Hyperdontia or supernumerary teeth is an oral health anomaly in which one or more extra teeth develop in the mouth. These additional teeth are called supernumerary teeth and can erupt as primary or permanent teeth. Anyone who has more than 20 deciduous, or primary, teeth or 32 permanent teeth is considered to have hyperdontia.
Researchers estimate that between 1% and 4% of the population experience hyperdontia, with males being affected twice as frequently as females. While multiple supernumerary teeth can appear in one patient, the majority of hyperdontia cases only involve one extra tooth.
Extra teeth can erupt anywhere in the dental arch, but most commonly occur as permanent, anterior (front), maxillary (upper) incisors. These extra teeth are called mesiodentes and often erupt on the palate between the top two front teeth.
Other common supernumerary teeth are classified by their location in the mouth, as such:
- Distodens/distomolar (2nd most common supernumerary tooth): Extra fourth molar which often presents like an impacted wisdom tooth
- Natal tooth: Extra primarytooth which presents at birth or shortly afterward
- Paramolar: Extra molar which can erupt buccally (between the cheek and gum) or palatally (toward the palate side of the mouth) to the existing molars
- Peridens: Extra tooth which erupts outside the midline of the dental arch
Supernumerary teeth can also be classified by their shape, which includes:
- Supplemental: Tooth shape is similar to the shape of the teeth in the surrounding area. Supplemental supernumerary teeth most often occur as primary teeth.
- Conical/peg-shaped: Tooth starts wide at the base and narrows at the top, making it appear sharp. Conical supernumerary teeth are the most common and typically present with a normal root.
- Tuberculate: Tooth has a barrel or tube shape. Tuberculate supernumerary teeth rarely erupt and usually have abnormal roots. They can delay the eruption of other teeth.
- Compound odontoma: Tooth is comprised of several small, tooth-shaped growths.
- Complex odontoma: Tooth is comprised of an area of disordered tooth-like tissue.
- Molariform: Tooth is shaped like a premolar with a complete root, typically erupting near the molars.
What Causes Hyperdontia (Extra Teeth)?
The cause of supernumerary teeth developing is not entirely understood, although there are some hereditary syndromes and conditions that are considered to be associated with hyperdontia.
Risk factors for hyperdontia include:
- Cleft lip and/or palate: Congenital condition which causes an opening in the roof of the mouth and/or upper lip
- Gardner’s syndrome: Genetic disorder that can cause skull and colon growths, as well as skin cysts
- Cleidocranial dysplasia: Condition that can cause abnormal collarbone and skull development
- Fabray disease: Syndrome that presents with skin rashes, abdominal pain, pain in the feet and hands, and an inability to perspire
- Ehlers-Danlos syndrome: Congenital condition that causes loose, easily dislocated joints, scoliosis, pain in the joints and muscles, and easily bruised skin
- Down Syndrome: Genetic disorder, also called trisomy 21, which is associated with delayed physical growth, certain facial features, and some possible intellectual disabilities
While these conditions are considered risk factors for hyperdontia, supernumerary teeth can erupt in patients with no history of any of these medical issues. Researchers believe that environmental factors may contribute to hyperdontia, as well as overactivity of the dental lamina (zone of cells involved in tooth formation) during the teeth’s developmental stage.
Some cases of hyperdontia do not need treatment. For cases which cause cosmetic or functional problems, the treatment typically consists of removal of the extra tooth or teeth. Supernumerary teeth should be removed if:
- An underlying genetic condition exists which results in the extra tooth/teeth
- The patient is having difficulty brushing or flossing teeth due to the extra tooth
- The extra tooth is causing pain or discomfort
- Chewing properly is hindered due to the extra tooth
- The extra tooth is causing crowding of the other teeth
Supernumerary teeth can cause oral complications that can lead to more serious conditions, therefore detecting, evaluating, and treating hyperdontia is imperative to limit cosmetic and functional problems that may occur if the condition is left untreated.
Possible complications from hyperdontia can include:
- Delayed eruption of adjacent teeth
- Crowding of the permanent teeth which may require orthodontic correctionhttp://www.kidsdentalonline.com/orthodontics/young-kids-need-braces/
- Development of cysts and tumors
- Fusion with other erupting teeth
- Decomposition of other teeth due to the placement or shape of the supernumerary teeth
- Difficulty eating or chewing
- Problems performing normal dental hygiene
- Gum disease
- Displacement, misalignment, or impaction of normal permanent teeth
Extraction of supernumerary teeth is performed under local or general anesthetic, depending on the location and development of the extra tooth. Your pediatric dentist may have you consult with an orthodontist, as well, if the supernumerary tooth has affected your child’s bite.
If your child has hyperdontia or you suspect that your child may have a supernumerary tooth erupting, contact the Kid’s Dental office for an evaluation.
At Kids Dental, we offer comprehensive, family-centered pediatric dental care in a child-friendly nurturing environment. If you are looking for a place to call your dental home, please schedule a consultation with one of our pediatric dentists by completing an Online Appointment Request or calling either office.
Plano Office Phone: 972-378-5437
Carrollton Office Phone: 972-394-2140