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PlayWell Pediatric Blog

My Kid Has Shark Teeth!

April 20, 2023

While not as exciting as a shark, the “shark teeth” effect in a human child is certainly a cool phenomenon and surprisingly not uncommon. It’s usually a sign of dental crowding. Kids have 4 incisors with a canine on both ends, and they act like goal posts; these goal posts do NOT move and the jaw in that area does not grow wider. Therefore, what you have between the two canines is what you have. We like to see kids with nice little spaces between their baby teeth as a sign that there is built-in room. The body’s plan is to, between 6-8 years of age, eject the 4 small baby teeth lower incisors to make way for 4 larger permanent lower incisors. If you have some extra room already, this can go really smoothly. Some kids see me with baby teeth that look straight and in perfect, adjacent contact – like a kid with permanent teeth who has already had braces. When we see this in baby teeth, though, knowing we still have to trade out small teeth for big teeth, we know the future holds some crowding for us. If a permanent tooth wants to erupt and does not have enough space to come in and sit shoulder-to-shoulder with the adjacent teeth, it has 3 options:

  1. It can come in crooked or sideways, because it’s smaller in that dimension and can fit between the adjacent teeth
  2. It can come in straight but, without room for its full width, has to come in behind the row of adjacent teeth. This means the permanent tooth erupts NOT underneath the baby tooth, but behind it, and therefore it often fails to kick out the baby tooth, causing the “shark teeth” phenomenon
  3. The permanent tooth can be stuck in the bone, developed, but unable to find room to erupt anywhere. This situation is the only one of these 3 that would more definitely require a consult with the orthodontist to consider phase 1 “interceptive orthodontics” at a younger age than the otherwise typical orthodontics-aged candidates that are our teenagers

When kids have option 1, we can often wait until the teenage years to do orthodontics, if desired, to achieve straight teeth. For option 3, as mentioned, sometimes early intervention is needed not to achieve straight teeth, but just because it’s important for teeth to come in the mouth when they’re supposed to, or else the orthodontic problem kicked to the future can become a lot bigger of a problem. For the sharky option 2, often times we wait. Cheeks and lips push teeth inwards, and the tongue pushes teeth outwards. If the permanent tooth does the “shark tooth” thing, then it’s closer to the tongue. It acts like a paddle catching more than its fair share of tongue-pressure. As it erupts and the paddle gets longer, the tongue pushes it forwards and this usually results in the baby tooth continuing to loosen and to fall out like normal, if perhaps a little delayed. I may help to extract the baby tooth if this process doesn’t happen within a year or two of the permanent tooth’s initial eruption into the mouth, but I find the process usually takes care of itself!

We get a lot of concerned calls about shark teeth, but really it’s often a self-resolving problem, though a definite sign of crowding and potential future orthodontic need. It's otherwise just kind of a cool situation for kids to show off at school and may very well be sufficient justification to walk around sneakily humming the Jaws theme: “duuun dun… duuun dun….”

A kid playing with his toys

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