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How many teeth is too many? In typical cases, adults grow 32 permanent teeth, and children have only 20 primary teeth.

What does it mean if you or your child develop more than usual? Are you becoming one of the X-Men? 

Nope! You are simply one of the many Americans with hyperdontia, and there are many explanations and solutions available to your family.

What is hyperdontia?

Hyperdontia is a condition that causes extra teeth to grow in both children and adults. These are also referred to as supernumerary teeth.

These extra teeth grow within your dental arches and are most likely to develop near the incisors or in the molar area.

Is hyperdontia bad? No, hyperdontia is not “bad,” and there are many options available in cases of extra teeth — in fact, not every patient needs treatment. 

Nevertheless, it’s vital to get your, or your child’s, mouth checked if you notice an abnormally high number of teeth to avoid potential issues.

Risk Factors for Hyperdontia

Not everyone has the same odds of developing additional teeth. Here are some of the risk factors for hyperdontia.

Hyperdontia in Children 

Hyperdontia is much less common in pediatric dentistry, with only 0.3% to 0.8% of kids experiencing the condition in their “baby teeth,” also known as deciduous teeth.

Despite its rarity, it’s still quite important to chat with your pediatric dentist about the condition, as supernumerary teeth can cause overcrowding and other issues in some cases. While you’re waiting for your appointment, try these tips.

Hyperdontia in Adults

Studies show that adults are more likely to develop additional teeth than children. 

Is hyperdontia rare? Hyperdontia is relatively rare, with the prevalence of adult hyperdontia ranging anywhere from 0.1% up to 3.8% in permanent dentition.

Adult men are also significantly more likely to develop this condition than women, at a 2:1 ratio in some studies.

Causes of Hyperdontia

What causes hyperdontia? There are many potential causes of hyperdontia, mainly hereditary genetic disorders. These may include: 

  • Cleidocranial dysplasia: This causes abnormalities in skull and collarbone development. 
  • Cleft lip or cleft palate: These conditions create openings in the roof of the mouth or upper lip, which can cause ear infections and/or trouble breathing, eating, or speaking.
  • Fabry disease: Fabry creates the inability to sweat, skin rashes that appear red or blue, and hand, foot, and abdominal pain. 
  • Ehlers-Danlos syndrome: This disease affects joints and makes dislocation easier, causes pain around joints and muscles, scoliosis, and easy bruising.
  • Gardner’s syndrome: Gardner’s leads to growths on the colon and skull and cysts in the skin.
  • Down syndrome: Down syndrome is associated with intellectual disabilities, delayed development, and distinctive facial features.

These genetic conditions are some of the most likely causes of hyperdontia.

What happens inside the mouth when an extra tooth is growing? For answers, look inside the dental arch containing the lamina and buds where new teeth form. 

The dental lamina grows within the jaws, giving rise to the enamel as teeth form in the tooth bud. This process begins before birth, which is why we recommend bringing your baby in for their first checkup at one year old.

Early treatment allows us to spot symptoms of hyperdontia and other potential issues early, helping us plan the best treatment options for your child and guiding their dental development. Plus, we can give tips on how to get their oral microbiome thriving early for lifelong health.

Hyperdontia Symptoms

Symptoms of hyperdontia are usually relatively easy to notice and may include: 

  • Visible extra teeth, most commonly found close to the incisors
  • Pain and swelling around the tooth, in the gums, or the surrounding jaw
  • Malocclusion, as extra teeth can push their way in and take up space, crowding other teeth in the mouth (this can also happen in cases of impaction, where the tooth doesn’t fully break the gumline)

Shapes of Teeth

Not all supernumerary teeth are the same, and many shapes and types may occur. Here are how the shapes of teeth associated with hyperdontia are classified:

  • Supplemental: Supplemental teeth have the same shape and anatomy as the teeth near which they grow. Other tooth shapes that do not match the adjacent teeth are classified as rudimentary teeth.
  • Conical or peg-shaped teeth: These are characterized by a broader base and grow narrower at the top of the tooth. They may look or feel sharp.
  • Tuberculate: This shape of tooth is shaped like a tube or barrel.
  • Compound odontoma: This tooth shape is characterized by several smaller, tooth-like growths clustered near one another.
  • Complex odontoma: This shape of hyperdontia is a bit different, as it is comprised of an area of tooth-like tissue that grows in a disordered fashion.

These shapes vary, as do the locations in the mouth that hyperdontia is likely to happen.

Placement of Teeth

The placement of teeth in hyperdontia can vary. Hyperdontia is more common in certain parts of the mouth.

