Hyperdontia is the medical term for having extra teeth. It can happen to adults and children, and presents as extra teeth growing directly behind or close to existing permanent teeth. In permanent teeth, the prevalence of hyperdontia is between 0.1% and 3.8%. It is likely to occur in 0.3% to 0.6% of children with baby teeth. Hyperdontia is not usually painful and unlikely to require treatment, but if it interferes with oral health, may require dental intervention. If you are concerned about extra teeth, this article is a complete guide to the signs, symptoms and cause of hyperdontia, diagnosis, treatment, and when it is time to see a dentist.
What is Hyperdontia?
Hyperdontia is when you have supernumerary (extra) teeth in the dental arch. Adults have 32 teeth and children have 20. Anything above this number of teeth is called hyperdontia. Extra teeth can occur in any of the curved areas attached to the jaw, and can be just one extra tooth or several extra teeth. They may grow just on one side of the mouth, or both sides, and can occur in the upper and lower jaws, although the upper jaw is most common. Sometimes the extra teeth can appear alone or in a group. They can be visible or impacted.
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Types of Supernumerary Teeth
There are several types of supernumerary teeth which are classified by dentists based on their location and shape. Dentists use these classifications for the purpose of identification, diagnosis and treatment plans.
Location of Extra Teeth
To classify extra teeth in terms of location, dentists look at the position in the mouth. The three main positions are:
- Paramolar: This supernumerary tooth is located in the back of the mouth next to a molar. Treatment options depend on the severity of the symptoms, and may be anything from observation to removal.
- Distomolar: This supernumerary tooth is positioned next to the third molars. These types of molars are usually impacted. Frequency of distomolars is low but they may need extraction if they start to become symptomatic. Should extraction become necessary, it must be done carefully to prevent any damage to the adjacent teeth as sometimes they can be fused with the adjacent tooth structure.
- Mesioden: This is the most common type of supernumerary tooth, situated behind or around the incisors, the four teeth at the front of the mouth used for biting. The most common mesiodens occur between or behind the two front teeth. When this type of extra tooth grows, it is important to have treatment quickly as it can lead to dental issues later on. Management of mesiodens usually requires extraction.
Shape of Extra Teeth
Extra teeth are also classified by shape. The main shapes of supernumerary teeth are:
- Conical: Conical shaped teeth look cone or peg shaped. They usually present with a normal root but the tooth is wide at the base and narrow at the top, making it appear sharp.
- Compound odontoma: This type of tooth looks like a combination of tooth-like growths compounded together.
- Complex odontoma: This type looks like a single tooth but is made up of dental tissue that resembles normal teeth or a calcified mass, complex odontomas are usually found in the upper jaw.
- Tuberculate: These teeth are in the shape of a barrel or tube. They tend to grow in pairs and rarely erupt from the gums.
Symptoms of Hyperdontia
The main sign of hyperdontia is having one or more extra teeth. However, sometimes extra teeth can put pressure on your jaw and gums, resulting in these symptoms.
- Pain and tenderness: Extra teeth can result in pain and tenderness in the jaw. However, it is rare for hyperdontia to cause too much discomfort.
- Overcrowding, misalignment: Sometimes extra teeth can cause crowding within the dental arch, forcing the other teeth to grow in incorrect positions. Misaligned teeth may be a sign of hyperdontia.
- Delayed eruption of neighbouring teeth: If you have delayed eruption of primary teeth, it could be because of hyperdontia. When you have more teeth than your jaw can accommodate, primary teeth have no room to grow through the gum.
Risk factors for Hyperdontia
The exact cause of hyperdontia is unknown although experts agree there are some risk factors that might make one more prone to having supernumerary teeth. Risk factors for hyperdontia include:
- Genetic factors: Hyperdontia can run in families, which suggest that it may have a genetic risk component. Parents with extra teeth are more likely to have children that develop the same condition.
- Syndromes and conditions: Hyperdontia appears to be more common in people with certain conditions and syndromes. These conditions and syndromes can sometimes result in this type of dental anomaly.
-Down syndrome: Hyperdontia is often seen in people with down syndrome. The orofacial and skeletal development associated with down syndrome contributes to dental problems like decreased tooth size, partial anodontia and hyperdontia.
-Cleft lip and cleft palate: People born with a cleft lip or cleft palate can develop extra teeth. This is because the cleft can affect the upper bone and gums that contain the teeth, causing dental anomalies.
