors. At 9-11 years old, the lower canines change. By the age of 10-12, the upper canines and small molars grow. The formation of the bite ends at the age of 13-14 years.

A child’s tooth grows above the tooth when the baby tooth does not leave its place in due time. In this case, parents should definitely consult a doctor. The earlier the pathology is detected, the easier it is to correct the child’s second dentition.

You don’t have to wait for your baby teeth to suddenly fall out on their own! If you notice that your child’s molars are cutting in, but his baby teeth aren’t even loose yet, take him to the dentist. With “shark” teeth, not only the appearance, but also the shape of the jaw is disrupted.

Possible complications

Chronic osteomyelitis of the lower jaw

As a result of incorrect or untimely treatment of hyperdontia, the situation may become more complicated. The most common options are: malocclusion and the development of speech defects.

Ignoring the problem of the growth of double dentition leads to chronic osteomyelitis of the jaw against the background of the inflammatory process of dentin, as well as to the death of the rudiments of molars and their abnormal growth.

In addition, the child receives psychological trauma caused by the aesthetic factor and the negative attitude of others.

Mouthguard as a preventive measure for the second dentition

In dental practice, mouth guards are worn by children over four years of age. At this age, the child is already consciously approaching wearing a trainer and can wear it for a long time. The device is made according to individual casts, taking into account the characteristics of jaw development. The material from which the mouthguard is made is soft and does not injure the mucous membrane.

From the age of two, children can wear removable plates to correct bad habits. If a child often sucks a pacifier or fingers, his bite does not develop properly. These children are more likely to have teeth growing in two rows. A soft plate will help avoid this.

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Natadent specialists know how to win over the youngest patients. Most guys leave the dentist's office without the same fears. True professionals in their field not only master their tools flawlessly, but also make every trip to them as comfortable as possible.

When to hesitate to see a doctor

If a “shark” problem appears and the child complains of pain, the gums are inflamed, swollen, you need to immediately get dental care. Also warning symptoms are:

bad breath;
bleeding of the affected gums;
separation of pus in the area of inflammation;
severe discomfort while chewing food.

You should not wait a day if the child has a predisposition to malocclusion, for example, if he has previously undergone treatment for malocclusion or one of the parents wore braces. In all these situations, removal should be carried out as soon as possible. This measure will be a good prevention of possible complications.

Molars fall out

If molars suddenly begin to fall out suddenly, this is a sign that the child’s health is not in the best condition. Tooth loss is preceded by both systemic diseases (immune problems, impaired development of connective tissue) and local ones (caries, pulpitis, periodontal disease, etc.). Tooth from permanent dentition. When lost, it leaves behind a permanent problem. A radical solution could be a complete insertion of an artificial tooth - but... Before it is carried out, the child will have to use a removable and replaceable prosthesis before he grows up.

When is bone augmentation needed?

For implantation to be carried out flawlessly, a sufficient amount of bone tissue is required. If teeth are missing for more than a year, then in 95% of cases bone grafting will be needed due to atrophy. Osteoplasty is needed so that the implant does not damage blood vessels, nerves, and recreates normal anatomy. The strength of root fixation also depends on it.

Our Center uses the following methods:

Sinus lifting is a bone grafting procedure performed on the upper jaw in the area of the maxillary sinus. The mucous membrane is lifted, the vacated space is filled with bone chips. Often performed simultaneously with implantation.
Guided bone regeneration - the gum is exfoliated, bone material is added, and covered with a membrane. Implants are installed at the same time if the bone deficiency is small. Recovery takes six months.

Implantation without bone grafting is possible when, along with implantation, the process of tissue growth begins. This technology is optimal; bone growth stimulators are fixed to the neck of the implant. The procedure is low-traumatic, but expensive. Its type - autotransplantation (transplantation of bone blocks from other parts of the human body) - is not used in the clinic, because the blocks can dissolve.

The sooner the tooth is restored, the less bone loss develops, so surgery to build it up may not be necessary.

Possible reasons

The exact cause of this disease has not been identified. Experts believe that the cause is a violation of the formation of tooth buds in the embryonic period. For example, this can happen if a woman took certain medications during pregnancy, had bad habits, or suffered from certain infectious diseases.

There is also a version that the pleasant appearance of abnormally located teeth is atavism. The essence of this theory is that in past centuries people had a larger number of teeth than today, so some patients show signs of returning to the original structure of the dentition. According to statistics, this anomaly occurs in 7% of cases.

Price

The clinic uses a case payment system. The cases are designed for installation of 1 implant. Accordingly, if two teeth are missing, the package cost will double.

The cost of the surgical stage includes:

anesthesia;
implant;
plug, abutment, former;
complex of reconstruction and basic bone augmentation;
repeat CT.

The price of implants varies depending on the type of bone. Nobel Biocare PMC (cheaper) is intended for weak bones, and Nobel Biocare Conical Parallel CC (more expensive) is for dense bone tissue.

The cost of prosthetics includes:

making a crown;
taking impressions;
installation.