  • Mesioden. The mesioden is the most common type of supernumerary tooth, and it grows around one of the 4 front teeth. The mesioden is sometimes referred to as a central incisor, growing on the roof of the mouth centered between and just behind maxillary anterior incisors.
  • Distomolar. This extra tooth grows in line with the molars in the back of the mouth.
  • Paramolar. This additional tooth grows next to a molar rather than inline.

Up to 98% of supernumerary teeth grow in the roof of the mouth, and less than 24% of cases involve more than one extra tooth.

However, only a dentist can let you know exactly what you’re dealing with in cases of hyperdontia. How do they get to the bottom of diagnosing and treating these cases?

How is hyperdontia diagnosed?

Hyperdontia is usually straightforward to diagnose, especially if the tooth has already grown in. If the tooth has not erupted yet, an x-ray will reveal their presence, or your dentist may ask for a CT scan to get a better picture of what’s going on in your mouth and jaw.

Treatment for Hyperdontia 

The recommended treatment options for hyperdontia vary by each case. In many cases of hyperdontia, treatment may not be necessary. Many additional teeth cause no pain or other symptoms and are perfectly fine to leave as they are.

In some cases of hyperdontia, surgery to extract the tooth may be necessary, for example, when it causes:

  • Overcrowded, crooked teeth
  • Damage to teeth that haven’t erupted yet
  • Delayed eruption of permanent teeth in children
  • Difficulty or damage when chewing
  • Difficulty when trying to brush or floss, which may result in gum disease or cavities forming
  • Self-consciousness about your personal appearance

In some cases, orthodontic treatment may be appropriate to shift the adjacent teeth back into place.

Moving Forward

Does hyperdontia go away? No, hyperdontia does not go away on its own. You will need a dentist’s professional opinion to determine the best course of action for you.

When addressed properly, hyperdontia can be corrected or even left in place, but the peace of mind that comes with a dental visit is the best prescription to help you move forward.

Sources

  1. Rathee, M., & Jain, P. (2020). Embryology, Teeth. StatPearls [Internet]. Full text: https://www.ncbi.nlm.nih.gov/books/NBK560515/ 
  2. Nayak, G., Shetty, S., Singh, I., & Pitalia, D. (2012). Paramolar–A supernumerary molar: A case report and an overview. Dental Research Journal, 9(6), 797. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612233/ 
  3. Parolia, A., Kundabala, M., Dahal, M., Mohan, M., & Thomas, M. S. (2011). Management of supernumerary teeth. Journal of conservative dentistry: JCD, 14(3), 221. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198547/ 
  4. Ata-Ali, F., Ata-Ali, J., Peñarrocha-Oltra, D., & Peñarrocha-Diago, M. (2014). Prevalence, etiology, diagnosis, treatment and complications of supernumerary teeth. Journal of clinical and experimental dentistry, 6(4), e414. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282911/ 
  5. Diaz, A., Orozco, J., & Fonseca, M. (2009). Multiple hyperodontia: report of a case with 17 supernumerary teeth with non syndromic association. Med Oral Patol Oral Cir Bucal, 14(5), E229-31. Abstract: https://pubmed.ncbi.nlm.nih.gov/19218904/ 
  6. Subasioglu, A., Savas, S., Kucukyilmaz, E., Kesim, S., Yagci, A., & Dundar, M. (2015). Genetic background of supernumerary teeth. European journal of dentistry, 9(1), 153. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319293/ 
  7. Sekerci, A. E., Cantekin, K., Aydinbelge, M., & Ucar, F. İ. (2014). Prevalence of dental anomalies in the permanent dentition of children with Down syndrome. Journal of Dentistry for Children, 81(2), 78-83. Abstract: https://pubmed.ncbi.nlm.nih.gov/25198950/ 
  8. Kumar, A., Namdev, R., Bakshi, L., & Dutta, S. (2012). Supernumerary teeth: Report of four unusual cases. Contemporary clinical dentistry, 3(Suppl1), S71. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354792/ 
  9. Khambete, N., & Kumar, R. (2012). Genetics and presence of non-syndromic supernumerary teeth: A mystery case report and review of literature. Contemporary clinical dentistry, 3(4), 499. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636847/ 
  10. Meighani, G., & Pakdaman, A. (2010). Diagnosis and management of supernumerary (mesiodens): a review of the literature. Journal of dentistry (Tehran, Iran), 7(1), 41. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184724/ 
  11. Singhvi, V., Nambiar, S., & Shetty, S. (2013). Orthodontic management of non-syndromic multiple supernumerary teeth. Contemporary clinical dentistry, 4(4), 540. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883341/

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