Wednesday, July 17, 2024
HomePediatric DentistryDouble Teeth – Gemination and Fusion

Double Teeth – Gemination and Fusion

Many parents wait with great excitement and anticipation for the eruption of their baby’s first tooth.  Sadly, baby teeth don’t always look quite right.  This can cause extreme worry among parents.  Pictured to the left is one such scenario of a baby’s two upper teeth.  The tooth on the left is a “double tooth” while the one on the right is normal.

Double teeth are two teeth that are joined together by dentin or even by the pulp.  If you’re not sure what dentin and pulp are, take a look at the layers of a tooth.

There are two scientific terms for teeth that appear to be two teeth stuck together as one tooth: gemination and fusion.

Teeth Stuck Together: What is Gemination?

Tooth Twinning / Gemination - Close Up ViewGemination is when one developing tooth has split off into two distinct teeth that remain attached to each other and develop together.  Gemination comes from the latin word geminus which means twin.  You can think of gemination as two “twins” that are permanently attached.

When you count the geminated tooth as one tooth, there are a normal number of teeth in the mouth.  Rachel’s son (shown in the pictures) was shown to have gemination because he has all of his other teeth when you count the “double-tooth” as one tooth.

Teeth Stuck Together: What is Fusion?

Fusion is when two different developing teeth have joined together to create one tooth.  You can think of it as two teeth fusing together.  Gemination and fusion look very similar.  Sometimes the only way to tell them apart is to count the number of teeth.

When you count the fused teeth as one tooth, the person will be missing one tooth.

How Common Are Double Teeth?

Tooth Gemination
The same boy pictured above, a year or so later.  This boy has gemination. He has all four upper incisors including the double tooth. If he only had three upper incisors including the double tooth, it would be fusion.

Gemination and fusion have been reported to occur in the baby teeth in anywhere from 0.5% to 2.5% of Caucasian children.  It is more common in Asian children, where it has been reported to occur sometimes in excess of 5% of Asian kids.

Gemination and fusion occur most commonly in the upper front teeth.  However, it can also occur on the lower teeth as well.  As a general rule, if a double tooth is located in the upper teeth, it is probably gemination and if the double tooth is found in the lower teeth, then it is probably fusion.

Above and to the right, you can see the same boy’s twinned tooth now that he has gotten a little older.

Can Gemination and Fusion Happen with Permanent Teeth, Too?

Gemination and fusion do occur in permanent teeth, although it is not nearly as common as in baby teeth.  It reportedly occurs in one out of every 250 people.

Can Gemination and Fusion Cause Any Problems?

Gemination and fusion in the baby teeth can cause crowding, atypical spacing between the teeth, and can cause problems with or delay the eruption of the permanent teeth underneath.

Because of this, when a double tooth is found, you should have your dentist monitor the permanent teeth underneath it to ensure that they come in normal.  Sometimes, your dentist will have to remove the double tooth in order to allow the permanent tooth to erupt normally.

Rarely, there are no permanent teeth located under fused double teeth.  Your dentist will be able to provide more information about the permanent teeth through a simple x-ray.

One thing to watch out for is the propensity for fused and geminated teeth to have deep grooves between the “two” teeth.  This groove can be very susceptible to developing cavities as it is hard to get a toothbrush all the way down in the crevice to clean it properly.  You may want your dentist to put a sealant in this groove to help prevent a cavity.

How Are Gemination and Fusion Treated?

Sometimes, your dentist will be able to shave down and smooth the double tooth so that it doesn’t appear very obvious to the casual observer.  I say sometimes because the anatomy of twinned teeth can be complex.  If the pulp (click here to learn about the different layers of the tooth) is too close to the surface, then the dentist won’t be able to shave down very much of the surface.

Very rarely, the dentist may be able to surgically divide the teeth.  This often works best with fusion because both teeth usually have their own separate pulp chambers and root systems.  In any case, when surgically dividing the teeth, both teeth will need to have root canal treatment performed on them, which can end up being quite costly.

When Rachel gave me permission to use the photos of her son, she told me the following:

In case you’re curious – no one really notices it at all, even though it was obvious to me that we’d be constantly bombarded with questions about it. Maybe when he’s a little older (he’s almost 2-1/2 now).

Since kids will most likely lose all of their front teeth by the time they’re 9, you may elect to do nothing about the double tooth unless it’s a huge cosmetic concern.  Shannon W, one of the commenters on Rachel’s original post said to just “enjoy it’s cuteness”…and that may very well be sound advice!

Conclusion & Further Reading

For the record, I got my facts (the statistics) about gemination and fusion from this book: Oral and Maxillofacial Pathology by Neville.  If you want to read more on double teeth, that book is an excellent source.

Do you have any questions or comments about double teeth?  Do you or your child have double teeth?  If so, what did you do, if anything, to treat it?

Please share your experiences in the comments section below, so we can all learn from them.  Thanks for reading!

Updated Photos

Here’s a photo that Rachel recently shared with me showing her son with the double tooth still doing well a few years later!

Double Tooth

And a closeup of the double tooth:

Double Tooth Closeup

Extra Pictures of Tooth Twinning

Here’s an image of Deb’s son showing:

Gemination Tooth Twinning

You can read about his experience in this comment and this follow-up comment below.

If you would like to submit photos of twinned teeth, you can use this comment form or send me an email OralAnswers[at]gmail[dot]com.  Thanks!

I want to thank Rachel Inbar for allowing me to use two pictures of her son with a “double tooth” for this article.  Rachel runs a fertility blog and allows couples to share their fertility stories online.


  1. My daughter had a double tooth, till today. She is now 8 years old. The tooth was not the front tooth but the one right next to it(top). Our pediatric dentist chose to split the tooth where the grove was and then cover it with a what he described as a veneer, to prevent decay.The tooth fell out and we expect a normal tooth to follow. During the last set of x-rays he saw only one tooth coming in. She never had any problems with it! We called it her special tooth!

    very accurate explanation

    • Hi Katherine – Thanks for sharing your daughter’s story! That groove is one of the biggest problems with “double teeth.” The best way to manage it is to try to prevent decay, just like your dentist did.

      That’s great that you made it a positive experience for your child by calling it her special tooth, I’m sure that helped her to be more comfortable with it. I’m glad everything worked out with the permanent tooth underneath that one.

        • Without taking extra steps to prevent decay, it will build up quickly due to the very tight crevice between the teeth that traps decay in there. It will begin to eat away at the teeth very quickly.

  2. Hi thanks so much for this very useful and clear explanation. My daughter has a double front tooth which I now know is probably germinated. It was great to see the pics of the little boy as my daughter looks almost the same and no other parents seem to have seen or heard of it! My little girl has a genetic form of cancer and so this seemed so trivial we never really asked about it but since she has been in remission I asked the dentist about it and got very little info. She simple said obviously she couldn’t do anything about it now and sometimes the adult tooth can be the same which worried me. Is this the case?

    Due to my daughters condition we’re reluctant to have any unnecessary X-rays. Would having an X-ray to see what will come behind have any benefit? She is 2 and 1/2 years by the way. And the other mum is right. No one ever notices unless you point it out. Having been through everything she has this really doesn’t seem a biggie but I’d hate her to have more problems as the adult teeth come.

    Thanks again for the article.

    • Anna,
      I’m the mom of the little boy in the picture. Since my sister-in-law is a dentist and was able to “diagnose” him over the phone, we never even took him to a dentist. I wouldn’t bother with an x-ray – I don’t know what they can see now, but even if the permanent tooth is also geminated (which I understand is fairly rare) there’s nothing you can do about it…

      We also (like Katherine) call Yirmi’s tooth his “special tooth” and brush it extra carefully.

      Wishing your daughter good health. May a geminated tooth be the worst of your problems 🙂


      • Hi Rachael, my one year old daughter appears to have a germinated tooth, which looks very similar and is in the same position as your sons. I was wondering if you could give an update as to how things have gone for your son and whether his permanent teeth were affected too.

        • Hi,

          My son is now 8-1/2. His geminated tooth fell out on its own (with no decay) and his permanent tooth came in normally 🙂

          Good luck!

      • My 6 year old has had an x ray for his infused tooth. The x ray has shown that he has no tooth underneath to come through.
        So now the plan is that when it comes out, we will need to be prepared for him to have something in place to fill the gap. So in our instance, the x ray was helpful.

    • Thanks for your question Anna, and thanks for the great answer, Rachel! Nothing beats hearing from a mom whose child’s teeth are also geminated/fused.

      It may be comforting to know that it is even more rare for a permanent tooth/teeth to be geminated/fused. The x-ray would let you know if it’s occurring in the permanent tooth, but as Rachel said, there’s really not much you can do about it right now if it is.

      I’m glad your daughter’s cancer is in remission. I hope everything works out great for her!

  3. I just went to the dentist for my one year old and found out that the “cute giant” teeth, on my daughters bottom mouth, are twin teeth. We didn’t give it much thought since we are so occupied with our 3 year old son who got diagnosed with Intractible Epilepsy recently. We left the dentist sooo worried because the dentist said it like it wasn’t a big deal, but didn’t explain either. This article helped me let go of that worry and panic I felt coming on for my daughter. Thank you so much for the information.


    • Glad I could help, Silvia. Thank you for your comment – comments like yours inspire me to keep writing!

