This report documents two patients with inversion and impaction of the second premolar tooth. Family and personal histories of both patients were unremarkable with no abnormalities in general growth and development nor any history of trauma. Patient 1 was a 10-year-old female with inversion and impaction of the mandibular right second premolar. Fifteen months previously, pre-operative radiographic examination prior to extraction of the mandibular right second primary molar revealed a normal direction and eruptive pattern of the tooth in question. However, following extraction of the mandibular right second primary molar, the developing succedaneous premolar was seen to be inverted. This was suggestive of inversion resulting from an iatrogenic force during tooth extraction. The second patient was a 9-year-old male with inversion and impaction of the maxillary right second premolar. Radiographic examination 3 months prior to the initial visit at our hospital showed an existing inversion of this tooth. This pointed to a developmental abnormality in the location of the original tooth bud.