Extra Teeth Growing in Gums
Supernumerary teeth, also known as hyperdontia, refer to the presence of extra teeth in the dental arch, which exceeds the normal dental count. In children, supernumerary teeth can occur in both primary (deciduous) and permanent dentition, though they are more common in permanent dentition. The prevalence of supernumerary teeth in children ranges from 0.1 to 3.8% in the primary dentition and 0.2 to 3.6% in the permanent dentition.
Recent academic research has revealed fascinating insights into the phenomenon of extra teeth growing in the gums, a condition known as supernumerary teeth or hyperdontia. This dental anomaly results from an increased number of tooth germs developing during the embryonic stage. Among the most common types of supernumerary teeth is the mesiodens, which appears near the midline between the two central incisors. Other types include paramolars and distomolars, which are extra molar teeth that may develop alongside or behind the last molars in the dental arch.
Ectopic eruption, another related dental issue, occurs when a tooth takes an abnormal path during its eruption, sometimes caused by the presence of a supernumerary tooth. The extra tooth can obstruct the normal eruption of adjacent teeth, leading to dental impaction. An impacted tooth is unable to fully erupt into its proper position within the dental arch, often causing pain, inflammation, and other complications.
Furthermore, odontomas, which are benign tumors composed of dental tissue, may be associated with supernumerary teeth. These growths can interfere with the eruption of neighboring teeth and may require surgical intervention for removal.
Current research in the field of dentistry continues to explore the genetic and environmental factors contributing to the development of supernumerary teeth. Understanding these factors will help dental professionals better diagnose and manage hyperdontia, improving the quality of life for affected individuals.
Types of Supernumerary Teeth in Children
There are several types of supernumerary teeth commonly found in children, and they include:
- Mesiodens: This is the most common type of supernumerary tooth, occurring in the maxillary (upper jaw) central incisor region. Mesiodens usually appear as a small, peg-shaped tooth between the two upper front teeth (central incisors).
- Distomolars: These are extra teeth located distal (towards the back) to the third molars or wisdom teeth. Distomolars typically occur in the upper jaw and are the second most common type of supernumerary tooth in children.
- Paramolars: Paramolars are extra teeth located buccal (closer to the cheek) or lingual (closer to the tongue) to a molar. They are usually found adjacent to the upper or lower molars.
- Supernumerary lateral incisors: These extra teeth are adjacent to the maxillary or mandibular (lower jaw) lateral incisors. They are less common than mesiodens and distomolars.
- Supernumerary premolars: Although less common, some children may have extra premolars in their upper or lower jaw.
These are the primary types of supernumerary teeth found in children. The occurrence of these extra teeth can vary based on genetics, and they may cause complications such as crowding, impaction, or delayed eruption of adjacent teeth. Treatment options typically include monitoring, orthodontic intervention, or surgical removal, depending on the specific case and potential complications.
Supernumerary teeth can be classified based on their shape and location:
- Shape: a. Supplemental: These teeth resemble the shape of regular teeth and are often found adjacent to them. b. Rudimentary: These teeth have an irregular or underdeveloped shape and can be conical, tuberculate, or molariform.
- Location: a. Mesiodens: The most common type, located in the maxillary midline between the two central incisors. b. Paramolars: Extra molars found buccally or lingually to the regular molar series. c. Distomolars: Extra molars located distal to the third molars.
The etiology of supernumerary teeth remains unclear, but it is believed to involve genetic and environmental factors. Some theories include the phylogenetic theory, the dichotomy theory, and the dental lamina hyperactivity theory. Supernumerary teeth are also associated with certain syndromes such as Gardner’s syndrome, Cleidocranial dysplasia, and Crouzon syndrome.
Clinical implications of supernumerary teeth in children can vary from asymptomatic to causing complications, such as:
- Crowding or malocclusion
- Delayed or ectopic eruption of adjacent teeth
- Diastema (a gap between teeth)
- Root resorption of adjacent teeth
- Cysts or tumours
What are supernumerary teeth?
