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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19320
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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This morning I noticed something hard on my 8 year old daughters

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This morning I noticed something hard on my 8 year old daughter's gum. I looks like a piece of tooth. It is on the top baby tooth 2 in from the front tooth. Do you know what it could be?
It will help if you could provide some clarification:
When you say that it looks like a tooth, do you mean that you see white material protruding forward from the gums above a baby tooth?

Customer: replied 4 years ago.
Yes and it is hard like a tooth
If it is hard, but not a visible tooth, then there are a couple of common possibilities.

If you are seeing what looks like a tooth protruding forward from the gum above a bay tooth, the primary concern is that the permanent tooth is coming in crooked. This is potentially a reason for pulling the baby tooth. If the baby tooth is slow to come out, then the developing permanent tooth may have nowhere to go, so may come in crooked. Of course, we typically do not pull baby teeth, but if it is slow to come out spontaneously and the permanent tooth is becoming misaligned, then it may be better to pull the baby tooth.

If there is no tooth material visible, but only a hard prominence, it may still be a tooth that is still covered with gum material, but another possible cause of a solid prominence off the gum would be a bony exostosis, which is a protrusion of extra bone material.

At this point, it would be appropriate for her to be seen by her dentist. If the diagnosis is not apparent from exam, a plain dental x-ray will be able to assess the status of the developing permanent teeth, including if the permanent tooth in this location is in such a position that it would be better to remove the baby tooth.

If you have any further questions or need clarification, please let me know.

Customer: replied 4 years ago.

Thank you very much for your help.


What is the cause of the things you list above?


My daughter has quite a lot of adult teeth, much more than any of her friends. She has never had any gaps in her mouth as te adult teeth have always been already in place when the baby teeth have fallen out.


She has a very small face and a very small jaw. Could it be that there simply isn't room in her jaw for all of her teeth?

I'm sorry for the delay, but I had stepped away from the computer when I did not receive any follow-up questions for a while.

There is usually no specific cause for baby teeth that are slow to come out causing the permanent tooth to be angulated. It falls in the same category of why some children have well aligned teeth and others have misaligned teeth that need braces to achieve proper alignment and position relative to each other. There is nothing medically "wrong" with children and adolescents that need braces; it is just the way that the teeth come in for some people. Within this context, the overall size of the mouth and jaw is a factor, but that still would not be considered an abnormality unless it is particularly small.

Dr. D. Love and 2 other Medical Specialists are ready to help you
Customer: replied 4 years ago.

No problem. Thank you for coming back to me. I have made an appointment for the dentist and will try not to worry.


My daughter has had problems with her teeth, with the enamol not forming properly on 2 of her baby teeth. When I was pregnant there was an anomoly with the umbilical cord where there was only one artery and one vein (single umbilical artery). I know that this can lead to a lack of nutrients to the developing feotus, could this cause problems with the enamol on teeth?


Sorry, this is the final question.


Thank you.

There is no specific association of a single umbilical artery with abnormal tooth development, however, it is also true that a single umbilical artery has been shown to affect multiple organ system development and could, in theory, affect any organ or tissue development, including the teeth.

Customer: replied 4 years ago.

Thank you very much.

You're welcome.

I hope that I have provided you with excellent service.

Customer: replied 4 years ago.

Do you mind if I ask you one last question?


I think you're right about it being a tooth in the gum as the baby tooth underneath it is a little wobbly so hopefully it will come out. There was also a little blood in the sink this morning when my daughter brushed her teeth.


Is there a particular reason why my daughter has so many adult teeth already? When we saw our dentist last time she said a tooth that was wobbly shouldn't come out until my daughter is 12, but when it came out the adult tooth was already behind it. Not just a small bit still to grow but the adult tooth the proper size already in place.


My dentist did worry me a bit when she said my daughter shouldn't be losing certain baby teeth so early. What can you do about baby teeth coming out if the adult teeth are already in place behind them?


My daughter has a very good diet with lots of fruit and vegetables and only has one glass of juice a day. She drinks plenty of water and milk.


Thank you.

Actually, children will typically have most of the adult teeth inside the gums by this age. They may not yet be ready to erupt, as that process will take several more years for all of them to erupt, but the teeth can be seen by x-ray. So there is no abnormality that she has so many permanent teeth. If the permanent teeth are getting out of alignment because of persistence of the baby teeth, then the baby teeth can be pulled, but if it is already wobbly, there is probably no need to do this at this point.

Customer: replied 4 years ago.

Thank you again, so it isn't strange that so many of her adult teeth have already erupted? I just wonder that maybe because of her small jaw there simply isn't room for the baby teeth and adult teeth in the gums?

How many of her permanent teeth have already erupted?

Customer: replied 4 years ago.

She has 5 at the top, and 6 at the bottom.

That is within the normal range of what would be expected. It is on the fast side of the normal range, but it still is within the normal range. The latest of the first 12 teeth would be the two upper lateral incisors, which will typically erupt when 8-9 years of age.

Customer: replied 4 years ago.

If more teeth were to erupt and this would fall outside of the normal range what would be the reason for this?

The greatest factor in determining time of eruption of permanent teeth is genetic including a greater tendency for earlier eruption in certain races. Girls also tend to be earlier than boys, although only by a few months. So the primary factor that explains variation in time or eruption is simply the way that person is. As I noted above, it is similar to why some children and adolescents need braces; it is the way it is for that person. It is possible that facial structure can affect the time of eruption, but the studies indicate that most problems with facial bone development does not affect tooth eruption.

Customer: replied 4 years ago.

Thank you so much, you have been really helpful. If only someone had told me how stressful and worrying it is being a parent! There is always something.

You're welcome.

Well, if you want to be warned, it frequently only gets worse as she becomes an adolescent.