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Tooth Alignment

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: My five-year-old just lost her tooth. I noticed that when it came out, there was one behind it. Will it become an overbite tooth or will it fit in place after she has lost the other ones?

A: It is common at this age for teeth to appear to be squished in the mouth and to seem to be pointing in funny directions. More often than not, everything tends to line up normally over time (this is not to say that your child will not need braces on her teeth when she is older, though). Although it is difficult to say for sure without actually seeing in your daughter's mouth, more than likely the tooth "behind it" will move nicely into place.

Remember that we have two sets of teeth--primary (first set) and secondary (final permanent teeth). Teeth erupt and fall out at varying times from one child to the next. The 20 primary teeth usually come out by two years of age, which are important for function as well as holding a place for the permanent teeth. There are 32 permanent teeth, designed to last a lifetime.

Between the ages of 5 and 12 years of age, your child will have a mixture of primary and secondary teeth. You do not mention which tooth of your daughter's has fallen out, but my bet is it is one of the front ones (usual pattern would be on the bottom). I am also assuming your daughter's tooth fell out on its own, not due to injury or trauma. If not or if there's any doubt, I would have her examined by a pediatric dentist, a specialist trained in the care of children's teeth.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

Please note: This "Expert Advice" area of should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.


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