Supernumerary teeth, or hyperdontia, are extra teeth that develop in addition to normal primary or permanent teeth. They can occur in any region of the dental arch and can vary in shape, size, and eruption status.
What causes supernumerary teeth in children?
The exact cause of supernumerary teeth is still not fully understood. However, research suggests that genetic and environmental factors may affect their development. Some genetic syndromes, such as cleidocranial dysplasia, Gardner’s syndrome, and cleft lip and palate, have been associated with an increased risk of supernumerary teeth.
How common are supernumerary teeth in children?
Supernumerary teeth are relatively rare, with a prevalence ranging between 0.15% and 3.9% in the general population. They are more common in permanent dentition than primary dentition and are more frequently observed in males than females.
What are the potential complications of supernumerary teeth?
Supernumerary teeth can lead to several complications, including crowding, the delayed or ectopic eruption of adjacent teeth, diastema (a gap between teeth), root resorption, cyst formation, and sometimes, an increased risk of dental caries and periodontal disease.
How are supernumerary teeth diagnosed?
A clinical examination and radiographic imaging, such as panoramic or periapical radiographs, are essential for diagnosing supernumerary teeth. Three-dimensional imaging techniques like cone-beam computed tomography (CBCT) can provide more detailed information about the position and morphology of the supernumerary teeth.
What is the recommended treatment for supernumerary teeth?
The treatment approach for supernumerary teeth depends on several factors, including the type, location, and potential complications associated with the extra tooth. In some cases, no intervention may be required, while in others, extraction or surgical removal of the supernumerary tooth may be necessary. Orthodontic treatment might also be needed to address any dental malocclusions or crowding caused by the presence of the extra tooth.
Can supernumerary teeth be prevented?
There is currently no known method to prevent the formation of supernumerary teeth, as their development is influenced by complex genetic and environmental factors. Early diagnosis and appropriate management are crucial in minimizing complications and maintaining optimal oral health in children with supernumerary teeth.
Management of supernumerary teeth depends on the child’s age, the type and location of the extra tooth, and the presence of associated complications. Treatment options include observation, extraction using sleep dentistry for children or laughing gas in the dental chair. The timing and approach of treatment are determined on a case-by-case basis, considering the potential risks and benefits. A multidisciplinary approach involving paediatric dentists and oral surgeons is often necessary for optimal management.
Best Practices for Treating Supernumerary Teeth
Supernumerary teeth are extra teeth that can develop in addition to the normal number of teeth in the dental arch.
- Diagnosis: Early diagnosis of supernumerary teeth is crucial to avoid complications. Dentists typically use a combination of clinical examination, dental histories, and radiographic imaging, such as panoramic radiographs or cone-beam computed tomography (CBCT) scans, to diagnose supernumerary teeth.
- Management options: The appropriate management of supernumerary teeth depends on factors like the patient’s age, the position and type of supernumerary teeth, and the presence of associated complications. The main management options are:
a. Observation: In cases where the supernumerary tooth is not causing any issues, a dentist may decide to monitor the tooth and surrounding structures through regular check-ups and radiographic examinations.
b. Extraction: If the supernumerary tooth is causing complications such as impaction, crowding, or delayed eruption of adjacent teeth, tooth extraction may be recommended. The timing of the extraction depends on various factors, such as the stage of root development of the adjacent teeth and the patient’s overall dental development.
c. Orthodontic intervention: In cases where the supernumerary tooth has caused crowding or malocclusion, orthodontic treatment may be necessary to correct the dental alignment after extracting the supernumerary tooth.
- Preventive measures and follow-up: Regular dental check-ups are crucial for the early detection and management of supernumerary teeth. Dentists should closely monitor the patient’s dental development, eruption pattern, and oral health. They should also educate parents about regular dental visits and good oral hygiene.
Remember, each case is unique, and the management plan should be tailored to the individual patient’s needs, considering factors such as age, dental development, and any associated complications.