      I wish you luck caring for your son, it sounds like you’ve got a lot on your plate. Have a great day!

  4. Thanks for this post! My son had three teeth erupt at the same time last week–or so I thought. Two of the three are not in far enough to tell, but it looks like they may actually be one geminated tooth. Currently, it looks as though the top front right tooth and its neighbor are growing in smaller and closer together than the left two teeth. However, today I thought I saw by the gums that they may be connected. Thanks to your article, and the responses, I won’t be caught off guard if it turns out to be geminated.

  5. My 3 year old daughter has double teeth that are fused and look exactly like Rachel’s son. She went to the dentist for the first time today and sadly, she has the rarity of not having a second permanent tooth underneath. She’ll only have her front tooth and then her canine. Obviously we’ll have to wait it out but our dentist suggested that we begin thinking of which options we’d like to consider – one would be to keep a space there until she’s in her mid teens and could have a tooth implanted (which will be costly) or let her canine be next to her front tooth and allow the other teeth to spread out. I’ll probably opt for the first option so she’ll have a normal smile and her teeth are aligned properly. I always assumed that she had all of her permanent teeth so I’m disheartened to learn that this isn’t the case. No one notices her baby teeth now but in life, not having a ‘front’ish tooth is a big deal. At least there should be cosmetic options. Thanks for the article!

    • Thanks for your comment, Mia. It’s always good to think about the future and trying to make her permanent teeth look as good as they can. I hope everything goes well for her!

  6. I am so happy to find this. My daughters doctor doesn’t believe me that her front bottom teeth are supposed to be two teeth but they are fused together. No one else I have talked to gets it either but both of her bottom front teeth I believe to be four in total. Is it odd that both of her bottom front teeth would do this? I am just waiting for her incisors to come in so I can show the doctor. Not that there is anything they can do about it but I was just hoping they could help me find out more about it. I haven’t searched for anything about it since before this was put up but I am glad I searched again.

    • Hi Jade – I’m glad the article helped. You can thank Rachel for the great pictures.

      I’m not sure whether you’re saying that your daughter’s front “two” bottom teeth are the ones that are fused together and you’re waiting for the two lateral incisors next to those “two” central teeth to come in. Or, have all “four” lower incisors come in and you’re saying that both appear fused so there are only two separate teeth?

      I couldn’t find any statistics regarding multiple fusions of teeth in children. I would suspect that if there are two teeth that have fused, then the probability of having two other fused teeth goes up, but I can’t find any scientific literature to back this up.

      Your best bet is probably to simply take your daughter in to a pediatric dentist for evaluation. The American Academy of Pediatric Dentistry does recommend that a child visit the dentist by the time they turn 1 or within 6 months of getting their first tooth (whichever comes first.)

      I hope that helps. Thanks for your comment!

      • My daughter apparently has two pairs of fused teeth on the bottom front, or so the dentist told us today. In other words, her 4 lower front teeth are fused into two “double” teeth. On her first visit (at age 2), the dentist just noted that they were extremely tight (can’t even get floss between them), but today (6 months later) they said they were fused. They got kind of excited because they don’t see it very often, especially two at once.

        • My son has the same problem and he is 1.5 yo now. I’m so worried because the dentist said he has never seen this before. The only thing we can do is to wait until he’s bigger and go to check again 🙁

    • I have a 7 year old that had a bad injury to his mouth when he was 4. The denist told us that his tooth was dead. We would not know if there would be any injurys to the permanate teeth until they came in. Well he has lost one front top tooth and the adult one seems to be coming in ok. But the other front tooth (the dead one) is coming through and the baby tooth is attatched to the adult tooth. Is this the same thing going on as these babies are experiencing?

      • Hi Christine – I haven’t ever heard of baby teeth getting knocked into the permanent tooth and then fusing together. If that is what looks like is going on, then it would probably not be the same thing that I mentioned in this article.

        Only a dental professional who can examine your son to let you know what is going on with the tooth. I wish I could be of more help – I hope that helped somewhat. Thanks for your comment, Christine!

  7. This is interesting! We visited at dentist today, and she told that our 11 months old son has a double teeth, looking totally same as boy has in the photos (Thank you to Rachel too)! I haven’t ever heard about this, and I was worried about what does that means! We are living in Finland, Northern Europe, and I didn’t found any good Finnish web site about this kind of thing at all, and after seeking I searched by international web sites and I found your article, so thanks your information and photos! Now we know more and we don’t have to worry anymore, that seems to be just “a special teeth” with little little cosmetic concern. We hope that after this double teeth he is going to get normal teeth, but we have to wait many years to see what’s happen. I am so curious to know more what is the main reason, why this has happened, is it just genetic, so I have to get that book you recommended as soon as possible to read.

    • Hi Milka – Thanks for leaving a comment! I love learning that something I wrote has helped people learn more about dental health. Hopefully your son has perfect teeth waiting to come up underneath his double tooth.

      We’re not exactly sure why people get double teeth, but we know that it’s because two developing teeth have grown together or one has incompletely divided into two teeth. It is more common in certain families, leading researchers to believe that there is a genetic component.

      The oral pathology book is expensive, and it’s probably more than you need. I believe it only has a couple of pages out of 1000 that talk about gemination and fusion. If I were you, I would probably save my money and just search the internet and talk to my dentist about it.

      I hope that helps! Thanks for your comment, Milka!

  8. Checking this site to see if any parents left comments of problems due to gemination. My son who is now three has gemination of his 2 front teeth (so it looks like 4) anyway the split in his teeth eventually seperated due to decay. Cleaning behind the teeth way very difficult because there was a deep v shape. We have since seen a pediatric dentist who will be removing his 2 front teeth this week. We have been putting this off for sometime now but no longer can due to pain in his mouth. He will be having this done in the hospital and we are definatly not looking forward to this. Praying All goes well and his Adult teeth will be normal.

    • Hi Wendi – Thanks for sharing your son’s story with us! I hope everything goes well at the hospital and that two beautiful front teeth eventually poke through to give him a great smile. Have a great day!

  9. My son 7 years old has the two permanent central bottom teeth geminated. Both have a V-shape groove in the middle and one of them has the root larger than the other and the pulp at the top is dividend into the to part of the tooh (sorry for my english but it is not my mothe tongue). The dentist I let him visit wants to wait further 6-7 month before to undertake something, because they are not completely erupted yet. Furthermore these two theet are distant from one another and the lateral upper incisors are not yet errupted. I would like to have your opinion about the fact thet they are permanent theeth and what is usually done in this case. Do you thinc that also in case of permanent theet the cause is genetic?
    They are very evident when my son lought, so appart from the “medical aspect”, I’m also worried about “social” aspect.
    Thank you for your opinion. Sofia

    • Hi Sofia – Since the teeth are so far apart, are you sure it’s gemination? It could be that the four bottom teeth “fused” into two bottom teeth. In either case, since we are dealing with permanent teeth, it would probably be a good idea to get something done at least with the groove so that it doesn’t get a cavity.

      My pediatric dentistry book says this about treatment options for gemination and fusion: “Fusion and gemination in the permanent dentition are…difficult to treat and should also be referred to a specialist. It is possible in some cases to divide fused permanent teeth, move one or both of the resulting teeth into good position and then restore the remaining tooth or teeth. It is quite possible that endodontic treatment will be required for the resulting teeth.”

      Another treatment option that I have heard of is having the tooth re-shaped at the dental office to make it appear more natural.

      As for the genetic aspect, I think that genes do play a role in fusion and gemination, but they are certainly not a determining factor. Sometimes things happen by chance and we just don’t have an explanation for them.

      Thanks for your comment, Sofia!

      • Thank you for your reply. Yes, we are sure it is a gemination, because we have counted the teeth in the x-ray picture and each of them can be counted as one teeth.


        • Thanks for the update, Sofia. Since it’s gemination, hopefully the teeth can be re-contoured so they appear to be a more normal size. If you take your son to a pediatric dentist, they will be able to give you more specific treatment options for your son’s teeth. Good luck!

  10. Hi!

    My 8 year old son has what appears to be a germinated permanent front tooth coming in . . . sideways of all things. The corner is pointing down. At first it looked like two teeth, one coming in overlapping the other but the orthodontist thinks it looks like one tooth. He was not able to get floss in between them. We are off to have x-rays done to see if there is one or two roots. We are hoping it is not fused together which means he only has an extra tooth which needs to be removed, if it is only one tooth . . . I am not sure what the options are as he rarely has seen this. Should I seek an orthodontist who has seen more cases of this? Is an orthodontist the best option for this or is there another specialist for this? My son really wants help because he is getting teased at school.

    Thanks for any help.

    • Hi Deb – Hopefully the x-rays turn out well and you find out that they’re not fused together. A pediatric dentist usually has the most training in geminated and fused teeth. If it is an extra tooth, then it can probably be removed without any problems. If it isn’t an extra tooth, then the pediatric dentist will be able to examine your son and let you know what treatment option is best. Sometimes they can re-shape the teeth to make it appear more like a normal tooth. Also, if there is a groove, that would make the tooth more susceptible to a cavity and the dentist could fill that in.

      I hope that helps. If you have any other questions, let me know. Thanks for your comment, Deb!

