Have your dentist ever told you that your child has hyperdontia? The supernumerary or the extra teeth can cause this condition, but it does not cause any serious health issues.
Hyperdontia can affect 1-4% of the world’s population. It is typically found in a higher number of males as compared to females.
But there is no exact answer to what is the cause of hyperdontia. If you want to know about it, then keep reading this blog.
What Is Hyperdontia?
When the child is born then they have 20 primary or deciduous teeth, when it compared to the 32 permanent teeth of adults.
When the child grows then permanent teeth replace the primary teeth. The standard number of primary teeth is 20 and the permanent teeth are 32.
The primary teeth are the first set of teeth in a person’s mouth, generally, at the age of 36 months of age, and are shed by the time when the child is about 12 years old.
Then the permanent teeth take the place of primary teeth and they erupt completely by the time when the baby reaches 21 years of age.
But sometimes the extra teeth can grow anywhere on the lower and upper jaw, these extra teeth are called hyperdontia.
The dentist also refers to the extra teeth as supernumerary teeth. Well, hyperdontia is not typically painful, but it can cause some of the complications that lead to swelling and pain.
One or more supernumerary teeth are developed in one or more locations in a mouth. These extra teeth may be primary or permanent teeth.
The prevalence of hyperdontia in the permanent teeth ranges from 0.1% to 3.8% while the prevalence of hypodontia in primary teeth ranges from 0.3% to 0.6%.
Before knowing the types, causes, and treatments of hyperdontia, let’s look at the number of teeth in the mouth and the types of teeth
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How Many Teeth In A Mouth?
Teeth are one of the strongest parts of the body and they are made with proteins such as collagen and minerals like calcium.
Teeth can help you to chew the food and they also help to speak properly. Most of the adults have 32 teeth and these are known as permanent teeth or secondary teeth.
The secondary teeth contain:
- 8 incisors
- 4 canines and also called a cuspids
- 8 premolar they also called bicuspids
- 12 molars which include 4 wisdom teeth
The children have only 12 teeth which are called primary teeth, milk teeth, or temporary teeth. Primary teeth also contain the same 10 teeth in the upper and lower jaws, these are:
- 4 incisors
- 2 canines
- 4 molars
The primary teeth start growing through the gums when the baby is 6 months old. The lower incisors are the first primary teeth that come in.
Most of the kids have their all 20 primary teeth at the age of 3. And they usually start to lose their primary teeth between the ages of 6 to 12 years.
These primary teeth are replaced by the permanent teeth and the molars are the first permanent teeth that come in. Usually, many people have their permanent teeth in place at the age of 21.
Here are the types of teeth:-
The eight incisor teeth are located in the front part of the mouth. The four incisors appear in the upper jaw, the four incisors appear in the lower jaws.
The shape of these incisors teeth is like small chisels. They also have sharp edges that can help to bite the foods. When you sink your teeth into something such as an apple that time you use incisor teeth.
Incisors are usually the first set of teeth to erupt, they usually appear at about 6 months old. While the adults set to grow in between the ages of 6 and 8.
The four canine teeth are located just next to the incisors. The two canines appear on the top of the mouth and two are on the bottom of the mouth.
The canines are sharp and pointy which help to tear food. The primary baby canines come in between the ages of 16 months and 20 months.
Usually, the upper canine teeth grow first and then the lower canine teeth. The lower canines emerge in the opposite way.
Firstly, the lower canines poke through the gums at the age of 9 years, after that upper canines grow at the age of 11 or 12.
The eight premolars’ teeth are located just next to the canines. The four premolar teeth appear on the top of the mouth and four premolar teeth appear at the bottom of the mouth.
The premolar’s teeth are bigger in size as compared to the canines and incisors. They are flat on the surface with the ridges that help to crush and grind the food into smaller pieces that make the food easier to swallow.
Baby molar teeth are replaced by the adult’s premolars teeth.
The infants and young adult children don’t have their premolar teeth because these premolar teeth are start to come around the age of 10.
These 12 molars are one of the biggest and strongest teeth. Six molar teeth appear on the top of the jaw and six appear on the bottom of the jaw.
The main eight molars are sometimes divided into the 6 years and 12 years molars. These molars are based on when they typically grow in.
