What should I do if my 5 year old child’s tooth is growing in an abnormal position at the upper gums? (photos)

I sincerely hope I am not too late in answering your enquiry.

Thank you so much for including a picture of your son's dental condition which helped me get a clearer picture of what he is experiencing. As Dr Geraldine has pointed out the presence of tooth decay and also explained the need for dental radiographs ( X-rays ), I will not repeat those points.

The white area noted on the upper left gums is likely to be part of an existing baby tooth. This is a condition called root fenestration. This is likely due to the tooth decay on the upper left lateral incisor ( the second tooth from the right, as shown in the picture) which I assume may have been present for some time now. His body has been trying to fight this decay and infection. Unfortunately, in the process, the bone surrounding that tip of the tooth's roots has started to soften and dissolve. This causes us to be able to get a peek at the tooth roots through the gums or what I like to call a "window" effect.

I agree with you that the black tooth should be removed at present. At present, there are minimal risks as compared to the potential benefits reaped if the decayed tooth were removed. While I agree that baby teeth are important space holders for the permanent teeth, I think at this juncture, ensuring decay and any oral infection is quickly brought to a minimum should be considered our first priority for your son.

A more detailed examination should be conducted by your dentist to ensure there are no other dental cavities to be managed - especially at the back molars. These are common spots where decay may occur. I recommend you bring your son to a paediatric dentist ( a specialist dentist who is specially trained to see children ) or at least a dentist who is comfortable managing children at a young age to get started.

Hope this has helped you clear up any doubts!

I would recommend taking an X-Ray to check on a few matters:

1) If your son has all his permanent teeth and to assess their stage of development.

The upper front teeth usually erupt around 7 years of age. Early removal of the baby teeth means that your son will be without his front teeth for another 2 years, which could be why the dentist you saw was not keen to remove them. The Xray will also be able to show the root development of the permanent upper front teeth, which would tell us how soon it will be erupting.

2) To confirm if that is it is really the permanent front tooth growing out or an extra tooth.

Extra teeth (or supernumerary teeth) typically present themselves in the front area of the upper jaw. If it is an extra tooth, it will have to be removed. If it is one of the permanent teeth, I would suggest to wait until more of the front teeth erupt before embarking on some early form of orthodontic/braces treatment. I would advise seeing an orthodontist then to have it assessed.

3) Tooth decay

Your son has tooth decay on the upper front four teeth, chances are he would have decay at the back teeth/molars as well as they are harder to keep clean.

I would strongly recommend seeing a dentist or pedodontist (dentist who specializes in seeing children), and removing the badly broken down teeth, as well as treating the other teeth with decay. They would also be able to advise you on good oral habits and using the right toothpaste to fight against tooth decay.

Baby teeth are important for chewing, smiling and speaking, and most importantly, they help to preserve the space meant for the adult teeth to come through.

If they are lost too early, permanent teeth can drift into the space and this makes it difficult for other permanent teeth to come through. This will result in crooked teeth and even buried teeth as they have no space to erupt, hence we need to take care of our baby teeth as well.

Hope this helps! All the best!

Warm regards,
Dr Geraldine Lee