-Gardner syndrome: People with gardner syndrome have an increased risk of developing dental issues such as extra teeth. This rare inherited disorder causes multiple other issues including non cancerous tumors in their bones, intestines and on their skin.
–Ehlers-danlos syndrome: While people with ehlers-danlos syndrome experience distinct problems with the teeth and oral cavity, there are only a few recorded occurrences of hyperdontia from this syndrome. Research is continuing.
–Cleidocranial dysplasia: This syndrome affects the growth of the skull, face, teeth and bones in the body. A common side effect is dental issues like hyperdontia.
-Fabry disease: This disease causes an enzyme deficiency, which affects many areas, including the teeth, skin, brain, and nervous system. Craniofacial and oral changes associated with fabry disease cause dental abnormalities like supernumerary teeth.
- Environmental factors: Sometimes environmental factors like trauma to the mouth and jaw or taking some medications during pregnancy or infancy can result in hyperdontia.
- Gender: In adults, men are twice as likely to have hyperdontia than women.
Complications of Hyperdontia
Mild hyperdontia (one or two extra teeth) will usually not cause complications. However, dental issues can occur depending on the number of extra teeth and their location in the mouth. Some potential complications include:
- Impacted tooth – When extra teeth are taking up space in the mouth, some teeth may become impacted and not be able to break through the gum.
- Cavities – Sometimes extra teeth may be in an awkward position which will make it difficult to floss or brush, potentially leading to cavities.
- Crooked teeth – Overcrowding caused by hyperdontia can lead to teeth becoming crooked.
- Chewing issues – Depending on the number of teeth and location, extra teeth can make chewing more difficult.
- Malocclusion – Extra teeth in the jaw can lead to malocclusion, which means the teeth are not aligned properly.
- Gum disease – Sometimes extra teeth can lead to gum disease, an inflammation and infection of the gums and bones that support the teeth.
- Oral cysts – Small, non cancerous cysts can form in the mouth as a result of supernumerary teeth, particularly if there are impacted or unerupted teeth.
Diagnosis of Hyperdontia
If you notice extra teeth that have grown in, it is highly likely you have hyperdontia. However, for a proper diagnosis it is important to visit your dentist for a dental examination. Your dentist will look inside your mouth and perform a thorough dental examination. They may also then take x-rays or do a CT scan to see if there are any impacted supernumerary teeth.
Treatment and Management of Hyperdontia
The treatment and management of hyperdontia will depend on considerations like the patient’s age, the number of extra teeth, their location and whether the extra teeth are likely to cause problems. In the majority of cases, supernumerary teeth cause no major dental issues or pain. However, sometimes the dentist may recommend dental or orthodontic intervention. The different options for the treatment and management of hyperdontia are as follows:
- Observation with no current treatment, regular checkups and monitoring: If the current supernumerary teeth are not causing any symptoms or issues, they will be monitored with regular checkups.
- Mild painkillers: If you have mild pain or discomfort at times with hyperdontia, the dentist may recommend taking an anti-inflammatory medication like ibuprofen.
- Extraction: If the extra teeth or tooth is causing consistent pain, impacting or overcrowding, the dentist may recommend extraction. This is usually a simple process but will be timed according to the stage of root development and effect on the adjacent teeth.
- Orthodontic intervention: If supernumerary teeth have caused crowding or malocclusion, then orthodontic intervention may be required in addition to extraction. Generally, this will include follow up treatment like braces or invisalign after tooth extraction.
When To See The Dentist for Hyperdontia
You should see a dentist when you first discover extra teeth before you start to experience pain or other symptoms. In the case of children, organise a dental consultation if you notice a child’s permanent teeth are late to grow or there are large gaps in the mouth. Even if you have not noticed any of these symptoms, it is essential for adults and children to have regular dental checkups. This will ensure optimum oral health and, in the case of hyperdontia, allow the dentist to detect issues early enough to organise a treatment plan.
Hyperdontia is a dental condition that can occur in adults and children. Known as extra or supernumerary teeth, you may discover it yourself or via a dental examination. Our article explains what hyperdontia is, signs, symptoms, diagnoses and treatment so that you will know what to do if you discover supernumerary teeth. For further information on hyperdontia, or any other dental issue, contact the team at Hawthorn Road Family Dental.
