A tooth seemingly “growing in your gum” often refers to a tooth that has not emerged as expected or an extra tooth. While all teeth develop within the jawbone and gums, their normal process involves breaking through the gum line to become visible. When this natural eruption does not occur, or when additional teeth are present, it warrants a professional dental evaluation.
Normal Tooth Development
Teeth begin forming with primary teeth developing as early as six to eight weeks into prenatal development. Permanent teeth also begin to form in the jaws during childhood. Each tooth develops from specialized cells within the jawbone, encased in a sac that guides its growth. As the tooth matures, it gradually moves towards the surface, pushing through the gum tissue in a process known as eruption.
The first primary teeth emerge around six months of age, with children typically having a full set of 20 primary teeth by age three. Permanent teeth begin replacing primary teeth around age six, continuing to erupt until age 21, when individuals typically have 32 permanent teeth, including wisdom teeth. This sequential emergence creates a functional bite and aligns teeth properly within the dental arches.
When a Tooth Doesn’t Erupt Properly
A tooth may fail to erupt properly. An impacted tooth is one blocked from breaking through the gum or jawbone. Wisdom teeth are the most common to become impacted, due to a lack of space in the jaw or an abnormal angle of growth. Canines can also be impacted, a concern due to their important role in biting and maintaining dental arch integrity.
Another reason for a tooth remaining in the gum is supernumerary teeth, extra teeth beyond the normal count. They can develop anywhere in the mouth, but most frequently appear in the upper jaw, particularly between the two upper front teeth, where they are known as mesiodens. Supernumerary teeth vary in shape, from cone-shaped to those resembling normal teeth, and may be visible or remain hidden. These extra teeth can obstruct the eruption path of regular teeth, leading to their impaction or misalignment.
Other reasons for a tooth failing to erupt include cysts or tumors, or certain genetic conditions. Primary failure of eruption (PFE) is a rare genetic disorder where teeth fail to erupt despite an unobstructed pathway, often affecting molars. Mechanical failure of eruption, where a tooth is joined to the surrounding bone, also prevents proper emergence.
Recognizing Potential Issues
A tooth that is not erupting as it should may not always cause immediate symptoms, and sometimes it is only discovered during a routine dental X-ray. However, issues can arise. Pain or tenderness in the gum or jaw is a common symptom, which can be persistent or come and go. Swelling, redness, or bleeding of the gums around the affected area can also occur, sometimes accompanied by an unpleasant taste in the mouth or bad breath if an infection is present.
Difficulty opening the mouth or chewing can signal an issue. If the tooth is partially erupted, it can trap food and debris, increasing the risk of decay for the unerupted tooth itself or adjacent teeth, and leading to gum inflammation. Crowding or misalignment of other teeth might also be observed as the impacted tooth attempts to emerge, or a visible bulge in the gum might be present without a tooth breaking through.
Dental Diagnosis and Treatment
A dentist begins the diagnostic process with a clinical examination, looking for signs such as swollen tissue or a visible gap where a tooth should have emerged. Dental X-rays, including panoramic X-rays or 3D scans, are then used to visualize the tooth’s position, its angulation, and its relationship to surrounding structures like the jawbone and nerve pathways. This imaging helps determine the problem’s exact nature, whether it is an impacted tooth, a supernumerary tooth, or another underlying cause.
Treatment options vary based on the situation and if the tooth causes problems. For asymptomatic impacted teeth, regular monitoring may be recommended. If the tooth is causing pain, infection, or other oral health issues, extraction is a common treatment, particularly for impacted wisdom teeth or problematic supernumerary teeth. Surgical extraction may involve making an incision in the gum and removing a thin layer of bone to access the tooth, sometimes requiring the tooth to be removed in pieces.
For impacted teeth that can be guided into proper position, such as canines, surgical exposure and orthodontic eruption may be an option. This procedure involves exposing the tooth by removing gum tissue and possibly bone, then attaching an orthodontic bracket to guide it into alignment with braces. Addressing complications like infection may involve antibiotics, while cysts associated with unerupted teeth might also require removal.