The sensation of a tooth “growing out of the gums” unexpectedly is a common and concerning query. This feeling typically signals an abnormal or delayed pattern in tooth emergence, which can occur at any age. While teeth are naturally designed to move through the soft tissue, any deviation from the standard path or timing can create discomfort and the impression of an oddly positioned tooth. This abnormal presentation is usually related to a physical blockage, a positional error, or the presence of extra teeth.
The Standard Process of Tooth Eruption
The movement of a tooth from its developmental position within the jawbone into the mouth is a highly regulated physiological process known as tooth eruption. This process occurs in distinct stages, starting with the primary or “baby” teeth in infancy, which typically begin to appear around six months of age. The full set of 20 primary teeth is generally present by age three, establishing proper chewing function and maintaining space for the permanent set.
Around age six, the mixed dentition stage begins as the first permanent molars erupt behind the primary teeth. Following this, the permanent teeth actively push toward the oral cavity, causing the roots of the primary teeth to dissolve and loosen until they fall out. Eruption is considered complete when the tooth crown has fully emerged and made contact with the opposing tooth in the other jaw. The entire process of permanent tooth eruption, excluding the third molars, usually concludes by the early teenage years.
Impacted and Partially Erupted Teeth
The most frequent cause for the feeling of a tooth unexpectedly pushing through the gums, particularly in young adults, is an impacted or partially erupted third molar, commonly known as a wisdom tooth. Impaction occurs when a tooth is blocked from erupting fully into its correct functional position due to a physical barrier, such as bone, soft tissue, or another tooth. Wisdom teeth are the last to develop, typically erupting between the ages of 17 and 21, often finding insufficient space at the back of the jaw.
Impaction is classified by the tooth’s angle and depth within the jawbone, including vertical, angular, horizontal, or completely submerged below the gum line. A partially erupted tooth creates a direct connection between the mouth and the underlying tissue, which is a common site for bacterial accumulation and infection. This often leads to pericoronitis, the inflammation of the gum tissue surrounding the partially emerged tooth.
Symptoms of pericoronitis include pain, gum swelling, and a foul taste caused by pus or trapped food debris. The inflammatory response can cause jaw stiffness, difficulty swallowing, or facial swelling. The feeling of a tooth “growing” is often the painful, localized swelling of the inflamed gum flap as the tooth attempts to break through an obstructed path.
Ectopic and Supernumerary Teeth
Developmental errors can cause a tooth to form in the wrong place or result in extra teeth. Ectopic eruption occurs when a tooth begins to emerge far from its normal position along the dental arch, often due to a misdirected tooth bud. This positional error can cause the tooth to push against the root of an adjacent tooth or erupt high in the gum tissue. The upper canine teeth and the first permanent molars are the teeth most frequently affected by ectopic eruption.
A different issue is hyperdontia, characterized by supernumerary teeth, which are additional teeth beyond the standard count of 32 permanent teeth. These extra teeth vary in shape and size, sometimes resembling normal teeth or appearing small and cone-shaped. The most common example is a mesiodens, a small, peg-like extra tooth that frequently forms between the two upper central incisors.
Supernumerary teeth occur in about 1% to 4% of the population and often remain embedded in the bone. They can disrupt the path of normal teeth, causing them to erupt ectopically or become impacted. When these extra teeth emerge, they appear to be an entirely new tooth growing unexpectedly in an unusual location.
Diagnosis and Treatment Pathways
Any new, painful, or oddly positioned tooth requires immediate evaluation by a dental professional. Diagnosis involves a thorough clinical examination combined with specialized dental imaging. X-rays, such as panoramic radiographs or Cone-Beam Computed Tomography (CBCT) scans, visualize the complete structure of the jawbone. This confirms the precise location and angle of the tooth, determining if it is impacted, ectopically positioned, or supernumerary.
Treatment pathways are determined based on the cause, surrounding anatomical structures, and potential complications. For an impacted wisdom tooth causing recurrent pericoronitis, surgical extraction is the most common solution to remove the source of infection. In cases of ectopic eruption, orthodontic intervention may guide the tooth into its correct position, though surgical exposure may be necessary first. If a supernumerary tooth disrupts the eruption of a permanent tooth, surgical removal is typically performed to clear the path.
In certain asymptomatic cases where no damage is observed, a dentist may recommend observation with regular monitoring to track any changes.