    • Hi,
      Just an update on my son who is now 11. He does have a top, front geminated tooth with one root. We are seeing specialist in Toronto about an hour and a half drive from our home. No one in our region could help him and according to his specialist, it really is a rare case.

      The tooth is really large and the poor boy can hardly close his mouth. It looks like the only option is extracting that tooth and putting in an implant.

      • Hi Deb – Thanks for the update after nearly three years! Hopefully they get everything taken care of and the implant looks great – I hope everything goes well!

          • Hi Deb,
            I am so grateful for your sharing of your sons story! My eight yr old is just about to go through the same by the sound of thing. The X-ray and information to start are identical. I would love to see any photos or if you have any advice. cheers Donnamarie

            • Hi my son is now 14 and the tooth was extracted a year ago after much deliberation by a highly skilled team at Holland Bloorview children’s hospital in Toronto. They tried hard to come up with a solution to save part of the tooth, then talked about about doing an implantation of a premolar, to finally deciding it was best removed completely. That was one huge tooth that impressed the dental team at his extraction. He was fitted with a tooth on a retainer which is in his mouth even with braces and will remain there until he is old enough for his implant at 18 years of age (when he’s done growing). I hope sharing our process will help someone else. 🙂

      • Hello,
        My 10 year old has a front permanent “megadent”.
        He was 6 when his adult front teeth started to come through with the left coming through as 2 fused teeth in the shape of a w. Our dentist was able to cosmetically reshape with filler which has been fine so far. However as the tooth shares a root it cannot be split and will have to be taken out next year . I know it will be a huge gap and he will have to have a false tooth on a plate for a few years. I am hoping he does not lose too much jaw bone as when he is older I hope he will be able to have an implant.
        He also has an ectopic super numerate extra tooth behind the big tooth and a unerupted canine stuck near his nasal passage which shows no sign of descending and the dentist does not think a chain could be used to pull it down. It is comforting to hear that others have these issues.

  11. My 15 year old had this with his baby teeth on the upper left side. We didn’t do anything about it. If fell out when he was 7ish but was only replaced by one tooth – the left central incisor. He is missing his left lateral incisor.

    • Hi Cate – Thanks for sharing your experience with this. The upper lateral incisors are some of the most common congenitally missing teeth. That makes me wonder if missing lateral incisors are more common in people who have fusion or gemination on their upper incisors.

  12. I just found out today that my 8mo old son has fused teeth of the lower right incisors. They actually looked like two separate teeth until I peeked at them this morning before his dentist appointment. I noticed that the base of the teeth (which although the tops are quite small compared to the size of his other “normal” teeth, they taper out larger towards the bottom) were so close together it looked like they were touching. Well, my dentist today confirmed that he has either fused teeth or a geminated tooth… I guess we’ll have to wait and count the teeth to find out which, but I think it’s fused based on the fact that the teeth are so spaced apart at the top, they erupted a week apart and look nothing like the picture above – more like a wider than normal tooth that has had a bad run in with something hard that took a big chip out of it!

    Thank you for the clearly written information about this interesting (and cute) anomoly! I will be bookmarking your page to show my husband when he gets home, because you’ve explained it so much better than I could!

    • Hi Stephanie – I’m glad it helped! Thanks for sharing your comment with us. Let us know what happens and if you decide to do anything for it. Thanks for your comment!

    • Hi, Tom,

      My 8 years old daughter has her lower right incisor like fused teeth, whilst she has all of her baby tooth normally grown and few of which retired normal. We took her to dental health center 2 days ago, after taking x-ray, the dentist told me that the numbers are normal and it is normal circumstances in children just growth in different shapes. I am afraid we may miss any possible early treatment to rectify the situation, as such I would like to see if you have other comments on our case. I may send a picture if necessary.

  13. We just returned from the dentist today with the information that my 6 year old son has two, permanent, fused teeth; one has come in completely and the other is starting to come in. X-rays confirmed that that one was also fused. I had wondered about the large size of the tooth and the deep groove in the center, but wasn’t real concerned. At this point, preliminary X-rays show that my son’s front four teeth are still in his jaw and have not emerged yet, which means that both of these fused teeth are also extra teeth. Obviously, orthodontics are in our future! I immediately went online and have appreciated the posts put forth by the other parents. I was also intrigued to know that it is more common in Asian children. Although my son is not Asian, he is Native Alaskan and we have experienced other minor maladies that are more common in Asian children. We are waiting to visit the orthodontist until the second fused tooth has come in, so I will keep you posted on the treatment.

    • Hi Jennifer – Thanks for sharing your experience! My nephew had an extra tooth that ended up needing to get removed, but it wasn’t fused. I imagine those two fused teeth will be a little more difficult to remove. I’m glad he still has four front teeth – that’s not a bad situation to be in! Let us know what ends up happening.

  14. I just found a double molar in our 2 year old. The first one came in nicely about a month ago. It was nicely shaped with the 4 prongs on it but now there are 2 prongs that just popped out to the inside of the roof of her mouth. The front teeth seem to be a common thing, but are double molars common too?

    • Hi Jennifer – While double teeth can happen to any of the teeth, they are much more common in the front teeth (incisors.) If the other two prongs are coming in at a different angle, it might be another tooth, or the double tooth could be mis-shaped. Let your child’s dentist know and they’ll be able to let you know what the best way to treat it is. Thanks for your comment!

  15. Hi Tom,

    I am hoping you can help me. Do you know if it is a genetic disorder that causes germination or fusion. My 2 year old daughter was born with a fistual (anteriorly displaced anus) instead of a proper anus. She had surgery when 7 months old to correct it. She has also had VSD (two small holes) which have corrected itself on its own. Once her teeth started coming in I noticed she has germination/fusion on her lower tooth. Because of her initial genetic disorders do you think the odds are higher that she will have this with her adult teeth as well? This is not common in the family.

    Right now it appears they do not cause her any harm.

    • Hi Jackie – I looked in two different oral pathology books, but couldn’t find a clear-cut answer for you.

      I can tell you that gemination and fusion do occur LESS in permanent teeth than in baby teeth, so it is less likely that your daughter will have this in her permanent teeth.

      From what we learned in my dental genetics class, there are many different genes that are involved in the formation of teeth. My guess is that there is some genetic involvement. Some researchers believe that trauma to the teeth while they are developing can also cause gemination/fusion.

      I wish I could be of more help, but there’s a lot about the interactions between genes and tooth development that we just don’t know yet. My dental school is one of the leading dental schools when it comes to craniofacial genetic research, so hopefully we’ll continue to gain more knowledge about tooth development.

      Thanks for your comment, Jackie! Let me know if you have any other questions.

  16. I’m so glad I came across this website! At first it appeared that my daughter was cutting her left canine before the left lateral incisor. But now it appears she may have a fused incisor and canine, because she recently started cutting what looks like another canine on the same side? Her doctor said not to worry just up her first dental visit to 2yrs instead of 3yrs. The only problem is that the “extra” canine seems to be sitting very low! And sometimes it seems like if she bites down a certain way its uncomfortable?! We will most likely take her in early!

    • I would be more than happy to post a photo! Just not sure how? If its possible and would help please let me know! ~ Sherri

    • Hi Sherri – The American Academy of Pediatric Dentistry actually recommends that a child visit the dentist by the time they turn one year old! You can read more here about what happens at the first dental visit. As far as the tooth goes, it could be fused – your child’s dentist will be able to let you know for sure. If she is in pain, the tooth may be able to be re-contoured to help get her out of pain.

      I hope that helps – Let me know if you have any other questions, Sherri. Thanks for your comment!

  17. i have a five year old that has a fused tooth on top just like the one in the picture. he has lost the front tooth next to it and his two bootom teeth and now the tooth next to his bootom teeth has come out but the fused teeth have not become loose at all. im wondering why that is?

    • Hi Patty – Fused teeth can sometimes stick around in the mouth for a longer time than they should. Your dentist can take an x-ray of the tooth to see if the permanent tooth is coming in normally and to find out if the roots of the fused tooth are dissolving as they should. Sometimes it is necessary for fused teeth to be taken out by the dentist so that the permanent teeth can come in normally.

      I hope that helps, Patty. Let me know if you have any other questions. Thanks for your comment!

  18. My son has what looks exactly like this!! I have been trying to search for more pictures and examples but cant find any. I am curious to what the tooth will look like when he is older.

    • Hi Tiffany – If it is a permanent tooth, your son’s dentist can smooth it out and give you some options on how to modify its appearance if that’s what you want to have done. If the tooth gets a cavity along the junction of the two teeth and needs to get pulled, an implant would be an option to replace it.

      I wish I had more pictures of it to share – maybe when I get into private practice and start seeing a lot of patients I’ll find some! If any one has any pictures that you wouldn’t mind me posting here, feel free to send to me via email:
      I hope that helps – let me know if you have any other questions. Thanks for your comment, Tiffany!

  19. My daughter had a double tooth on the front top tooth as a baby, she is now 10 and has perfect front adult teeth.

    My 6 year old son however has his adult top right tooth coming through which looks to be like THREE teeth infused into one. I am worried that as this is ‘cosmetic’ our denstist will not treat him. Could this cause future minor speach defects ???



    • Hi Tanya – I haven’t heard of three teeth being fused into one, but I’m sure it’s possible. However, from what you describe, it sounds like your son may just have very prominent mamelons on his front teeth. You can take a look at this article describing mamelons and this article with more pictures of mamelons to be sure.