The large surface area of the molars can help to grind the foods. While eating, the tongue can push the food back to the mouth, and then the molar teeth can break up the foods into small pieces which are enough to swallow easily.
Molars also include the four wisdom teeth and this is the last set of teeth that come in. These last set of molars teeth usually come in between the ages of 17 and 25.
These wisdom teeth are also known as third molars. But not everyone has that much enough space in their mouth for this last group of teeth.
Sometimes, these wisdom teeth are impacted, which means they are stocked under the gums. And they also have a space to grow in.
How Common Is Hyperdontia?
Hyperdontia affects more than 200,000 Americans per year. According to the survey, 2000 school children are having supernumerary teeth, 0.8% of them have primary dentitions and 2.1% of them have permanent dentitions.
The hyperdontia is more common with the permanent teeth as compared to the baby teeth.
It affects more individuals in the age range of 14-60 than those below 13. It is considered as chronic, persisting for a long time or life long.
Types Of Supernumerary Teeth?
Dentists classify the supernumerary teeth by their shape and their location. The extra teeth may be supplemental and they have the same shape and anatomy that is nearby the tooth.
In some cases, the rudimentary teeth are found which are abnormal in shape and smaller than the surrounding teeth. The rudimentary tooth can be conical that have a broad base and a narrow top.
In some other cases, the dentists may also find an extra tooth called odontoma. It is a benign tumor composed of the dental tissue that is formed irregularly.
An odontoma is a compound that is made up of a small tooth-like structure or the complex. It comprises a mass of the tissues that do not resemble a tooth.
These extra teeth can form anywhere throughout the mouth. So the dentist may classify the hyperdontia by their shape and location.
Here are some classification that is based on the shape of the teeth:-
1. Conical Hyperdontia
These hyperdontia teeth are small and peg-shaped. These teeth are wide from the base which narrow out near the top and make them look sharp.
These types of hyperdontia may occasionally be found in a high and inverted into the palate, they are also with the normal roots.
Conical is one of the most common types of hyperdontia and it mostly occurs on permanent teeth.
These supernumerary teeth appear near the central incisors and they potentially displace them.
2. Tuberculate Hyperdontia
These teeth have tube or barrel-shaped. They possess more than one cusp of the tubercle and it impacts the gums.
Tuberculatus have abnormal roots and seldom erupt, they also occur in pairs. These extra teeth are located on the palate near the central incisors which can delay the eruption of those teeth.
According to CDA, this type rarely erupts and is associated with the delayed eruption of incisors.
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This hyperdontia is described as a duplication of the teeth because this extra tooth is shaped similarly to the type of tooth that grows near it.
Supplemental teeth are found most commonly in baby teeth. These teeth usually appear near the lateral incisors and they erupt.
4. Odontone Hyperdontia
It is the fourth category of a supernumerary tooth and it refers to any tumor of odontogenic origin.
This category of hyperdontia is not universally accepted because these teeth have no defined or regular shape.
Odontone appears more like a disorganized and diffuse mass of dental tissues. It is divided into two categories:-
- Complex odontoma which has rather than a single tooth and an area of the tooth-like tissue are not grown in an order group.
- Complex odontoma tooths are made up of several small teeth and they grow nears to each other.
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5. Molariform Hyperdontia
These teeth have a complete root and the shape of the extra teeth resemble premolars. These teeth appear next to the molars.
The types of the supernumerary tooth according to the location are:-
1. Mesiodens Hyperdontia
It is the most common supernumerary tooth that is present in the middle of central incisors. These extra teeth are conical in shape and they are quite rare in the primary teeth of children.
These extra teeth can appear on the roof of the mouth. Around 0.15% to 4% of people have this type of extra tooth. The mesiodens teeth usually grow behind the normal front teeth.
2. Paramolar Hyperdontia
Premolar teeth are also considered as extra molars which are typically small and are developing.
These hyperdontia grow in the gums and appear on the inside or outside of the normal teeth.
These extra teeth are less common and less noticeable since they grow around the molars at the sides of the mouth.
3. Distomolar Hyperdontia
These supernumerary teeth are located in the region behind the molar tooth. These extra molar teeth are usually smaller than normal molars, in rare cases, multiple hyperdontia occur.
The supernumerary wisdom teeth grow in line with the other teeth. Having these supernumerary wisdom teeth is pretty rare and they hardly erupt.
