When is the eruption of a molar in children dangerous What are the best treatment methods

Have you noticed that your child’s molar is coming in at an unusual angle or tilted toward the cheek?
The eruption or “eruption out of place” of a molar is a common issue in many children and can worry parents, especially if the child experiences pain or difficulty eating.

Most of the time, this problem occurs due to limited jaw space or delayed loss of baby teeth, and sometimes it’s caused by genetic factors or mild gum inflammation.

The good news is that most cases can be treated easily if detected early.

In this Delly Medical article, we’ll cover:

The causes of a molar erupting out of its normal position.
Symptoms that indicate you should visit a pediatric dentist.
Treatment methods, including medications or surgery.
Essential tips to protect your child from complications.

Keep reading until the end to learn how to handle this issue with simple and effective steps, helping your child’s smile return to its natural, beautiful state.

Is it normal for a child’s molar to erupt out of place?
Not always. If the molar comes in at a slight angle and there’s no pain, it may not cause any problems. But if the tooth erupts toward the cheek or tilts onto other teeth, you should visit a dentist immediately to prevent crowding or discomfort for your child.
Can an erupting molar cause pain?
Yes, sometimes there may be mild pain or gum swelling, especially if the molar tries to come in at the wrong angle. In other cases, the child may feel no pain at all, which is why regular check-ups with a dentist are important even if there’s no complaint.
Can the molar move back to its natural position on its own?
If the child is young and the jaw is still growing, the tooth might shift slightly and settle into its correct position over time. However, most cases require monitoring or minor orthodontic intervention to ensure proper alignment and prevent crowding.
Can an erupting molar affect other teeth?
Yes, definitely. A misaligned molar can push against neighboring teeth, causing tilting or crowding of the entire row. Early dental check-ups are the best way to prevent alignment problems.
Does an erupting molar always require surgery?
No. Most cases are simple and don’t need surgery. Surgery is only necessary if:

The child suffers from severe pain or repeated infections.
The molar is tilted or impacted under the gum.
There is a supernumerary tooth affecting normal teeth.

Can it be treated with medication alone?
Yes, if the case is mild and there’s no infection. The dentist may recommend:

Mild pain relievers.
Topical gels to soothe the gums.
Antiseptic mouth rinses to reduce bacteria.

Regular follow-up is essential to ensure the tooth is moving in the right direction and there are no complications.

When should you visit the dentist immediately?
See the dentist promptly if your child shows any of these signs:

Persistent pain or gum swelling.
Bleeding or discharge from the tooth area.
The molar erupts at a very unusual angle.
Difficulty chewing or speaking.

These symptoms may indicate the tooth is coming in incorrectly or there’s an infection needing immediate treatment.

Can an erupting molar affect a child’s smile or appearance?
Yes, in some cases. If the molar erupts incorrectly and causes crowding or tilting of nearby teeth, it can affect the smile or dental alignment. The good news is that early treatment can prevent permanent deformities, and the dentist can correct the situation with orthodontics or minor interventions.

Stages of an Erupting Molar Out of Place in Children

Tooth eruption doesn’t happen suddenly; it goes through several stages that the dentist can identify through exams and X-rays.

Formation inside the jaw
The tooth develops inside the jawbone like any normal tooth. If there’s a problem with the root direction or limited space, it may start to erupt at an angle or in the wrong direction.
Initial eruption (pushing stage)
The tooth begins moving up toward the gum surface. If a baby tooth hasn’t fallen out yet or there’s crowding, the molar may change direction and erupt in the wrong spot.
Partial eruption
Part of the molar appears above the gum, while the rest remains buried. At this stage, mild inflammation or discomfort while eating or brushing may occur.
Full eruption out of place
The molar fully appears but not in its correct position, possibly leaning toward the cheek or tongue. This may cause:

Pain or irritation while chewing.
Difficulty cleaning the tooth.
Early decay due to trapped food.

Stabilization or complications
If left untreated, the molar may settle in the wrong place, causing:

Tooth crowding.
Changes in the smile’s appearance.
Impact on permanent teeth that haven’t erupted yet.

Causes of a Molar Erupting Out of Place in Children

Sometimes, molars (primary or “laughing teeth”) erupt in the wrong spot or at an angle, causing them to appear outside the normal dental row. The main causes include:

Limited jaw space
If the jaw is small, the teeth may not have enough room to come in straight, forcing the molar to tilt or erupt in a different direction.
Delayed loss of baby teeth
If a baby tooth hasn’t fallen out on time, the permanent molar may erupt at an angle or in an inappropriate position.
Tooth crowding
When there are more teeth than available space, teeth may overlap or erupt out of alignment, causing molars to come in outside the normal row.
Genetic factors
If a parent had similar dental issues, the child may inherit jaw shape or tooth alignment tendencies that make molars more likely to erupt incorrectly.
Jaw or gum growth issues
Sometimes, a small barrier in the bone or gum prevents proper tooth eruption, causing it to come in at a different angle.
Injury or trauma to the mouth
A fall or blow to the mouth can alter the eruption direction of the tooth under the gum, causing it to emerge in an abnormal position.

Symptoms of a Misaligned or Erupting Molar in Children

When a molar erupts in the wrong place or at an angle, there are several signs you may notice in your child:

Irregular teeth appearance
The tooth appears outside the natural dental row, toward the cheek or tongue, affecting the overall look of the mouth.
Difficulty chewing
The child may complain that eating hurts or they can’t bite properly due to the misaligned molar.
Jaw pain or pressure
The child might feel mild pain or tension around the tooth, especially while eating or during eruption.
Tooth rubbing against gum or cheek
A tooth erupting toward the cheek can cause minor cuts or sores from constant friction.
Gum inflammation or redness
The gums around the tooth may swell or turn red due to pressure or irritation.
Crowding of adjacent teeth
The protruding tooth can push neighboring teeth, causing crowding in the dental arch.
Difficulty cleaning the teeth
The misaligned molar may be hard to reach, increasing the risk of cavities or bad breath.

