Upper incisor teeth in children stages of growth care and treatment

The eruption of the upper front teeth (maxillary incisors) in children is one of the most important stages of oral and dental development, directly affecting speech, chewing, and even the appearance of the smile. These teeth usually appear at the beginning of the teething stage, but sometimes issues like protrusion or irregular growth may occur, which can worry parents. In this article from Dalily Medical, we will cover everything about upper front teeth in children: from the causes and normal stages of eruption, to diagnosis methods and the best treatment options, whether through orthodontics or surgery, as well as key tips for managing them at home.

❓ When should I start orthodontic treatment for protruding upper front teeth?
It’s best to visit a dentist or orthodontist for the first check-up when your child is 6–7 years old. At this age, the permanent teeth start to appear, and if there is any protrusion, the dentist can monitor it early and choose the most appropriate time to start treatment.

❓ Does braces treatment hurt the child?
Braces aren’t usually very painful. It’s normal for the child to feel slight pressure or tension during the first few days after fitting the braces or after adjustment sessions, and this discomfort usually disappears within a few days.

❓ Do teeth need to be extracted before braces?
Not always. If there’s severe crowding in the jaw, the dentist may extract one or two teeth to create space for proper alignment. However, in most cases, extractions are not necessary.

❓ How long does orthodontic treatment for protruding teeth take?
⏱️ The duration varies depending on the child’s condition and the severity of protrusion, but on average, it ranges from 12 to 24 months. In mild cases, it may be shorter.

❓ Can braces return teeth to their normal position?
✅ Yes. In most cases, braces can move the upper front teeth to their correct position and noticeably improve the smile, provided the child follows the dentist’s instructions and attends regular appointments.

❓ Can teeth protrude again after braces removal?
This can happen if the child doesn’t use a retainer as prescribed. Retainers are essential to maintain the new position of the teeth.

❓ Is orthodontic treatment suitable for all ages?
Yes, braces are effective at any age, but the earlier the treatment begins (childhood or early adolescence), the faster and more effective the results, as the jawbones are still flexible and easier to adjust.

Causes of Protruding Upper Front Teeth in Children

The upper front teeth are the first and most prominent teeth to appear in a child’s mouth, usually at the front of the upper jaw. While they typically erupt in the first year of life, they may sometimes appear late or in an abnormal position. Common causes include:

Genetic factors: If parents had early, late, or irregular front teeth, the child may inherit a similar pattern.
Jaw growth patterns: Upper front teeth usually appear between 8–12 months. Slow jaw growth or misaligned teeth may delay eruption or cause abnormal positioning.
Oral habits: Thumb sucking or prolonged pacifier use can push the front teeth forward.
Nutritional deficiencies: Lack of calcium or vitamin D can weaken teeth development or delay eruption.
Gum infections: Gum inflammation or infection may delay or prevent proper eruption.
Extra teeth or delayed shedding of baby teeth: Supernumerary teeth or retained primary teeth may block proper eruption.
Trauma: Falls or injuries to the mouth can change eruption direction or delay teeth appearance.

Types of Upper Front Teeth

Central incisors:

Number: 2 (left and right in the upper jaw).
Eruption: 8–12 months.
Function: Cutting food, helping with speech, and shaping the smile.

Lateral incisors:

Number: 2 (beside the central incisors).
Eruption: 9–13 months.
Function: Assist central incisors in cutting food and shaping the dental arch.

Note: Children initially have 4 upper incisors (2 central + 2 lateral). These baby teeth are later replaced by permanent teeth between ages 6–8 years.

Complications of Upper Front Teeth Problems

Problems with upper incisors—whether delayed eruption, breakage, decay, or protrusion—can cause:

Difficulty cutting food and chewing
Speech problems or delayed speech development
Aesthetic issues affecting the smile and self-confidence
Higher risk of cavities and gum disease
Jaw growth and teeth alignment issues
Increased risk of injuries or fractures

Stages of Upper Front Teeth Development

Pre-eruption (birth – 6 months): Teeth develop under the gums. Clean gums with a damp cloth after feeding.
Primary incisors eruption (8–12 months): Central incisors appear first, then lateral incisors. Teething symptoms like drooling and irritability may occur.
Stability (1–6 years): Baby teeth fully function for chewing and speech. Teach regular brushing.
Beginning of replacement (6–8 years): Central baby incisors shed at 6–7 years; lateral at 7–8 years, making room for permanent teeth.
Permanent teeth eruption (7–9 years): Permanent central incisors appear at 7–8 years; lateral at 8–9 years. Any delay or abnormal protrusion requires a dental visit.

Diagnosis of Upper Front Teeth Issues

Clinical examination: Visual inspection of eruption timing, alignment, crowding, spacing, and decay.
Evaluation of teething and growth: Compare eruption timing with child’s age; delayed eruption may indicate growth issues.
X-rays (if needed): Determine tooth position, root shape, and presence of underlying issues.
Oral habits assessment: Thumb sucking, prolonged pacifier use, or tongue thrusting.
Speech and function evaluation: Check if tooth alignment affects speech or chewing; refer to a speech therapist if necessary.

Surgical Treatment for Upper Front Teeth

Surgery is rarely needed; most cases improve with braces or habit correction. Surgery may be considered in cases of:

Impacted incisors: Teeth that fail to erupt may require exposure surgery, sometimes followed by minor orthodontic guidance.
Severe crowding or extra teeth: Surgical removal of extra teeth may be needed before orthodontic alignment.
Severe upper jaw protrusion: Corrective jaw surgery (orthognathic surgery) may be needed in adolescence.
Injuries or fractures: Surgical intervention to restore bone or stabilize teeth may be necessary, sometimes with temporary implants.

Tip for parents: Surgery is a last resort. Regular dental follow-ups from ages 5–7 can prevent most problems requiring surgical intervention.

Orthodontic Treatment for Upper Front Teeth

Most issues with protruding or misaligned upper incisors can be corrected with orthodontics, especially while the child is still growing.

Common orthodontic methods:

Removable appliances: For ages 6–10, guide jaw and teeth growth; effective if the issue is caused by habits like thumb sucking or tongue thrusting.
Fixed braces: After permanent teeth eruption, align teeth and correct crowding or protrusion.
Functional appliances: Guide jaw growth, especially for upper jaw protrusion or delayed lower jaw growth.
Retainers: Worn after braces to maintain results. Neglecting retainers may lead to relapse.

Cases needing surgery with braces:

Severe upper jaw protrusion (skeletal Class II)
Significant lower jaw delay or retrusion
Congenital deformities or abnormal jaw growth
Failure of braces alone due to skeletal problems

Parent Tips for Upper Front Teeth

Start oral hygiene early: Clean gums before teeth erupt; brush gently twice daily after teeth appear.
Stop harmful habits early: Cease thumb sucking by age 2–3; stop pacifier use by 18 months; address tongue thrusting.
Regular dental visits: First visit at first tooth or age 1, then check-ups every 6 months.
Healthy nutrition: Limit sugar, provide calcium-rich foods and vitamin D, and encourage fruits and vegetables.
Monitor teeth appearance: Check for abnormal angles, crowding, or protrusion; consult a dentist early.
Support speech development: Encourage clear speech; consult a speech therapist if teeth affect pronunciation.