Have you ever met someone with a smile full of what looked like too many teeth? A person with supernumerary or more teeth than usual has hyperdontia. It is a condition that causes too many teeth to grow anywhere in the curved areas where teeth attach to your jaw. This area is also called dental arches.
Primary teeth are the first set of teeth that erupt in a baby’s mouth around 36 months of age. As the child reaches 12 years old, these are replaced by permanent teeth. Around 21 years of age, the permanent teeth are normally completed. A person who develops more than 20 primary teeth or more than 32 permanent teeth has hyperdontia. The additional teeth are also known as supernumerary teeth.
Hyperdontia is more common with permanent, anterior incisors, in the upper arch and the fourth molars. These generally appear as extra impacted wisdom teeth. Mesiodens are extra maxillary incisor and distodens or distomolars are extra fourth molar. Extra primary teeth are called natal teeth. Up to 3% of people have extra teeth growing somewhere in their mouths.
Hyperdontia can be diagnosed either by sight or by x-ray. An x-ray will show teeth that are not yet fully emerged. In some cases, a CT scan may be recommended for further diagnosis. Here are the types of hyperdontia.
Types of hyperdontia according to shape:
- Supplementary: Teeth that are normal in shape and are usually found at the end of the tooth series.
- Tuberculate: Teeth that are more tube or barrel-shaped with more than one cusp.
- Conical: Teeth that are peg-shaped or pointy which may occasionally be found high and inverted into the palate.
- Odontoma: Either a collection of teeth-like growths or a mass of tooth-like tissue. It is further subdivided into two categories – complex composite odontoma and compound composite odontoma.
Types of hyperdontia according to position:
- Mesiodens: Most common type located at the roof of the mouth or around behind the normal front teeth.
- Paramolars: Less common and less noticeable because they grow at the back of the mouth, next to a molar.
- Distomolars: Also known as extra wisdom teeth that grow in line with other molars. Having extra wisdom teeth is pretty rare and they hardly ever erupt. A dental x-ray can identify them, and the first symptom of extra wisdom teeth is likely to be tooth pain.
Hyperdontia is usually painless. However, pressure from the extra teeth may make jaw and gums swollen and painful. It may also make teeth look crooked.
What Causes Hyperdontia?
The cause of hyperdontia is still unclear up to this date but some theories suggest that it is caused by local, independent, conditioned hyperactivity of the dental lamina or other hereditary conditions like:
- Gardner’s syndrome. Causes skull growths, skin cysts, and colon growths
- Ehlers-Danlos syndrome. Causes loose joints, scoliosis, painful muscles, and easily bruised skin
- Fabry disease. Inability to sweat, red or blue skin rash, abdominal pain, and painful hands or feet
- Cleft palate and lip. Birth defects that cause opening in the roof of the mouth or upper lip, ear infection, and trouble eating or speaking
- Cleidocranial dysplasia. Abnormal development of the skull and collarbone
How Is Hyperdontia Treated?
The treatment for hyperdontia depends on the type and position of the extra tooth and how it affects the other teeth. It is best to consult your dentist for the right treatment plan. Some cases of hyperdontia don’t need treatment. Others require removing the extra teeth especially when you:
- have problems chewing or your extra teeth cut your mouth when you chew
- feel pain due to overcrowding
- have a hard time properly brushing or flossing teeth which could lead to decay or gum disease
- feel self-conscious about the appearance of your teeth
- correlated pathology
If the extra teeth are starting to affect your dental hygiene or is causing discomfort, it is best to remove them as soon as possible. This will help avoid future problems such as gum disease or crooked teeth. Dentists may also prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) for pain.
What Are Risk Factors For Hyperdontia?
Supernumerary teeth may cause dental problems that interfere with the normal function of the mouth. Some of these issues include:
- Tooth impaction
- Increased risk of infection, periodontal disease, and tooth decay from difficulty cleaning crowded teeth
- Issues with chewing properly
- Cyst or tumor growth
Regardless of how many extra teeth you have, getting regular checkups and maintaining good oral hygiene habits is still best to keep your teeth healthy. Ask your dentist for flossing and brushing tips for extra teeth that are hard to clean. Make sure to tell your doctor about any pain, inflammation, discomfort, or weakness in your mouth.
If you or your child develops more teeth in either the primary or adult set, don’t hesitate to visit the dentist for an official diagnosis.