      Fusion and gemination aren’t just cosmetic. Sometimes the groove where the teeth connect needs to be filled in to prevent a cavity from forming. There are also ways to smooth out the tooth and make it appear smaller.

      As for the speech defects, I’m not exactly sure. My guess is that if your son has already learned to speak well at age six, then I would assume that everything would be fine (but that’s not my area of expertise!) I hope that helped, Tanya. Let me know if you have any other questions. Thanks for your comment, Tanya!

  20. My dentist wants to remove my 7yr old son’s fused permanent bottom tooth. He said it is usually a no no but is very difficult to fix and won’t be too noticable as others will take its place when he puts braces on him in the fututre. The dentist also said that some other teeth coming through had only a little room so this would help them too.
    I never noticed the fusion as all of his teeth came through normally and we had thought that his bottom tooth had turned sideways when the one next to it came through. But the dentist tells me it is one tooth. How can happen, it was a normal bottom tooth all by its self now suddenly its part of the next? Wouldn\t it come through like this?

    • Hi Haley – Sometimes the teeth do need to be removed. If there isn’t any decay, then sometimes they can be kept.

      Is it a fused tooth (two teeth stuck together) or a geminated tooth (one tooth that split into two)? If it is a fused tooth and it is removed, your son will be left with only two mandibular incisors.

      After reading the last part of your comment, it makes me wonder whether or not it is a fused tooth. The teeth fuse as they are developing, so it would not be possible for it to be a normal tooth and then become a fused tooth.

      I hope that helps. A second opinion may be a good idea considering that there’s no going back after the tooth is extracted.

      Let me know if you have any other questions. Thanks for your comment!

  21. Great page Tom. Super helpful, thanks.
    My 3-year-old daughter has fusion of her bottom right incisors. I read another comment about the genetics of fused/germinated teeth and was wondering along that same line. I have 4 other children who have always been extremely healthy (no ear infections, no strep. throat). Well, my 3-year-old has had it all, RSV/bronchiolitis, a ruptured eardrum from otitis media, strep. throat, & some skin bumps/tags that nobody is sure about. I was just wondering if you’ve found anything out about if these teeth are related to an immunodeficiency or any other defect.
    Could it have anything to do with high doses of thyroid or antidepressants during pregnancy?

    • Hi Matt – I haven’t heard of gemination/fusion being related to an immunodeficiency or other condition. The problem with a lot of these different conditions is that there simply isn’t a lot of research money to back lots of studies looking into the relationships between gemination/fusion and other problems.

      I think there definitely is a lot that we will uncover in the future, but right now the answers just aren’t clear. I wish I could be of more help. Let me know if you find out anything. Thanks for your comment, Matt!

    • Hi Tom,

      I have a question about allowing the twin tooth to naturally come out. I like so many others hadn’t noticed the “twin” immediately. When we noticed, we asked the dentist to check it out. We took an x-ray and confirmed it was a one tooth root. At first he told us it would interfere with growth and that we might consider extraction. However on another visit he shared that when you remove it before it is ready it does a disservice to the adult tooth that’s underneath. The baby tooth has a purpose in staying until the adult tooth is ready. Maybe it gives some resistance or stress and thus allows the adult tooth to adequately begin to grow.

      All of that said, tonight the tooth came out with a lot of twists, biting into hard food, etc. The odd thing there was a big chunk of her gum that seemed to be on the tooth. Once it came out, there was no “gum” on the tooth but it seemed to be half hanging half not from the inside gum. We had her gargle with salt water but there’s a funny look and looseness to her gum where the tooth fell out. Can you address this issue?

      • Hi Jodi – Since it was a larger tooth (causing a large hole when it was lost), my guess is that the gums will just need some extra time to heal. Since I’ve never dealt with this issue clinically, I really can’t share much from experience.

        I hope that helps – Thanks for your comment, Jodi. Let me know if you have any other questions.

  22. Hi, I have a friend whose son has this anomaly (he’s one) on the tooth next to one of his front bottom teeth. Since he doesn’t have many other teeth yet we don’t know if it’s geminated or fused. But I wanted to chime in on the genetics thing since so many on here have mentioned serious genetic disease in the family of those with the fused tooth (genetic cancer, epilepsy, etc) and since my friend’s son also has a very serious genetic syndrome (unknown at this time which one). Anyway I’m guessing that it will come to light eventually that these “minor” anomalies in most people are signs of genetic defects that could seriously affect siblings or children, depending on the number of cells these defects affect in a given person. I have “minor” anomalies (strabismus, small head, missing permanent tooth (still have a baby tooth), and hypermobility but very few other health problems. So I’ve always assumed my anomalies were kind of unique, “no big deal”, fun factoids to share, etc, nothing more since docs are quick to assure “don’t worry.” However, my son was born with severe special needs – he is nearly blind, has seizures, requires feeding tube, brain malformation, not to mention similar “minor” problems to the ones I mentioned in myself. Genetic testing revealed we are both missing the same 14 genes off a chromosome. Why does it affect him so much more than me? Who knows but the best guess is the deletion occurs in more cells in my son than in me. My other son seems to be affected more than me, but less than my second son, on a spectrum of severity. People who have minor anomalies like these fused teeth with only one or two other ‘oddities,” when it comes time to have kids, may want to get genetic testing (microarray) to see if they are carriers of obvious problems like deletions/duplications/translocations that could have much bigger implications on children than themselves. Just my opinion.

    • Hi Mmmom – Thanks for your comment. Genetic testing can help bring many things to light. On the dental side, there’s not much known about the genetics of teeth since there so many different genes involved and many of the anomalies we see are caused by anomalies in more than one gene.

      • Mmmom, your post prompted me to reply with our story. My son, who turns 8 in 4 weeks, lost his ‘special tooth’ yesterday. He was thrilled as he was sick of his ‘middle tooth’. He stopped smiling with his mouth open when he was 5 yrs old as he was embarassed even then. I consider us a fairly normal family HOWEVER, just like in your post, both my sons have hypermobile joints (the older one has DAMP syndrome – ADHD and developmental coordination delay), my husband at 39 still has a baby tooth in his lower jaw with the adult tooth behind it and the list of conditions wrong with my sisters son is incredible (arthrogriposis mulitplex congenita, blindness, epilepsy, has a pacemaker, severe intellectual disability). I always say I will ensure that when my oldest son marries, that his partner is well aware of the possibility their children will have ‘issues’. My younger son – the one who up til yesterday had the special tooth – doesnt have any other issues that we’re aware of but it will be interesting to see what develops in HIS children.

        By the way, the tooth fairy was very generous with this special gift. Our boys normally get $1 for a tooth but since this one was such a special tooth, the tooth fairy left $5 and she even left the tooth for me to keep in my son’s baby box – wasn’t that lovely of her?

  23. Thanks for this info … I have a cutie pie 18 months who has twin teeth :). It’s actually not so noticable only when you pick up her upper lip :). I will take her to get them looked at may to get a sealant on it !!! My kids all have there own tooth stories … By far I am loving my daughters cutie twins … !!!

  24. Wanted to get your thoughts on my 8 year old. She has 2 permanent teeth fused together. The roots are also fused and very large. It is causing crowding and for the mid-line to be off. What are your thoughts about removing and do you know of any way to prevent bone loss until she is old enough for an implant? We have tried having tooth shaved on the sides but does not help with crowding due to the roots.

    • I was so glad to finally read a comment that related to my situation more aptly. I have commented before about my 7 year old who also has two fused permanent teeth (actually, four). Hi fused teeth also have the fused roots. We have had an orthodontics visit and he has some of the same issues with obvious overcrowding that Amber’s daughter has. However, the first orthodontist did not recommend removal or implants. Instead, he wants to go with an expansion to make more room on the top for his teeth that have not come in yet. He also recommended some braces for a crossbite. He indicated no need to pull the teeth and just suggested that his very large teeth will not appear as large as he grows. If, in the future, my son isn’t happy with the teeth, then I’m sure implants might be an option, or some of the filing or reshaping. We are actually going to get a second orthodontic opinion, just to be certain, so I will let Amber and your other readers know if anything comes up different. Fortunately, at this age, my son is thrilled to have teeth that resemble SpongeBob’s . Sadly, I know that will probably change.

      • Thanks for sharing, Jennifer! I don’t have much experience in this area, so I’m glad you chimed in. Keep us updated on what goes on with your son. Thanks again!

    • Hi Amber – Depending on how self-conscious the tooth makes your daughter, you may want to have her hold on to it for as long as she can. As for the crowding, if it’s two teeth that are fused, then it would seem that it’s taking up less space than two regular tooth would. If there is still crowding with fusion, it could be an issue with the size of the jaw bone, which can be corrected at her age with braces. It does sound like a complex case – I don’t have much experience with that at this point. Good luck getting it figured out! I wish I could be of more help – let me know if you have any other questions. Thanks for your comment, Amber!

