Human adults typically end up with 32 permanent teeth in total. Healthy children have 20 impermanent teeth or “baby teeth”, also called primary or deciduous teeth, which are expected to fall out prior to adulthood.
So, what if these numbers get thrown off and your child suddenly has more than the usual number of teeth? How do you know when to seek help and what, if any, treatment is available?
The condition of having extra teeth is called hyperdontia.
Once in a while, extra teeth will develop in a condition known as hyperdontia. The extra teeth themselves are called supernumerary teeth, and they are found growing anywhere in or along the dental arches. They’re seen twice as often in males than in females. You can generally find them anywhere in the mouth, but they occur more commonly among permanent rather than baby teeth. They’re most frequently seen in the areas close to or right behind the correctly placed teeth.
How can you tell which are the extra teeth?
Occurring in less than 4 percent of all humans, hyperdontia is quite rare. To establish a proper diagnosis, it’s easiest to wait until the teeth are grown in, or to look carefully when conducting routine dental X-rays. If there’s any question, a CT scan may be suggested.
Supernumeraries can be difficult to identify for various reasons. They commonly erupt as normal teeth do, have typical shapes, and show up in the expected alignment as baby teeth. Most often, they arrive as one, single tooth, although they may also very occasionally develop in clusters - sometimes up to 30!
What are the different types of supernumerary teeth?
There are a few different types of supernumerary teeth, categorized either by shape or location in the mouth, including the following:
Organized by shape:
Tuberculate: these are shaped like a barrel. They’re often impacted, have abnormal roots, and come in pairs. Often found near the central incisors, these may stop them from erupting properly.
Supplemental: these are shaped like the teeth around them, most often found near the lateral incisors, or at the end of a row of teeth.
Conical: these are shaped like an upside-down cone, wider at the base and narrow at the top. They grow most often behind the front teeth, potentially disrupting their placement.
Compound odontoma: these are shaped like a cluster of small tooth-shaped growths.
Complex odontoma: similar to the compound odontoma, these are arranged in a more haphazard way.
Organized by location in the mouth:
Distomolar: this type of supernumerary grows right in line with your molars.
Paramolar: this type grows in the rear of your mouth, beside the molars.
Mesiodens: the most common supernumerary, these grow near or between the two front teeth.
What causes supernumerary teeth?
When it comes to the causes of supernumeraries, genetics play the largest factor. However, it is common for folks with supernumeraries to also have co-occurring conditions, including Ehler-Danlos syndrome, Down syndrome, Cleft lip or palate, Gardner’s syndrome, Cleidocranial dysplasia, Crouzon disease, Apert syndrome, Cherubism, or Fabry’s syndrome.
Are there complications?
While it’s not necessarily painful, having extra teeth can cause other types of problems. For example, they can put uncomfortable pressure on nearby teeth, gum, and jaw regions, causing swelling at times. They can also create overcrowding conditions which make some teeth crooked or cause damage to their roots. Sometimes their positioning may prevent orthodontic treatments like braces, too.
For young people, additional teeth may cause more problematic issues with their bite alignment, the delayed eruption of and/or improper positioning of nearby teeth, and the development of cysts and tumors. One study showed that 11% of those with supernumeraries had cysts around them. In some unusual occurrences, the teeth may even grow into the nasal cavity. These issues in turn can also cause problems with chewing, impacted teeth, malocclusions, inaccurate jaw positioning, increased likelihood of decay, periodontal disease, gum infection, and in the worst case scenarios, facial deformities, and speech impediments.
When to consult an orthodontist:
Since serious complications can arise from having extra teeth, it’s important to consider a treatment strategy as early as possible. It’s best to contact your family’s dental professional for a thorough examination, diagnosis, and treatment plan if you suspect supernumeraries. At Jungle Roots, we offer a complimentary consultation during which we could examine your child’s teeth and determine the best comprehensive plan of action for them and your family.
To establish the proper treatment strategy, we would consider the patient’s age, dental and health history, and the size, position, and number of supernumeraries they have. The way the extra teeth alter the position or timely eruption of other teeth nearby, or impact the patient’s bite would be considered as well, as would any problems with chewing, difficulty with brushing or flossing due to the position of teeth, and any discomfort or self-consciousness from overcrowding that the patient is experiencing.
There are several possible approaches to the problem, including waiting to see what develops over time, (as long as things aren’t too complicated at the moment), tooth extraction, surgical extraction, or other orthodontic methods. If there is only mild pain or discomfort, ibuprofen or similar pain medication may be recommended. Some patients probably won’t need any treatment, while others may need it right away. For those with impacted supernumeraries, we may coordinate with an oral surgeon in order to remove them and provide optimal care.
In some cases, teeth may need to be extracted right away if they’re causing such problems in children, others may be fine waiting until the patient is at least 8 to 10 years old, which allows minimal damage to and proper development of the roots of normal teeth.
Although hyperdontia is a rare problem, it has a broad range of symptoms and it can cause numerous complications in the lives it does affect. If you suspect your child has supernumerary teeth, don’t hesitate to contact us for an evaluation. We offer a free consultation, during which all your questions may be asked and answered while your child’s teeth are examined in person. While there are several ways to treat hyperdontia, we’ll be sure to create the optimal treatment plan for your family’s needs. We always look forward to seeing and speaking to our patients, so don’t hesitate to call anytime -- and happy summer!
At Jungle Roots Children’s Dentistry & Orthodontics, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist.