Is It Normal for My Child’s Permanent Teeth to Come In Crooked?

Your child’s baby teeth looked fairly straight. Then the permanent teeth started coming in — and suddenly one looks crooked, another is turned, or the new teeth seem much too large for the available space.

Some irregularity as permanent teeth erupt can be part of normal dental development. But crooked or crowded teeth can also be an early sign that there may not be enough space or that your child’s bite should be evaluated.

The appearance of one new tooth does not tell the whole story. Your dentist can look at how your child’s teeth and jaws are developing and determine whether the best approach is simply to watch, or whether an orthodontic evaluation may be appropriate.

Why Do Permanent Teeth Sometimes Come In Crooked?

Children go through a transition when baby teeth are being lost while permanent teeth are erupting. During this period, the mouth can look surprisingly uneven.

A permanent tooth may initially appear rotated, angled or crowded for several reasons, including:

What matters is not only whether one tooth looks crooked today, but how the entire mouth is developing as additional permanent teeth erupt.

Why Do My Child’s Adult Teeth Look So Big?

Parents are sometimes surprised by the size of the first permanent front teeth.

Permanent teeth are larger than the baby teeth they replace, and when only a few have erupted they can look disproportionately large in a child’s face and mouth.

As your child grows and additional permanent teeth erupt, the overall appearance changes. Large-looking front teeth by themselves do not necessarily mean something is wrong.

Will Crooked Permanent Teeth Straighten on Their Own?

Sometimes the position of newly erupted teeth changes as the mouth continues to develop. But parents should not assume that significant crowding or an abnormal bite will automatically correct itself.

Whether improvement is likely depends on the reason the teeth are crooked, how much space is available, the position of other developing teeth and your child’s overall dental and jaw development.

That is why watching development with your dentist is more useful than trying to predict the outcome from one tooth alone.

When Should I Ask the Dentist About Crooked Teeth?

You can bring up concerns about tooth position at any regular dental visit. You do not need to wait until every permanent tooth has come in.

It is especially worth asking if you notice:

A dental examination can help determine whether what you are seeing is part of a developing smile that should be monitored or something that deserves further evaluation.

Does My Child Need an Orthodontist?

Not necessarily.

Seeing crooked permanent teeth does not automatically mean your child needs braces or immediate orthodontic treatment.

Your child’s regular dentist can monitor tooth eruption and bite development and discuss whether an orthodontic evaluation is appropriate.

The American Association of Orthodontists recommends an orthodontic checkup no later than age 7. An evaluation at that age does not mean treatment must begin — many children are simply monitored as they continue to grow.

Read
When Should My Child Have an Orthodontic Evaluation?

What If an Adult Tooth Is Coming In Behind a Baby Tooth?

Sometimes a permanent tooth begins erupting behind a baby tooth that has not yet fallen out. Parents often notice this with the lower front teeth.

That situation deserves its own evaluation because the next step depends on how loose the baby tooth is, where the permanent tooth is erupting and how the teeth continue to develop.

If that is what you’re seeing, don’t assume the permanent tooth is simply “coming in crooked.” Have your dentist take a look.

Read
My Child’s Adult Tooth Is Coming In Behind a Baby Tooth — What Should I Do?

Will My Child Need Dental X-Rays?

Not every concern about crooked teeth requires dental X-rays.

When imaging is clinically useful, however, X-rays can provide information about developing permanent teeth and structures that cannot be fully evaluated by looking in the mouth alone.

The decision should be based on your child’s individual diagnostic needs.

Read
Does My Child Need Dental X-Rays? Are They Safe?

Keep Watching the Whole Smile

One crooked permanent tooth can look alarming when it first appears, but dental development happens over years.

Regular dental visits allow your dentist to follow how baby teeth are being lost, how permanent teeth are erupting, whether enough space is available and how your child’s bite is developing.

The goal is not to make every developing smile perfectly straight immediately. It is to recognize problems that need attention while avoiding unnecessary treatment when monitoring is appropriate.

If you’re wondering how often your child should be seen while their teeth are developing, read
How Often Should Kids Go to the Dentist?

Children’s Dental Care Near Beaverton

Cedar Hills Dental Care provides family dentistry for children and adults near Beaverton. Our practice has served the community since 1986 and has cared for more than 10,000 smiles.

Christine Chin, DMD brings more than 35 years of dental experience and is an Oregon Health & Science University-educated dentist. Regular dental visits give us an opportunity to follow your child’s teeth and dental development as they grow.

If a new permanent tooth looks crooked, crowded or out of place, ask us about it. We can evaluate what is happening and discuss whether monitoring or further evaluation may be appropriate.

Learn more about our
Dental Care for Children
and our growing collection of resources for parents.

Further Reading for Parents

If you have questions about how your child’s permanent teeth are coming in, these Cedar Hills Dental Care articles may also help:

• When Should My Child Have an Orthodontic Evaluation?
• My Child’s Adult Tooth Is Coming In Behind a Baby Tooth — What Should I Do?
• Does My Child Need Dental X-Rays? Are They Safe?
• How Often Should Kids Go to the Dentist?
• Dental Care for Children: Prevention, Development & Lifelong Oral Health