Paid separately:

tooth extraction with one-stage implantation - the price depends on the complexity (simple is cheaper, complex is more expensive);
bone grafting or sinus lifting if necessary - the price depends on the amount of bone material and the method of osteoplasty.

How is removal carried out?

If the abnormal tooth is single and it is not difficult to get to it using surgical instruments, then there will be no problems, and the tooth will be removed using a standard method. If there are several teeth, they are located in hard-to-reach places, have several roots, or have not fully erupted - in this case, removal is carried out as follows:

The doctor administers an anesthetic so that the patient does not experience pain during the procedure.
A small incision is made on the mucous membrane.
If the roots of the tooth are deep, the doctor may make a small hole using a special bur to provide access to the root system of the tooth.
The tooth and root are removed using forceps.
Next, the area is disinfected using antiseptic agents.
Stitches are applied.
To avoid complications, antibiotics, anti-inflammatory drugs, etc. may be prescribed.

Please note that before surgery, an X-ray diagnosis is required. In this way, the doctor assesses the condition of the root system and other features. Only after the diagnosis is carried out is the issue of tooth extraction decided.

Is it possible to implant 2 teeth at once?

Implanting 2 teeth is no different from restoring one tooth. Artificial roots are also placed, which are then covered with crowns. It is better to install both units at once, without dividing them by time. This will reduce the preparation time, there will be no repeated anesthesia and double antibiotic therapy, which is undesirable to carry out more than once every six months.

Implantation is usually performed using the classical method:

Installation of an artificial root and prosthetics are separated by 2-6 months, which are needed for the implants to heal.
First, an implant is placed, the gum is sutured, and fusion occurs with the bone tissue.
After 2-6 months, the gum is cut, an abutment is placed, and the implant is covered with a crown.

During osseointegration, a removable temporary butterfly immediate prosthesis is worn.

Dear Doctor Orthodontist

The specialist will also examine the oral cavity and select an apparatus for correcting the dentition:

trainer - silicone or polyurethane device, mouthguard. Wear it for an hour before bed. The materials are light and easy to clean. The device corrects bite and diction, and also creates additional rigidity. This will help the jaw to expand for new teeth;
plate with expansion screw - a spacer made of soft plastic, with metal arches and a screw in the middle. It fits against the roof of your mouth and gums and provides pressure to your jaw and teeth. Indications: correction of jaw shape, teeth position, palate stretching;
palatal clasps are metal arches that are secured with hooks on two or four teeth. Rings are placed on the teeth, to which hooks are attached. Also, plates with screws are considered a type of clasp. Such devices correct the shape of only the upper jaw. But with their help you can move your teeth forward or backward, fix them and even tilt them.
And the most famous way to straighten teeth is braces. The structure is not removable thanks to the fixing glue-bond, which covers the teeth from the outside or inside. And an elastic arc made of steel or an alloy of nickel and titanium slowly but inevitably brings the “shark” smile into a Hollywood state.

The choice of correction method depends on the reason for the lack of space for teeth:

physiological feature of tooth formation;
insufficient jaw growth.

The age of the small patient is also taken into account. Braces can be installed from the age of 10, but they will work more effectively from the age of 12, when permanent teeth are actively growing. Up to 12 years old, plates and trainers are suitable. The second row of teeth is not a reason for frustration, but an opportunity to create a beautiful smile.

Guarantees

Our Center uses implants with a lifetime guarantee - Nobel Biocare. We provide guarantees:

2 years for treatment;
1 year for prosthetics;
lifetime for implantology.

Warranty obligations apply provided that the patient follows the doctor’s recommendations, rules of care and regularly visits the dentist. The warranty program includes a complex: for an implant, surgery, bone reconstruction and prosthetics.

Main differences from similar pathologies

Differentiating a split tooth from other outwardly similar anomalies is in some cases a difficult task , which can only be solved with the help of radiography, and even then not always.

Combined anomaly in the form of a styloid lateral incisor

The awl-shaped lateral incisor has a low, conical crown that converges at a blunt point.

The reason for its appearance is most often heredity, less often - endocrine disorders, delay in the loss of milk ducts. Often, subulate incisors are combined with other anomalies - agenesis (hypodontia), transposition of the canines, etc.

The difference between a subulate incisor and a forked one is the normal number of teeth in a row. Schizodontia increases it by one unit.

It is recommended to treat a permanent subwl incisor as it impairs esthetics and reduces the efficiency of chewing food. Usually it is restored with a composite or covered with an artificial crown.

Why short teeth can lead to big problems.

Come here to understand how to deal with speckled teeth.

At this address https://orto-info.ru/zubocheliustnye-anomalii/zubov/prorezyivaniya/chem-otlichaetsya-impaktnyiy.html we’ll talk about impact teeth.

Supernumerary microdont incisor

Like split teeth, supernumeraries increase the number of units compared to the norm. It can only be accurately differentiated from a split tooth using radiography. Like the subulate incisor, it grows from its own follicle.

