Extra Tooth: Mesiodens and Other Supernumerary Teeth
Has your child ever come up to you and told you that they have an extra tooth growing out of their upper jaw behind their permanent teeth? It's probably more likely that you've been told that your child has an extra tooth, or supernumerary tooth (we try to make up complicated words!) as dentists like to call it.
If so, you're not alone! It is estimated that supernumerary, or extra teeth occur in 2% of Caucasian children, with an even higher frequency in those of Asian descent.
Below you can see an x-ray of a child with a supernumerary tooth. The original x-ray is on the left, and I outlined the supernumerary tooth in green in the x-ray on the right.
This particular extra tooth is called a mesiodens. That means that it is right between the two upper middle front teeth. Only about 25% of these teeth actually erupt into the mouth. Most mesiodens teeth stay in the jawbone and never make it into the mouth.
What Causes Supernumerary Teeth?
Currently, it is believed that supernumerary teeth occur due to the continued growth of the tissue that forms teeth, known as the dental lamina.
Supernumerary teeth can be hereditary or they may be associated with one of two conditions: Gardner's Syndrome and Cleidocranial Dysplasia. Supernumerary teeth can also occur in people that don't have those two conditions and in those withouta family history of supernumerary teeth.
How Common Are Extra (Supernumerary) Teeth?
It is estimated that supernumerary teeth occur in 0.1-3.8% of Caucasians. They are even more common than that in people of Asian descent, although I couldn't find any hard numbers.
Supernumerary Teeth are twice as common in boys as they are in girls. Most supernumerary teeth form before the age of 20, although they are more commonly found with the permanent teeth rather than the baby teeth.
What are Supernumerary Teeth Called?
Extra teeth have a lot of names! They are classified based upon where they are located and what they look like.
If an extra tooth is located in the middle of the two front teeth, it is called a mesiodens. If the extra tooth is located around the molar area, it is called a paramolar. If the extra tooth is located behind the wisdom teeth, it is known as a distodens.
If an extra tooth is shaped like another "normal" tooth, it is called a supplemental tooth. If it is not shaped like a normal tooth, then it is known as a rudimentary tooth. Rudimental teeth are then classified based on what they look like:
- Conical Rudimentary Teeth look small or peg-shaped.
- Tuberculate Rudimentary Teeth appear to be barrel-shaped and have more than one cusp.
- Molariform Rudimentary Teeth look similar to premolar or molar teeth, but not enough to be called a supplemental tooth.
What Does a Supernumerary Tooth Look Like?
When I was out visiting my sister last summer, she told me that my nephew had to get an extra tooth removed. She told me I could even take a picture and put it up on Oral Answers.
You can see my nephew's supernumerary tooth to the right. It was a mesiodens, since it was growing right between his front two teeth. As you can see, the tooth doesn't really resemble any particular tooth, it just looks like a cylindrical piece of enamel.
Where Do Supernumerary Teeth Occur?
Almost all (around 95%) supernumerary teeth occur in the upper jaw. They mostly occur between the upper two front teeth. After that, you are most likely to find a supernumerary teeth behind the wisdom teeth.
Interstingly, supernumerary teeth don't always occur in the jaws. Neville's Oral Pathology textbook states, "Although most supernumerary teeth occur in the jaws, examples have been reported in the gingiva, maxillary tuberosity, soft palate, maxillary sinus, sphenomaxillary fissure, nasal cavity, and between the orbit and the brain. The eruption of accessory teeth is variable and dependent on the degree of space available."
As you can see, supernumerary teeth can pretty much occur anywhere in your head, although they are most likely to occur in your jaws like the rest of your teeth.
Do You Need to Have Supernumerary Teeth Removed?
Most dentists recommend removing supernumerary teeth because they can cause problems. Regezi's Oral Pathology textbook states:
The significance of supernumerary teeth is that they occupy space. When they are impacted, they may block the eruption of other teeth, or they may cause delayed eruption or maleruption of adjacent teeth. If supernumerary teeth erupt, they may cause malalignment of the dentition and may be cosmetically objectionable.
Because they can cause problems, it is generally a good idea to have supernumerary teeth removed.
If you have extra teeth, don't be alarmed! It is pretty common to have supernumerary teeth. You can work with your dentist to figure out what your options are for removing the tooth and aligning your smile correctly.
Have you had a supernumerary tooth? Do you have any questions about supernumerary teeth? I'd love to hear what you have to say in the comments section below. Thanks for reading!
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