Supernumerary teeth

January 12, 2015


Supernumerary teeth are a dental anomaly whereby the patient has extra teeth in addition to the regular number of teeth. The condition is referred to as hyperdontia. The extra teeth can be located anywhere in the dental arch and can be uncomfortable for the patient. The condition however manifests itself more in the maxilla than in the mandible as a single tooth or multiple teeth. Hyperdontia occurs more among the permanent teeth than in deciduous teeth.

There are different types of hyperdontia, and they are classified according to the teeth shape position. Among those classified by shape:

  1. supplemental where the tooth has a normal shape
  2. tuberculate where the teeth are barrel shaped
  3. conical shaped extra tooth
  4. compound odontoma
  5. complex odontoma.

Those classified by position include:

  1. mesiodens that occur between the maxillary central incisors
  2. paramolar or distomolar.

These teeth may erupt normally, remain impacted, assume an abnormal path of eruption or appear inverted. 

The occurrence of supernumerary teeth has not been fully understood and has been associated with several theories. One of these theories suggests that supernumerary teeth occur as a result of the dichotomy of the tooth bud. Another theory states that the occurrence is as a result of local, independent and conditioned hyperactivity of the dental lamina. There is however evidence to show that the condition occurs due to hereditary and environmental conditions. It is easy to diagnose supernumerary teeth at an early stage; this is done by exploring the dental x-rays. The anomaly is also strongly associated with developmental disorders such as cleft lip and palate, chondroectodermal dysplasia and Anderson’s syndrome.

 

Difference between tooth fusion and tooth gemination

Supernumerary teeth do not lead to the occurrence of complications. The anomaly however may lead to failure or delay of the eruption of permanent teeth, displacement, dilacerations, gingival inflammation, dental caries, crowding and other pathological problems such as cyst formation. It is recommended that these extra teeth are removed at an early stage.

Hyperdontia may be detected by chance during radiographic examination. Detection can also occur when dentists explore eruption failures of permanent teeth, persistence of deciduous teeth and presence of a wide diastema. The anomaly can be managed by either removal or endodontic therapy and tooth crowning. Another way to deal with supernumerary teeth is to maintain it in the arch which would require continuous monitoring by the dentist. It is however advisable that these type of teeth are removed since it may lead to other complications.

The teeth should be extracted carefully since if done wrongly there might be damage occasioned to the adjacent permanent teeth. The extraction may be difficult when the supernumerary tooth is infused at crown or root level with the adjacent tooth. Patients with hyperdontia should, therefore, not be alarmed since this anomaly may be corrected so that they achieve a normal dental structure.

Image credit to: supernumeraryteeth.com