A supernumerary microdont incisor has reduced dimensions compared to normal ones. Its treatment depends on the clinical picture. If it causes discomfort, interferes with speech, chewing and aesthetics, it is removed.

Gemination (doubling)

An anomaly close, but not identical to bifurcation. Schizodontia is characterized by the formation of 2 completely separated teeth identical to each other.

Gemination is only an attempt at separation, in which the units grown from one embryo are not completely separated from each other. In particular, they have separate crowns, but fused roots.

Or from the occlusal plane there is a deep depression in the middle of the crown. However, in terms of etiology, gemination and schizodentia are completely identical; teeth grow from the same follicle.

On the radiograph, the unit that has undergone gemination has one large pulp cavity and an enlarged root.

Typical problems

PHOTO: The child's lower permanent incisors erupted in the second row. In this situation, it is necessary to free up space by removing the mobile baby teeth so that the permanent teeth can take the correct position in the dental arch.

Sometimes the permanent upper and lower incisors erupt behind the primary ones (“second row”), which do not have time to resolve by this time. This situation requires the intervention of a dental surgeon.

Progression of previously formed caries on the teeth, especially in the area of primary chewing teeth.

The eruption of the first permanent molar in conditions of poor individual oral hygiene and the presence of a large number of untreated carious teeth nearby is often accompanied by the development of caries on the erupting young tooth (molar). During the process of eruption, the 6th tooth is partially covered with a mucous membrane, like a hood, under which plaque and food debris become clogged. The carious process in such conditions develops extremely rapidly, often unnoticed by the patient and his parents, and is quickly complicated by inflammation of the nerve of the tooth.

Timing of baby teeth loss

The primary bite is formed during the period of active jaw growth. In this regard, already at the age of 3-4 years, three spaces should be formed - interdental spaces, which are necessary to ensure the physiological displacement of teeth during their replacement, the correct location of the erupting permanent teeth in the dentition.

By the age of five, children begin to experience, and then steadily progress, loosening of their teeth. This process is due to the gradual resorption of the roots of baby teeth, the place of which in the jaw is taken by the rudiments of permanent teeth moving towards the edge of the gum. When the time comes, the loose tooth falls out, and a permanent one should begin to emerge in its place within 2-3 weeks.

The entire period of mixed dentition requires increased attention from parents and specialists to the condition of the child’s oral cavity. Any pathological changes can lead to impaired teething, the formation of occlusion anomalies, crowding of teeth and other changes. Ideally, at the age of 5-6 years, you should visit the dentist every 2-3 months.

Molar tooth hurts

After the molar has emerged from the gums, the “young” tooth enamel is not fully saturated with all the necessary microelements. During this period, the tooth is especially vulnerable: it is strictly forbidden to subject it to overload. It is not for nothing that children are advised not to chew, for example, candy, large quantities of peanuts, or any solid foods. If you neglect this rule, children may immediately develop caries, and this is the path to problems with specific teeth. Caries gradually turns into pulpitis (damage to the internal cavity of the tooth) and periodontitis (damage to the ligaments surrounding the tooth). The child often experiences toothache and poor general health. Without turning to a professional doctor for help in time, parents can lead their child to various consequences - up to the complete loss of a diseased tooth. If a predisposition to the appearance of carious lesions has been identified, their prevention may involve closing the natural deep pockets surrounding the molars. This is done using high-quality composite materials. In this case, food debris will not accumulate in these places, destructive microflora will not develop, and the period of susceptibility to caries will pass when the teenager grows up.

Doctor's advice - crowns can be placed immediately

For this purpose, a one-stage implantation method is used, when an implant is placed and covered with a crown on top, without waiting for its engraftment. The method is used when there is a sufficient amount of bone tissue. Used for dental units that do not actively participate in chewing. The crown is placed temporary, made of plastic or metal-plastic, and removed from the bite (lower in height) to eliminate active loads. After engraftment, it changes to permanent.

Levin Dmitry Valerievich

Chief physician, Ph.D.

Is it possible to install implants immediately after removing 2 teeth?

This method is possible. Single-stage implantation is used, in which the implant is placed immediately into the hole after tooth extraction. But the following conditions must be met:

the procedure is planned in advance to allow for diagnostics and assessment of the operation;
removal was carried out atraumatically, without damaging the alveolar process;
there should be no inflammation, cysts, granulomas, purulent processes;
the volume of bone tissue is sufficient for the implant to be securely fixed.

Alternatives to implantation

Dental bridge - structures in the form of welded crowns are placed in place of missing teeth. Along the edges they rest on supporting living teeth, the middle pendant teeth replace lost teeth. The method has disadvantages - grinding and depulping of supporting units, the process of bone atrophy continues, short service life in comparison with implants - up to 15 years.
A removable denture is an artificial gum with plastic crowns. It is attached to adjacent teeth with hooks or to the gums using suction. Under such prostheses, bone atrophy progresses with greater force. In addition, it is uncomfortable for a person to chew, and long-term addiction occurs. Service life - up to 7 years.