  25. I have an almost 13 month old daughter and she has two geminated teeth , one on each side of the front top teeth. One isn’t as bad as the other. One looks like it is already splitting in half. She has already been to a dentist and they have confirmed that it is gemination and not fusion. They will monitor her every six months. Any information or precautions or advice would be greatly appreciated. Thanks in advance

  26. My son will be 4 in 3 months. Since the day his front tooth poked through the gums I know it wasn’t right. I started calling dentists when he was just a year old but could not find one that would see children under 3 even though I described the situation. I finally found a dentist to see him a few months before his 3rd birthday. After a visual exam he informed me that there was a small cavity in the groove on the back of the tooth that needed to be treated as soon as possible but that he was not equipped to treat a child that young in his office and referred me to a pediatric dentist about an hour away. I called the dentist and explained the situation and was told that the earliest appointment I could get was 7 months away. I’ve got a 3 year old with a cavity and the only pediatric dentist won’t even see him. You can imagine the frustration. I did find a local dentist who was supposed to be “very good with children” to see him. After x-rays and a visual examine they determined that he had an extra tooth ( As if that wasn’t already obvious.) but did nothing else. Shortly after that my son started to complain that his tooth was hurting and made another appointment with the last dentist. After another visual exam they referred me back to the Pediatric dentist who couldn’t see him for 7 months, only this time I told that that his was complaining about being in pain and got an appointment in 2 days. That appointment was yesterday. The diagnosis… my sons tooth is so far decayed that he needs either a double root canal or an extraction. They also told me that they see children as young as 6 months, which is odd since it takes 7 months to get an appointment for a child with a real dental issue. In either case I wish I had heard of this dentist sooner. Can anyone please give me some advice as to what to do for my son. I do not want him to be in pain but how do I decide between a root canal or an extraction as his age. Any advice is appreciated.

  27. We took my son to the dentist today and he is 6 years old. The dentist told us he only has 2 of his permanent lower front teeth and they are “big”. She told my husband that cosmetic dentistry is available when he gets older. What happens to that space? Are the “big” teeth double? They have not broke through yet and actually he hasn’t lost any baby teeth yet.

  28. I had a fused tooth on the bottom as a child and when it fell out nothing came up in it’s place. Now my oldest son also has one and it just fell out last week and there was a permanent underneath! What’s interesting is he also has another one up top and I’ll be curious to see if anything is underneath that too.

    My mother never treated my tooth any different and I haven’t treated my son’s special in any way either other than to keep it well brushed along with his other teeth. I wonder how common it is to pass on this kind of tooth on, genetically speaking, and also how common it is for a child to have two of them?

  29. My daughter had her fused tooth pulled when she was 4 yrs old-it was the top right canine tooth and the fused tooth was an extra that was sideways. I was originally told that it needed a filling but when that appointment came around they told me that it had to be pulled because of decay. The told me the adult tooth should come back around 5-7 yrs old. She is now 8 and still doesn’t have a tooth there. I have asked her dentist, even taken her to 2 other dentist and never seem to get a clear answer on when the tooth will come back. I seem to just get “everything looks fine”. How long should it take before this tooth comes back? The last dentist did XRays and said she doesn’t see the tooth well enough yet to see if it is fused or not so I am assuming that there is an adult tooth there.

  30. My ten year old son still has a fused tooth (first/primary tooth) at the front. We were advised by our dentist to leave it alone and wait for it to come out naturally which we have done. It is now wobbly and I expect it to come out by the end of the week. With regards to why he has it- it is interesting to see the comments regarding genetics above- I had never even thought of that as I had always presumed it was due to me getting a very bad case of flu in the first three months of pregnancy. I had a very high temperature for a number of days which the doctors tried to control with paracetamol. I remember looking in my ‘what to expect’ book at the time and it said this was the time that the teeth were developing. When his teeth first started coming though and I noticed he had a double tooth at the front, I immediately presumed it was due to the high temperature- but perhaps not?

  31. My daughter who is 6 next month has a fused lower tooth. Her adult tooth has actually come up behind it a few weeks ago and the baby fused tooth has not come out. It is slightly wobbly, but it doesn’t seem to get anywhere near falling out.

    I don’t see a second tooth coming up, so I assume she has another fused tooth. Would that be right? I wasn’t sure whether to leave it to see if it falls out or take her to see the dentist. My daughter on the other hand is quite delighted to still have her ‘special’ tooth! She loves it when our dentist has all the dental nurses and students having a look at it.

    Glad I found your site, it is so helpful.

    • Since my last post we eventually got a review appointment with the dentist today as the baby tooth wasn’t budging. The dentist extracted it and no wonder it wouldn’t wobble out – the baby tooth had a huge root like I’ve never seen on a baby tooth before. Wish everyone had a dentist like her as she is amazing with little ones and my daughter had no idea she had had an injection!. Only problem tonight is that the disolving gauze/packing is starting to fall out and I’m not sure what to do about it 🙁

      • Well… I am the mother of five-and-a-half year old twins, both girls. One of my daughters has one set of fused teeth on her bottom, just left of center; my other daughter, who also has dentinogenesis imperfecta, has fused teeth (also bottom), on each side of her bottom front teeth.
        Both girls have permanent teeth coming in, several a little early, and they took full pan x-rays on each girl’s mouth at their last appointment. Sooo…my daughter who has only one set of fused baby teeth ALSO, as it turns out, has the exact same two permanent teeth, still underneath her gums, fused together. My other daughter, with dentinogenesis imperfecta, and with two sets of fused baby teeth, is MISSING a permanent tooth, under each fused set–the ones that are supposed to be to the immedIate left and right of bottom center. They’re just not there, apparently, and never will be.
        I’ve never done anything special about the fused teeth, other than taking extra special care in cleaning them. I imagine it will be the same as their permanent teeth. There’s nothing I can do to change anything, other than take everything as it comes, and keep them as healthy as possible.

  32. Grrrr! I wish I would have known what my son had sooneer! I was told not to worry about it. Just found the website today and today he had his tooth extracted because of the decay that took place! We brush every day and he doesn’t have that much sugar-kind of frustrating to say the least! I will definately advise anyone else I know to take action soon after it comes in so our situation doesn’t happen to anyone else.

    Thanks for the helpful information!

    • Hi Sharon,
      I feel your pain! My little guy is 2 1/2 and we have just discovered that he has quite a bit of decay between his two fused teeth. I never thought much about the teeth and figured they would straighten out. We are trying to decide between extracting the two or having the dentist try to clean cavity and cap teeth. Any thoughts? The thought of putting him under IV sedation just to try and save the teeth is a little scary, not to mention it’s a pricey procedure…


  33. My daughter has a double tooth at the bottom. She is African American. Weird after reading your article that African American’s aren’t listed as having this occur.Her cousin also has this same tooth in the same location. Talked to the dentist and he said that there are no issues with it and as long as it only had one root which it does that when it falls out the tooth should be normal.

  34. The pedicatrician informed me that my daughter had a ‘bifid tooth’ when we were at her 12 month check-up. She didn’t seem to act like it was a big deal, but I immediately began to worry. I was initially only able to find academic articles on the internet which resulted in my being more worried than before I started to research. Thank you so much for creating this site and providing information that is user friendly. I feel much better after reading your information!

  35. Thank you so much for posting this very clear explanation of gemination/ fusion with teeth. My one year old son’s tooth picture looks identical to this child’s here. It’s comforting to see that this is somewhat common. Thanks for the article!

  36. my son is now almost 13yrs old,, when he was little his top 2nd right tooth came in as two seperate teeth one was the same shape but smaller then the one on the other side while the other was a small pointed tooth,, the dentist said it had been a tooth that had split,, he lost the teeth at the normal age and when his adult tooth came threw it was larger then his front teeth,, the orthodontist said it was geminated,, from the front it looks like a tooth with a groove going down it but if you look at it from under neath its a T type shape,, anyway he is more then happy to keep his funky tooth it adds to his character and no one seems to notice it…

  37. Hi, my daughter turned 5 in March and her front tooth looks just like the boy in the pictures. Because of insurance reasons we haven’t seen a dentist yet but I watch over the tooth a lot. She also fell and chipped that same tooth and a corner broke off a couple of years ago. Sometimes I think that tooth now looks a little discolored but I’m not sure. Hopefully we go to a dentist soon. Sometimes she acts like she can’t bite into hard cookies or other foods with that side of her mouth and favors the other side for more strong bites.

  38. My son, 5, recently had to have his bottom 4 front teeth removed because there were actually 2 “double teeth.” The adults were coming in behind them and the babies weren’t even loose yet. Now he only has two adult teeth growing in place where there should be four and there will be no others coming in. The two adults have a large space between them. I’m hoping once the babies come out and the adult teeth on either side eventually come in that they will at least somewhat push the two together and look alright.

  39. My 6 year old daughter has a twin tooth just like the picture. When it first came in I worried about her being made fun of as she got older. It has never happened. Her dentist has always reminded her that when she loses that tooth she will get extra money from the tooth fairy because it is special and double. We went for her 6 month cleaning today and when they asked if there were any medical changes since our last visit I told them about us finding out a couple of weeks ago that she has a dermoid cyst/teratoma in her head right behind her ear. She is scheduled for surgery to have it removed in a few weeks. I was curious as to weather it was related to the twin tooth at all since it is a development problem while in the womb. Have any of you experience a dermoid cyst in your child? The hygenist thought it was a possiblity to look into. She said the same stem cell that makes teeth also would cause the dermoid cyst problem.

