The appearance of a second row of teeth, commonly known as “shark teeth,” is a frequent concern for parents during a child’s transition to permanent dentition. This phenomenon can look alarming, leading many to assume that immediate orthodontic treatment like braces is required. While braces are effective for correcting tooth position, they are not typically the initial solution for addressing the retained baby tooth itself. Understanding the standard treatment protocol clarifies when simple removal is sufficient and when a comprehensive orthodontic plan becomes necessary to guide the permanent teeth into proper alignment.
Defining “Shark Teeth”
The term “shark teeth” is a nickname for what dentists refer to as retained deciduous teeth or, more broadly, ectopic eruption. This condition occurs when a permanent tooth erupts before the corresponding primary, or baby, tooth has naturally fallen out. Normally, the permanent tooth develops directly beneath the baby tooth, and its upward movement causes the baby tooth’s root to dissolve, a process called root resorption. This resorption loosens the primary tooth, allowing it to shed and making space for the new tooth.
In cases of ectopic eruption, the permanent tooth develops on a slightly different path, often positioned behind the primary tooth, particularly in the lower front incisors. Since the new tooth is not pushing directly on the primary root, root resorption fails to complete, leaving the baby tooth firmly in place. The permanent tooth erupts behind the baby tooth, creating the characteristic double-row appearance. This event is most common around age six to eight, when the lower front teeth emerge, and can happen again around ages 11 to 12 as the permanent canines and molars erupt.
Standard Treatment Protocols
The most common intervention for “shark teeth” is a simple extraction of the retained primary tooth. This procedure is performed when the baby tooth shows no signs of loosening naturally, typically a few weeks after the permanent tooth has visibly erupted behind it. Removing the primary tooth eliminates the physical barrier blocking the permanent tooth’s path into the dental arch.
Once the obstruction is gone, the permanent tooth often moves forward into its correct position spontaneously. This natural correction is facilitated by the constant pressure exerted by the tongue, which pushes the tooth forward and outward. Pediatric dentists monitor the site closely after extraction to ensure the permanent tooth is migrating into the appropriate spot within the arch. Timely extraction is important because the baby teeth act as natural space maintainers, and their prolonged retention can contribute to long-term alignment issues.
When Braces Are Necessary
Braces are not used to treat the initial “shark teeth” problem, but they become necessary to correct resulting malocclusion or misalignment. If the permanent tooth does not self-correct after the baby tooth is extracted, or if the lack of space has led to significant crowding, a full course of orthodontic treatment may be required. This intervention focuses on guiding the permanent tooth into a stable, functional, and aesthetically pleasing position.
Orthodontic mechanics create the necessary space within the jaw and move malpositioned teeth. In some cases, the permanent tooth may have erupted with a rotational defect (twisted in its socket). Braces apply precise, continuous force to derotate the tooth and shift its position to align correctly with the other teeth.
Ectopic eruption can also be a symptom of a larger underlying issue, such as a mismatch between the size of the teeth and the jaw. If the jaw is too small to accommodate permanent teeth, the tooth that erupted behind the baby tooth will likely remain crowded. In these complex scenarios, braces or clear aligners are used to expand the arches, create adequate room, and establish a proper bite relationship. Orthodontic treatment ensures the permanent teeth are straightened and positioned for long-term oral health and function.