Well, if it's an extra tooth, you want to eventually get it out of there. I usually wait till I see if it is interfering with the normal eruption of the permanent incisors, or shows some other sign that there is trouble. If it's not causing an immediate problem, you can wait a while, usually till the child is 6 to 8 years old to deal with it so long as you are monitoring the situation. If it will erupt on it's own, then we can just extract it like a normal tooth (doesn't happen very often). If it does not or you can just tell that it's going nowhere, it needs to be surgical removed, hopefully "timed" correctly. I don't like to do it too soon as I don't want there to be any damage to the developing tooth buds from the surgical procedure. Eventually, you do need to have them removed. Once it is removed it is likely the new teeth will erupt in a fairly normal pattern.