  40. My son (the one in the pictures, now 4 years old) also has Aplasia Cutis Congenita – with him, it is a triangle-shaped scar that was present at birth (I know because I saw it in the hospital when he was less than a day old). I never considered that the two might be related – and the truth is, it doesn’t really matter if they are – neither are of any significance. At first, I tried ‘hiding’ the scar by leaving his hair longer to cover it, but by now I just don’t care. Let him grow up with the awareness that he has a scar and that it’s no big deal 🙂

  41. im 17 and my teeth are like that..first my two front teeth were normal then it when they fell out it started to grow weirdly,i thought everyone’s teeth were like that lol until my mom said it wasn’t

  42. Thank you so much for this article I really needed this! I have two children my son is 5yrs old and his teeth grew in with a small gap, my daughter who is 15 months old on the other hand has a double tooth and it had me worried because I had never seen nor heard of it and neither has anyone in my family. She oblivious has gemination because she all four front teeth it just that one doubled tooth. I happy find out that this is somewhat common. Once again thank you 🙂

    I wish there was a way for me to be able to post a picture of her tooth

  43. This article is very accurate…my 11 year old son has twin teeth. His are on top, the rare part of the story is he was born with this twin tooth. He had the one he was born with pulled, only to have another one grow in just like it. When he was 2 we had it pulled again b/c the dentist saw another tooth(permanent) behind it. Now that he is 11 he was having severe headaches and it ended up being b/c of the twin tooth. It has ANOTHER tooth behind it. The dentist pulled the tooth beside it to relieve the pressure and h/a but it was a permanent tooth. I am worried b/c my son has severe self esteem issues as all the kids in school pick on him or ask him why his tooth is like that. I hope that the visit to the orthodontist helps…….. thanks again for this info.

  44. Hi I am delighted to find this very helpful site! My son, who will be 1 next week, has what looks like a front tooth that is split in two. I am guessing it is gemination, so a twin tooth, which I reckon is extra special as he is a twin himself! I live in Ireland, and have contacted 3 pediatric dentists, but surprisingly, none of them have called me back with an appointment. When I mention his age, they go very vague and don’t want to see him!! Waiting on one more to call me back so fingers crossed!!

  45. I too have a daughter who is now 6 and has a double tooth. When she was
    About 7 months old is when the tooth started to show out of the gums.When I saw that
    It had two little teeth growing out together,I was so curious as to what had happen for it to be like that.
    So, I thought well she did bump her mouth while she was crawling a couple of weeks before and thought maybe it cracked the tooth as it was forming or growing out..LoL.. But I took her to the dentist and he informed me that she hadn’t cracked it as it was growing but that it was an infused tooth.. Then he tells me that sometimes they may not have a permanent tooth behind it,but that he would let me know from her x rays. Long story short, she is 6 now and the tooth is loose and the X-rays did show that she does have a permanent tooth and we are so excited about it falling out!!! I do have a question:With her baby tooth being infused ,does this mean the permanent one will be infused also?

  46. My 6 year old son has 2 sets of fused teeth 2 on the top and 2 on the bottom. I worked out they were fused rather than germinated due to the number of teeth he has. This morning the fused tooth on the bottom jaw fell out. My worry is that I can only see what looks like one tooth below and I’m worried his adult tooth will also be fused. Can anyone advise what the chances are that it will also be fused? Thank you.

    • Hi Catarina – Your son is more likely to have fused teeth in the permanent teeth if he had them in the baby teeth, but I don’t think the percentage has been determined. Hopefully someone with a child who has gone through this can chime in and share their story with you.

      If you want to be certain, you can go to your son’s dentist and ask to have a panoramic x-ray taken. This x-ray will show all of your son’s permanent teeth that are developing, and you will be able to find out if there is fusion/gemination going on with the permanent teeth. I hope that helps!

    • Hi folks. This is all very interesting. My 6 year old son has 2 fused bottom left incisors. About 3 months ago a raised bump started to form behind and around the fused tooth. I pointed out to our dentist that this could be the adult tooth pushing up and he just said It would be fine and just wait and see. Now last week the tip of the adult tooth erupted quite far behind the fused tooth which is only wobbling slightly. We’re going back to the dentist on Monday so hopefully they will do something about it! Maybe if they remove the fused tooth the new one will get a chance to grow straighter. No idea If the adult tooth will be a fused one or not . We will see. I will keep you posted.

      • Thanks for your comment, Laura! With fused teeth, it may be trickier for the adult tooth to push it out if it’s not fused and your dentist may recommend simply extracting the fused tooth to help the adult teeth come into the mouth in proper alignment.

  47. Hi Catarina,
    Our daughter had the two fused baby teeth. One was actually an extra tooth fused with the one that was supposed to be there. When her permanent teeth came in she had the same two teeth fused together. These teeth were also fused together at the root. However, our dentist referred us to a endodontist and periodontist. The two of them worked together and sectioned the tooth and root. They did a root canal on the part that was left and also a bone graft for where the tooth was taken out. She was 9 and she tolerated this all very well. Our dentist then bonded the tooth to make it look more normal. Our hope is that this tooth can survive this way until she is able to get a permanent implant around age 16. She got braces last month and so far so good.

    Hope this answers any questions for you.

  48. Thank you for sharing this information. My third little girl is 7 months old now and her second tooth (on the bottom) started coming in looking like 2 peg teeth, which concerned me. After they erupted more, I could tell they were connected, so it was actually one tooth. Then a third spike popped up and now it’s out enough that I can see it’s also connected! Are triple teeth as common as double teeth? What causes this? All I could think was that maybe while teething she bit something hard and cracked it. But it’s MUCH wider than one tooth should be. So they’re fused…..that’s so interesting…..I can’t wait until it’s out all the way and I can get a better look!!

  49. Just wanted to give my two cents. I’m an 18 year old guy that has a fused front tooth. Although permanent fused teeth are very rare, if anyone is worried it really is not as big a deal as it might seem at first. I had braces which straightened my teeth out of course and once I had those taken off my teeth looked normal. Only a few people have ever said anything to me about my tooth and those have been people that I am with a lot. The normal person usually does not even notice. I’m my own worst enemy about it but that’s just because I have to look at it every day. I just wanted to say from experience that most people don’t notice it like you might think they would. Best wishes.

    • Hi Taylor,

      Just wondering if you can post a photo. I have a son who has a front tooth that is fused and no one seems to know the best way to “fix” it.

      Many thanks.

    • Hi taylor , my little boy is 7 and has a front fused tooth ive been really worried , especially reading all the comments about it may mean he could have other health issues ! I was happy to read your comment that it hasnt been so bad for you , my son dillon dosent seem bothered at all and as of yet no ones picked on him , i just hope that never happens 🙁 hopfully he can have a veneer when hes older , also his second front tooth is coming in sideways , to make my self feel better i just think theres so many worse things that could happen and dillons teeth will be sorted by the time hes a teenager , kind regards keri

  50. My daughter, 13, has a fused incisor on the upper left. It’s a permanent tooth. I think it is fused as the dentist said root canaling had to be done if she does reshaping of the tooth. There was also overcrowding issue so one option was to remove the fused tooth and get braces to adjust the positions. But there was a symmetry problem and might affect the bite. In the end, dentist choose the least invasive method. She used resin to cosmetically cover the front and back groove of the tooth. She used some special light to bond the resin to the enamel. Now it looks like one tooth, nice. Fortunately, the tooth does not look much bigger than the corresponding incisor on the other side. The next step is to remove 2 upper and 2 lower premolars and start braces to adjust the teeth.

  51. I had a twin tooth as a child. We didn’t do anything to treat it. Eventually, it came out on its own and my permanent tooth came in normal. My teeth are a bit crooked but I am not sure if that is related.

  52. My 6-year-old’s N and M teeth were fused. It had to be extracted because the adult tooth was coming in behind it. There appears to be two teeth with a single root. The dentist wants to charge me for two extractions. I say I should pay for one, because it was one extraction ‘motion.’ Who’s right?

    • Not that my opinion counts, but I agree with you! If it’s one extraction, then you should not be charged for two. I would look for an oral surgeon who would put your family’s best interest above their own (IF such a doctor even exists :oP)

  53. Hi, my two year old daughter has a geminated upper inscisor. A lot of food gets stuck in the groove, and even though we brush regularly a small cavity has just begun to form. I just took her to a pediatric dentist who did a visual exam and said that my only option was to brush her teeth, and that if the tooth became infected they would have to extract it. Should i try to find another dentist? Does anyone else have any experience with treating small cavities on geminated teeth, or sealants? By the way, her twin sister has normal teeth.

    • Hi Gracee – Would your daughter sit still enough for a sealant to be placed? That would likely take a couple of minutes. Being that it’s a front tooth, it should be fairly easy to keep dry so that the sealant will stick well. If it is a very small cavity, this should be able to stop its growth until she is older and able to get some sort of a permanent filling.

  54. I wish I would have seen this site 2 years ago. I asked the dentist about, what he called a fused tooth, on my son. He assured me that it was more common than I realized and told me there was nothing to worry about. He even told me that they may seperate. My son’s fused teeth are the same teeth as Rachel’s son. I was cleaning the teeth about 6 months ago and a piece of the tooth came out from the in between. I called the dentist and he assured me that it was nothing to be worried about that this happens sometimes when they are seperating. We ended up seeing another dentist and she said that this was a crack in the tooth and that with the xray showed me that the tooth should not seperate since it is one root and one nerve section. the crack goes all the way to the nerve of the tooth. He doesnt complain about pain. We brush morning and night. They want to extract the teeth but he is only barely 3. Advice? My other fear is that he is having his tonsils removed on March 14 because they are very large, wouldnt there be a concern putting him to sleep so close together?