Types of Misaligned or Erupting Molars in Children

Not all misaligned molars are the same. The dentist classifies them based on direction and position, which helps determine the best treatment approach.

Eruption outward (toward the cheek)
The tooth tilts or protrudes toward the cheek, potentially causing minor cuts or friction inside the cheek while eating or speaking.
Eruption inward (toward the tongue)
The tooth appears closer to the tongue, making cleaning difficult and allowing food and bacteria to accumulate, which may cause cavities or mild infections. Sometimes the child feels a “bump” that irritates them during chewing or speaking.
Tilted or deviated eruption
The tooth erupts at an angle rather than vertically, pushing adjacent teeth and potentially causing crowding or misalignment of the entire row.
Partial eruption (half tooth visible)
Only part of the molar is visible above the gum; the rest remains buried. This may cause minor inflammation or food accumulation around the tooth.
Double or stacked eruption (tooth over tooth)
Rarely, a permanent tooth may erupt over an existing baby tooth, requiring prompt intervention to prevent misalignment.

Risks of a Misaligned or Erupting Molar in Children

A misaligned molar isn’t just an aesthetic issue; it can cause real problems for dental development:

Crowding and misalignment
The protruding molar can push neighboring teeth, disturbing their alignment, often requiring early orthodontic treatment.
Pain and gum inflammation
Friction between the tooth and gum or cheek can cause swelling or painful inflammation, especially while eating or brushing.
Increased risk of cavities
A misaligned molar is harder to clean, allowing food debris to accumulate, which increases the risk of decay and bad breath.
Chewing and speech difficulties
A tooth erupting toward the cheek or tongue can interfere with eating and speaking and may cause minor cuts.
Jaw pain or headaches
Pressure from the misaligned molar on surrounding teeth can sometimes lead to jaw pain or mild headaches.
Impact on jaw growth and permanent teeth
If left untreated, the molar may affect the eruption path of permanent teeth and alter the smile.
Cysts or chronic infections
Delayed treatment can lead to cyst formation around the tooth or chronic inflammation in the surrounding bone.

Diagnosis of a Misaligned or Erupting Molar in Children

Accurate diagnosis requires a dentist’s careful examination. Some cases are visible, while others need imaging to locate the tooth precisely.

Clinical examination
The dentist checks tooth alignment, gum condition, and looks for misalignment, crowding, pain, or redness.
Panoramic X-ray
This shows:

Tooth position inside the jaw
Growth direction (tilted, horizontal, or toward the cheek)
Relationship with adjacent teeth

3D CBCT scan
For complex cases, a 3D scan helps the dentist see nerves and bone structure in detail before any surgical intervention.
Observation of the child’s symptoms
Parents play a crucial role. If the child complains of pain, swelling, or abnormal gum appearance, see the dentist immediately. Early detection allows easier and faster treatment without complications.

Surgical Treatment for Misaligned or Erupting Molars

In some cases, the molar causes pain or affects alignment, requiring minor surgical intervention. The type of procedure depends on the tooth’s position:

Partially erupted tooth

Description: Half of the molar is visible; the rest is under the gum or bone.
Surgical treatment:
- Remove excess gum tissue covering the tooth
- Helps the tooth erupt naturally without pain
- Follow-up ensures proper eruption direction

Misaligned eruption

Description: Tooth erupts toward the cheek or neighboring teeth instead of its natural position.
Surgical treatment:
- Expose the tooth surgically
- Guide its path with orthodontics if the child is still growing
- Remove the tooth if it causes pressure or pain to adjacent teeth

Impacted tooth (partially or fully)

Description: Tooth is trapped under gum or bone and cannot erupt.
Surgical treatment:
- Small incision in gum and bone to access the tooth
- If useful, expose and guide with orthodontics
- Remove the tooth if it’s harmful to surrounding teeth

Extra tooth (supernumerary premolar)

Description: An additional tooth appears in an abnormal location.
Surgical treatment:
- Complete surgical removal
- Orthodontic follow-up if crowding or gaps occur

Post-surgical care:

Regular follow-up to ensure proper healing
Avoid hard or hot foods for the first 2 days
Gentle brushing with fluoride toothpaste
Follow prescribed medications

Medical Treatment for Misaligned or Erupting Molars

Not all cases require surgery. Mild cases can improve with medication and regular dental monitoring:

Pain relievers

Paracetamol or ibuprofen in age-appropriate doses
Reduces discomfort during eruption or after eating

Anti-inflammatory rinses or mouthwash

Chlorhexidine mouthwash for mild gum redness or swelling
Used carefully without swallowing

Topical gels

Teething gels applied once or twice daily on the affected area
Helps soothe discomfort during eating or sleeping

Antibiotics (for severe infection)

Prescribed for abscesses or painful inflammation
Follow the exact dosage and duration

Vitamins and minerals

Calcium, vitamin D, and phosphorus supplements support tooth and gum health
Balanced diet with milk, yogurt, cheese, and leafy vegetables

Important tips during medication treatment:

Never use medication, gels, or rinses without a dentist’s guidance
If pain or swelling increases, see the dentist immediately
Medication helps with symptoms, but correcting tooth position and monitoring the cause of misalignment is essential