Permanent tooth coming in before the baby tooth falls out? It’s not uncommon for a baby tooth to be replaced by an adult tooth before it falls out. This is known as premature exfoliation, and it can cause a variety of issues if not addressed properly. In some cases, the permanent tooth may come in crooked or misaligned, and it can be difficult to correct without professional help. It is important for parents to monitor their child’s oral health closely and take them to the dentist if they notice any signs of premature exfoliation. Early intervention can help ensure that the permanent teeth come in correctly and stay healthy.