  55. My son has fused tooth exactly like the photos of this little boy! Hes 4 years old. Almost 5. No one every notices. 🙂 …if you would like more photos to share I can send some 😉 we have had zero problems with his teeth and im about to schedule an xray to see how the adult teeth will come it.

    • Thanks for sharing, Eric. That would be great if you’d be willing to send along some photos for me to post. Hopefully everything looks good with the adult teeth. Have a great day!

  56. We just took our 10 month old son to the dentist today to discover that his front tooth is a germinated twin/double tooth. it’s good to know that it’s nothing to worry about 🙂

  57. Thank you very much for this information, Tom! My 2 year old son has a bottom germinated tooth, it was the first to pop up. The strange thing is that it belongs to his front, LEFT side of his mouth… and just like a birth defect he has, in his left hand (his fingers did not develop correctly). He has 5 fingers but 4 of them are shorter than average, as if they are missing the bone at the tip. We still have to run some tests on him, but have to wait a few more years. When we took him to his first visit to the dentist, at age 1, he told us this abnormality COULD be related (teeth/fingers). Have you heard of any similar cases??

    • Hi Alicia – I haven’t heard of it. Do you know what the birth defect is called? Sometimes these defets are so rare that it is hard to get any research done on them to shed more light on the dental effects.

  58. Thanks for all of the info! My 2 older daughters (7 & 6) both have different issues with their baby teeth. My oldest has twinning… they explained that her root split like an embryo would, and created 2 separate teeth. They are not fused as one. My 6 year old has gemination. I thought it was interesting that I have 2 daughters 13 months apart that both have some kind of twinning! My oldest daughter is also missing a bottom incisor (baby tooth). I’ve always joked that it came in the wrong place. Per xrays, all permanent teeth to be normal. Thank you again for the read!

  59. Hi my age is 30 yers.. My front teeth are not properly placed..they are leaning outward…is there any method to fix it….how much the cost???

  60. My son will be turning 1 Wednesday. I thought as his bottom teeth were coming in, he had 4 little teeth sprouting through. Now that they are all the way, he has 2 teeth and they have a very distinct split in the middle. Still looks like he has 4 teeth on the bottom. The split is very big and wide. I haven’t even seen a picture of a child with a split like my sons. Is this something I should have checked since they are baby teeth?

  61. My daughter, who is now a freshman in high school has a fused tooth in the front. When she was a little girl, we called it her “mega tooth” and thought it was cute. Now as a teenager, she is extremely self concious about it. She wont smile for pictures and since the two teeth are fused together, she has a small gap next to it on the side with the fusion. Her dentist has always just said “sometimes it happens” and never suggested any treatment. Im assuming if I get her treatment I would need to go to a cosmetic dentist? I would like her to smile for her senior pictures so I have 3 years and want to start up a treatment plan (the less evasive the better). She also needs braces for an under bite and cross bite. Which one should I focus on first? I just want her to feel confident enough to smile again!

  62. WOW thanks for this blog I needed to see this to put me at ease. I am African American and I have never seen a kid in my family or around me with this condition. Going to the dentist and getting a x ray REEEEEEEALLY was a good thing cause he let me know that her adult teeth will not be fused….I’ll never forget when I 1st seen it…so she was about 3-4 months and her front teeth were growing in I left her with her grandma(daddy’s side) came to get her and it looked like my daughters tooth was chipped I was furious to say the least. She let me know she has no clue how it happened, me being a 1st time mother also diagnosed with postpartum I went off on everyone in the house and didn’t allow her to be there without me…a couple of weeks later I looked like a complete B word “grandma” let me know that a few ppl on her side has the same condition but with there adult teeth….now she’s 7 and loosing her teeth no real issues just a little sensitivity. It seems like it doesn’t want to come out:/ it was loose, now the adult tooth is growing underneath & it’s no longer loose, why? Her bottom front 4 had to be pulled because the same thing happened with the adult teeth growing in. Anywho I thought I would share my story if anyone has any questions, can answer mine or has some great advice I’m’s weird but I feel bonded with you’s 🙂

  63. My 8 year old daughter had what looked to the dentist on the surface like a geminated baby tooth. We always thought it was so cute and called them her tiny teeth (Lower left incisor) Since a baby she never had any problems with decay or pain but the tooth never loosened and the adult teeth started to cut through around and out of place. After ortho X-Rays you could see the geminated teeth each had their own root and were fused. We went for an extraction and the tiny teeth were not so cute when trying to remove. The fused roots were attached to the gum line bone. Very painful during the first extraction attempt and we ended up at the oral surgeon. Now the tiny teeth are are out with a major super root attached! No damage to the gums or permanent teeth below thank goodness. I would recommend if/when extracting the fused teeth to make sure you are seen by an oral surgeon to prevent any unnecessary pain. Great to hear not everyone’s experience was as traumatic but worth a mention for others.

  64. you know i have a double tooth i am 10 years old since i was 7 yrs old i finally saw the ugliest tooth in my mouth,my double tooth was small and my normal tooth was large,next time i saw,my double tooth was actually sharp and my normal tooth was actually for biting herbs….i actually felt sad

  65. i was scared to go to a dentist and yet i have to, then my mom sugested that i dont need to,thats why my double tooth always hurt and everytime i bite or chew i actually bit my gums,if you actually see my double tooth,youde actully see its so brown like poo,it hurts when i touch

  66. I was wondering if this is a genetic anomaly? My first born had a fused bottom baby tooth. It fell out as it should, and his adult teeth came in normally. My 3rd born (who is 11mo) has gemination of her top tooth. It is very large, and I hope it doesn’t cause problems going forward, but as she gets a little older we will take her to a dentist for evaluation. Is it rare to have TWO children that have this? I am Caucasian and my husband is a pacific islander (Fijian/Indian)- does our ethnicity mix increase the chance of occurrence? Just curious.

  67. My 13 month old has only gotten one of his front middle teeth but it’s in the middle of where the two front teeth should be with no room for another to grow. Have you ever heard of this and what should i do. So instead of 4 front teeth he has 3.

  68. My 16 month old daughter has 16 teeth. I just discovered what I thought was her bottom incisor on the left is actually a second canine teeth as the incisor just cut through this week. Meaning she has two canine teeth side by side on her bottom left gum. They do not appear fused together as there is a gap between them. Will they fall out and be replaced by one permanent canine tooth there?

  69. I just took my one yr old daughter whose four top teeth are twinned– the dentist told me to take her to her doctoe because she could have a bone disorder. Is this true

  70. I’m an adult in my 30’s now but when I was a child, I had a fused/double lower front tooth, it wasn’t that noticeable but it was my permanent tooth. My dentist pulled it out! There wasn’t anything wrong with the tooth it was healthy. Maybe it was common practice back then 20 years ago. I’m glad they let them be now days.

  71. My 2.8year old son has a double tooth….it is very tight next to each other. Just recently I noticed what seems to be some decay between the 2 teeth. It is not turning black, but there seem to be a hole appearing between the two teeth. Should I take him to the dentist. Would they be able to do anything about it now? I have a good pic. Can I send it anywhere?

  72. Ljust want to apologize in case there is another post/question like mine, I did not read all of them. My 1 year old has what it seems to be germination tooth on top front teeth. They are two smaller teeth that are very close together, however one of them is very crooked and it doesn’t apear to be atatched to one another, I also want to add that his other tooth next to them (what it seems to me like another incisor) came out also crooked. I took him to de dentist and She was not able to take a good look at them but said the tooth next to them is a misshaped canine. Really?? Can tha happen? I just don’t know what to think. Anyone else with the same problem?

  73. hi, I’m 24 now and I have 3 layer of teeth back to back only for 2 pairs and I feel some problem in speaking because of this some words are not very clear what can I do now

  74. My Daughter will be 2 in January and has Fusion in her upper left tooth and incisor. The tooth is wider than her right tooth and the dentist pointed out her left incisor is definitly missing.

  75. I have a geminated front tooth and man is it ever huge. I have come to really love my little friend but sadly it’s a dead tooth now after some trauma to it so I am looking into getting veneers and possibly a more even, uniformed smile in the process. We will see how this goes, I am not sure they can turn a large tooth into a smaller one with veneers.

  76. Im 23 and as a child had one, Everyone called it a twin tooth…when I lost the baby tooth I got two adult teeth instead.. so I have five teeth on bottom row betwern the pointy ones. Ive alwats had problems with BAD crowding. Why did I get an extra tooth?

  77. Hi, Tom,

    My 8 years old daughter has her lower right incisor like fused teeth, whilst she has all of her baby tooth normally grown and few of which retired normal. We took her to dental health center 2 days ago, after taking x-ray, the dentist told me that the numbers are normal and it is normal circumstances in children just growth in different shapes. I am afraid we may miss any possible early treatment to rectify the situation, as such I would like to see if you have other comments on our case. I may send a picture if necessary.

    • I have an 8 yr old and the front tooth is infused – the dentist has told me to leave it to all the adult teeth come down! I am thinking I really need to act sooner but unsure who to believe. Any advice would be gratefully accepted.

