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Shark Teeth
Posted on 8/18/2015 by Fariba Mutschler
A surprising number of children develop a double row of teeth, especially on the lower front teeth. A six year old girl from Gresham saw me last week in my Portland office with just this condition.

Her mother was concerned that the permanent lower incisors would stay inside the lower primary (baby) incisors and look abnormal. She called them “shark teeth”.

Although this usually happens with lower incisors, it can also occur with upper incisors or primary molars.

Things to worry about:


•  The permanent teeth are completely through the gingiva (gums)
•  The primary teeth are solid or only very slightly mobile and loose
•  The upper permanent incisors are erupting inside the lower incisors to form a cross bite
•  The premolars are erupting under the primary molars sideways or into a scissors bite (opposite of a cross bite: the top back teeth are completely outside the lower teeth)

Things to not worry about:


•  The permanent teeth are still only partially erupted through the gingiva
•  The primary teeth are getting looser all the time
•  All of the permanent teeth are erupting towrds their normal position

What to do about it:


•  If the primary teeth are not getting loose as they should, then the best treatment is removing the primary teeth by extraction.
•  The timing of extraction depends on how the permanent teeth are growing
•  a crossbite or a scissors bite should be treated right away, lower incisors can usually wait longer.
•  The position of the permanent teeth will usually improve without orthodontic treatment if there is room available
•  tongue and lip pressure align the teeth quite nicely.

What happened with my young Gresham patient? Her adult front teeth in the middle were mostly through the gums inside the primary incisors and they were a bit twisted.

But the primary incisors were hardly loose at all. This was cause for worry.

There was enough space available for the twisted permanent teeth to move forward and line up straight. This was good.

I suggested that the baby teeth needed more fresh air and sunshine and a visit to the Tooth Fairy.
Using a topical anesthestic gel and a local anesthestic injection (we try not to use the word ‘shot’), a quick push and twist and the tooth was out before she knew it.

She was excited to get a treasure chest for her tooth and looking forward to a visit from the Tooth Fairy that night.
My daughter was a little nervous to have her dental work done but everyone in the office was super friendly and very reassuring and that helped her nervousness go away. Thanks for the excellent dental experience. ~ Lilyana G.


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