In general, human beings have two types of dentition. The first occurs in children between 6 months and 6 years approximately. This dentition is temporary and replaced by permanent teeth. Adult dentition begins at age 6 with the appearance of the first permanent tooth, which is generally the lower central incisor. The permanent dentition is completed at approximately 12 or 14 years of age and, as its name indicates, it is the final dentition, so if the one has extra teeth in the gum (hyperdontia) then that accompanies the person for the rest of life.
The number of teeth also varies depending on whether it is an adult or a child. In the temporary dentition, the number of teeth is 20: 2 central incisors, 2 lateral incisors, 2 canines, and 2 molars. On the other hand, for permanent dentition people have 2 central incisors, 2 laterals, 2 canines, 4 premolars, and 4 molars. However, it can happen that the number of teeth can vary and more or fewer teeth can be present than normal. If you have fewer teeth, it is called anodontia, but if you have more teeth, it is called hyperdontia, although some professionals may call it supernumerary.
What is hyperdontia or supernumerary teeth?
It is an anomaly characterized by the development of one or more additional teeth. These can occur both in temporary and permanent dentition, being more common in permanent dentition. The condition affects approximately 1 to 4 percent of the world’s population.
Classification of supernumerary teeth
Supernumerary teeth can erupt anywhere in the mouth; however, it is more common to find them in the dental arch. According to their location, they are classified as:
Mesiodens: a tooth that forms between the central incisors
Distomolar: teeth that grow behind the molars
Paramolar: a tooth grows alongside the molars outside of the dental arches
Natal tooth: teeth that present at birth or shortly after birth. The most common are mesiodens.
The supernumeraries can also be classified according to shape:
Supplementary: The shape of this tooth is the same or similar to the teeth that surround it.
Conical: They are usually wide at the base and narrow at the tip. are very similar to canines and have a root. Of note, this type of tooth is the most common.
Tuberculate– The tooth is either barrel-shaped or tube-shaped. They have normal roots and rarely erupt. This type of t00tth can delay the eruption of normal teeth.
Compound odontoma: This is a formation of different small teeth wrapped in a bag. These teeth do not erupt, but they can interfere with the eruption of normal teeth.
Complex odontoma: The tooth is formed from a tissue similar to normal teeth. They are irregular and there are usually several, not just one.
Molariform: The shape of this tooth is similar to premolars; they are fully rooted and usually erupt close to the molars.
If the supernumerary tooth or teeth are visible, they are classified as “erupted”; conversely, if the teeth are not visible, they are classified as “impacted”.
What causes hyperdontia?
Hyperdontia does not have an apparent cause; however, theories propose that the development of supernumerary teeth is due to the hyperactivity of the dental lamina cells, the precursors of tooth formation, although it can also be related to hereditary syndromes such as:
Cleft lip/palate: This is a condition characterized by a cleft or opening in the roof of the palate and upper lip.
Gardner syndrome: a genetic disorder that can cause the growth of the colon and skull and/or cysts on the skin.
Endocranial Dysplasia: a condition characterized by abnormal development of the clavicle and skull.
Faray’s disease: This syndrome presents with skin rashes, pain in the stomach, pain in the feet and hands, and inability to perspire.
Ehlers-Danlos Syndrome: This congenital condition causes loose joints, scoliosis, and pain in the joints and muscles.
Down syndrome: this condition is associated with growth retardation, very marked facial characteristics, and some intellectual disabilities.
Ellis van Creveld syndrome: This syndrome is characterized by causing dwarfism in the extremities and fingers and toes, It is also associated with cardiac abnormalities.
Nance-Horan Syndrome: This syndrome involves the development of cataracts affecting long-term vision.
Rubinstein-Taybi syndrome: This syndrome is characterized by short stature, intellectual disability, and some facial features, as well as problems with the teeth, heart, and kidneys.
Trichorhinophalangeal syndrome: This syndrome leads to bone and joint malformations, abnormalities of hair, teeth, and skin, as well as characteristic facial features.
What are the symptoms of supernumerary teeth?
Supernumerary teeth can develop singly or in multiples on both sides of the jaw, and on both upper and lower dental arches. Supernumerary teeth are asymptomatic, that is, they do not generate any type of discomfort or pain.
One of the most common characteristics is the shape of the teeth,.hey can be very similar to normal teeth, although the vast majority of supernumerary teeth have an atypical conical shape.
These teeth can cause problems or diseases in the mouth such as crowding of the teeth and caries (due to the accumulation of plaque as a result of dental malposition caused by the supernumerary tooth). They can prevent the normal eruption of the teeth or in the worst case with complex or compound odontomas, they can make the roots of the teeth erupt.
In addition to the above complications, the following may also occur:
- Delayed eruption
- Crowding of the teeth present in the mouth
- Development of cysts and tumors
- Fusion with other erupted teeth
- Difficulty eating or chewing
- Problems performing optimal dental hygiene
- Gum disease
- Displacement of teeth
How is hyperdontia diagnosed?
If the teeth are visible, diagnosis is very easy based on what the dentist sees with the naked eye. For unerupted teeth, the diagnosis is made by means of x-rays, preferably panoramic x-rays.
In some cases, other types of diagnostic means such as computerized axial tomography can be used. (CT)
How to Treat Extra Teeth in Gum?
In some cases, hyperdontia does not need treatment, although in most cases, it is suggested to be done.
The most common treatment is extraction or removal of the tooth; however, extraction is also recommended when you
- Have a genetic condition that predisposes the appearance of more teeth
- Have a genetic condition
- Cannot chew properly.
- Feel pain or discomfort in the case of dental crowding
- Have difficulty performing adequate oral hygiene
- Feel uncomfortable or self-conscious about the way your extra teeth look.
- Think affects your aesthetics
Extraction of supernumerary teeth is performed under local or general anesthesia depending upon the location and development of the extra tooth.
The age to perform the extraction of supernumerary teeth is also relative. it is preferred to be done as an adult; however, it must be evaluated how much it could affect neighboring teeth and structures.
If you have any questions about this or other topics, you can contact us at Channel Islands Family Dental as well as our page on Facebook. We look forward to your visit and we will make a timely diagnosis. Our dentists in Oxnard, Santa Paula, Ventura, Newbury Park, and Port Hueneme will be able to guide you toward the best treatment to take care of your health and give you back your best smile.
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