  78. My fiance Cory is 27 he has a fused tooth. He was never able to afford dental work until now. We went to consultation today with DR. Steve Astuto in Amarillo, TX for braces but they told us that he had 2 extra teeth. One fused with one of his permanent teeth, so before he can get braces he has to get the fused tooth separated. We have an appointment tomorrow for a consultation with Dr.Kirk Coury in Amarillo,TX about separating the fused tooth. The cost of the braces is going to be high I can only imagine the price for separating the fused teeth. For pictures please read his full story at

  79. Hello,

    I have a similar issue with my son, he is 10 years old. He has one “double teeth” on the up side , unfortunately the pulp is fusion too. This double tooth is formed by the central incisor and a tooth which was supernumerary. Until now, we haven’t got solutions for his problem. From my understanding, the two teeth cannot be separated because the pulp is commune. Can you help me with some advices for this?
    I need to say it is a big esthetically problem, especially that follows a very difficult period in his life, adolescence.

    Thank you,

    • My 10 year old had similar situation with his front teeth. He had 3 central incisors with the left 2 being fused. It was remedied with dental composite for a few years to change its appearance but last month had to be extracted leaving a big central gap for which he is wearing a denture. Takes a bit of getting used to but this is a short term solution. We have been told that in 18 months when teeth are straight he could have a bridge then when he’s an adult possibly a dental implant.
      Don’t worry children are resilient. I worried that my son would be teased but so far so good. I try to make light of the gap by emphasising the night,Eros no,bears of sportsmen who are missing teeth.

  80. Hi,
    I am 23 years old and I have a “double tooth” except instead of being side by side its in the back. It caused spacing and overcrowding to some of my teeth. I have asked my dentist plenty of times about it but he always say if he shave it down it will start turning black and he would have to pull it. Could you help me with this ?

    Thank You,

  81. My son has 4 front teeth 2 baby and 2 adult teeth that already came through, the baby teeth are wiggling but not getting any looser.. . his baby teeth are pushing forward and he looks like a rabbit

  82. HI this is very interesting topic, my son is 7 years old he fell on his chin and broke his baby lateral incisor tooth and a piece of it stayed in the gum. After that his central incisor grew back attached to the lateral tooth so his front teeth are not same size. can you please tell me if this issue can be fixed.
    Thank you

  83. Hi I have a wisdom tooth and one piecing through underneath my wisdom tooth so should I worry about it I am 20 and don’t have a dentist as I can’t afford one so what should I do ?

  84. I have a 2 year old boy who also has two teeth fused together.. One of them broke and i can see the decay. The dentist wants to put a composite over it (not sure of the correct wording so please forgive me) but would it be better if it were to be extracted?
    I am worried about the decay..will it cause problems for his immune system? At first the decay was not noticeable but now as time has gone by (it’s about a month in between appts) the decay is more noticeable.

    Thanks for your time!

  85. My niece’s double tooth fell out only to reveal an adult double tooth underneath! After reading this article, we now know that it is a fused tooth because the dentists at first did not realize she had a double tooth and thought one was missing. My brother, her uncle, also has an adult double tooth in the same spot as does our cousin so it must be a genetic thing in our family.

  86. My identical twin daughters were adopted from China in 2002. It was interesting to watch their baby teeth come in at the same time but on opposite sides. When their permanent teeth came in one had a double tooth in the front bottom and her sister is missing that tooth on the other side! We joke and say that Olivia stole Sara’s tooth in the womb which funny enough suits their personalities!

    Both girls are doing fine and finished orthodontia last year. Olivia’s double tooth is noticeable. only when we point it out.

  87. My son has lost his double tooth today (bottom left) and it already looks like the other one has started to appear underneath (as we have been waiting for this to fall out for quite some time now).
    It looks to me as though it will be one tooth again. I’ve read that this is rare but we will still treat it as his special tooth in any case.
    We have called it his special tooth since it came through… hence why the tooth fairy has been very generous this time!
    It was so good to read this article and to hear all of the stories…

  88. My son had a double tooth with one root. We called it his ‘heart tooth’. It was his canine and the next one forward, bottom right. When it fell out it was replaced with what we thought was an adult canine, but that fell out and had no root. I couldn’t convince the dentist about what happened. He now has two normal adult teeth in place of his heart tooth.

  89. Oh my gosh, Jane, that same thing just happened to my 9-year-old daughter! She had a double tooth on the bottom; it came out last year, and another (normal) tooth grew in… and it just fell out! It has no root, looks like a baby tooth, and I can see another tooth erupting already. I’ve been researching the web, and couldn’t find any mention of this happening to anyone else until I just read your comment. Hoping this tooth sticks around!:)

  90. My son is now 8. When he was a little over 1 his eye tooth was coming in and I thought he fell and chipped his tooth but he didn’t his tooth was fused. We never did anything to it. We thought it was cute just the way it was. Honestly I don’t think kids have ever noticed. He has never said anything. He’s had several X-rays so far not sure what his adult teeth look like the dentist just keeps watching. He hasn’t lost any baby teeth yet but when he looses I will save it

  91. My son now 10 had an adult front central incisor double tooth. The dentists monitored for 5 years and added composite to “square” it off so it looked presentable but he has very recently had it extracted leaving a big gap for which he now has to wear a denture plate to replace the gap.
    Ideally in the future he will be able to have a dental implant.
    I have been told by dental staff that it is a genetic anomaly that occurs in the womb so no body could have altered it as I worried initially that we all ate too much dairy therefore producing too much calcium etc etc! He also has a supernumary lateral incisor and his adult canine is shown on x Ray as somewhere near his nasal passage with no chance of presenting itself into his jaw!
    Luckily the UK has very good free dentistry for children!

  92. I think of my fused tooth as something special. My mother told me that when my baby teeth first came in that the two front lower teeth on the left side of my mouth were fused together. Our dentist at the time told my mother that it was likely the permanent teeth would come in normally and not to worry about my teeth. I’m 62 years old now and I see my current dentist twice a year. I’ve always believed that my tooth was unique and special to me. I may have been one of the lucky kids because I have never had any problems with my special tooth. I love my tooth and I’m all smiles.

  93. Hi, I’m a mom of an 11 yr old boy who has twinning on both of his front teeth. We have been working with his DDS and Orthodontist but sadly neither one have had any experience with a single twinning, much less a double. I’m in VA but would gladly travel anywhere to find someone experienced. I’m coming up with nothing. Any help?

  94. This is very interesting to me because my son has Gemination on one of his bottom teeth. Its not two teeth fused, its one that tired to split. He’s 6 years old right now and Its wiggly and almost ready to fall out along with some of his other front teeth (top and bottom). I’m kinda curious to see what it looks like when it comes out.

  95. I was told my daughter had a geminating tooth less than 6 months ago. She is not even 2 yet. I expressed my fears of this tooth growing down and pushing her front tooth out of the way or out completely … She also has very poor enamel. She brushed her teeth and loves too and she eats well. She was in so much pain after a cold last week I believed it was her ears from otitis media as she gets this about every six months. I noticed she put her thumb to her mouth and had been crying on and off over everything I said smile and let her like my teeth while I did hers and she screamed and flung back when I touched the normal front tooth. I then tried again and touched her other teeth and no problem I layed her down and pushed the tooth and the tooth moved it looked like the gum was grey. I think the geminated tooth is pushing down on her front tooth and not caused her to lose the root. She is in so much pain
    I don’t know if I believe this was a geminating tooth. Has anyone had this happen. Hers appeared more like a shark like incisor tooth that erupted high in the mouth and is working its way down. She has all the other normal number of teeth for her age

  96. My 15 month old son has what I believe is a germinated lateral top incisor. Unfortunately he already has a cavity behind the tooth. Our pediatric dentist recommended SDF (Silver diamine fluoride) treatment. This procedure keeps the tooth and kills the bacteria to stop it from getting worse but turns the area permanently black. Has anyone done this procedure or decided against it for a reason you’re willing to share with me?

  97. My son has a tooth on his bottom teeth that appears to be two teeth together. It’s his bottom center front right one and the one to the right of it. There appears to be a small separation in the top that when it first erupted looked like two separate ones before it came in more. Does this mean his permanent ones will come in fused or germinated or not necessarily? The tooth does look like it may have a slight tartar build up in the groove in the top. Should a dentist take a look at it for cavity vulnerability? Will this tooth affect his permanent teeth eruption?

  98. Hi, my son is 3 years old now but when he started to first cut his teeth I notice something. His upper left front tooth and the little on beside it, entered through the same whole in his gums. I read about it and it said that most of the time it only happens on one side. Well I was in for a shock when the upper right front tooth came in and the one right be side it also. My little one has 2 fusion teeth, and yes they can be a challenge. Being that both side are like cone shapes behind it was a hard to brush as great as I wanted. I would brush morning, evening and night. He still ended up with a little decay. My little one dentist put some kind of stuff on his teeth to harden the spot, in doing so it turned parts of his teeth black. So right now I guess u can say it’s a eating game. My little one isn’t showing any signs of discomfort, if it come to that out the teeth will go. I just hate that option because it’s 4 teeth. But I wouldn’t dare let him be in pain. Next appt is next month, maybe we can try and get a x ray since he’s a little older now. Well see


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