A dental x-ray can help to identify these supernumerary wisdom teeth. The first symptom of supernumerary wisdom teeth is likely a tooth pain.
4. Premolar Hyperdontia
This extra tooth grows in the premolar region. These extra teeth can appear as a single tooth as well as in multiple teeth.
The hyperdontia multiple teeth are rarely seen and they are mostly associated with conduction such as cleft lip, palate, and gardner syndrome.
The positional problems that are associated with hyperdontia include misalignment and crowding of normal teeth.
The fusing together of the permanent teeth because of improper chewing of food is also a positional problem.
The position of supernumerary teeth or whether the tooth is exposed or impacted can be determined by the appropriate dental treatment protocol.
What Are The Symptoms Of Hyperdontia?
One of the main symptoms of hyperdontia is the growth of extra teeth in the mouth. The extra teeth grow directly behind or close to the usual primary or permanent teeth.
These double teeth usually appear in adults and they are twice more common in men as compared to the women. But your child might also complain about the extra tooth in the mouth.
So, the doctor can help you to determine the type of double teeth by examining the shape and location of the extra teeth. Parents also notice this condition when their children are toddlers.
This condition is sometimes first noticed when the child begins to lose his primary teeth. The medical term of hyperdontia is an extra tooth.
These teeth can develop as single or multiple teeth. They develop on one or both sides of the mouth that is upper jaw, the lower jaw, or on both sides.
If these extra teeth are visible then the dentist can describe them as an eruption, but if they are under the gumline, then they are known as impacted.
Most of the extra teeth are single and impacted. The multiple teeth only occur in 12-23% of hyperdontia cases. 98% of extra teeth usually appear in the upper jawline.
Hyperdontia does not cause any pain. But if the teeth are overcrowded or some other complications occur, then they can cause pain and swell around the extra teeth because it can put the pressure on the gums & jaws.
What Are The Cause Of Hyperdontia
The cause of hyperdontia is unclear. Some experts believe that it may be a genetic factor, some caused by producing the hyperdontia in a carrier of the mutated gene.
One study shows that 1-2 % of healthy children develop extra teeth, while according to genetic studies, there are some children who inherit the conditions.
While the other researchers have not found an agreed-upon cause of hyperdontia. Well, the disruption or stimulation of the cells in the jawline is also a possible cause of extra teeth.
The abnormal division of the tooth buds is also a cause of double teeth. Some other possible causes of extra teeth are environmental factors and the overactivity of the dental lamina during the development of teeth because the dental lamina is the zone of cells that initiates the formation of gums.
Here are some other reasons that might cause hyperdontia:-
1. Gardner’s Syndrome
It is a genetic disorder that causes skin cysts, colon growth, and skull growth. They also cause benign growth and increase the risk of colon cancer.
This rare genetic disease can cause multiple colorectal polyps and also the various types of tumors.
This disease can also increase the risk of developing supernumerary teeth which are along with the other dental problems.
2. Cleidocranial Dysplasia
This disorder can cause the abnormal formation of teeth and bones in the skull and the collar areas.
Its characteristic features include absence or underdevelopment of collarbones, dental abnormalities and the delayed closing of the space between the skull bones.
The cleidocranial dysplasia often displays the development of supernumerary teeth and the retention of the primary teeth.
3. Cleft Lip And Palate
This condition is a birth defect that occurs when the baby’s lip or palate of the mouth does not form properly during the pregnancy.
This condition can cause an opening in the roof of the mouth or the upper lips which can cause trouble in speaking and eating or can cause an ear infection. The opening in the upper lips is likely to result in hyperdontia.
4. Ehlers-Danlos Syndrome
This condition is the genetic group of disorders that can affect the connective tissues which support the blood vessels, bones, skin, and the other organs of the body.
This inherited condition can cause loose joints that can easily dislocate, can cause scoliosis, results in bruised skin and pain in joints & muscles.
This syndrome can cause other life-threatening conditions. Dental abnormalities are one of the main symptoms of the conditions.
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5. Down Syndrome
Down syndrome is a genetic disorder that causes abnormal cell division which results in an extra full or a partial copy of the chromosome 21.
This extra genetic material can cause the development changes and the physical features of the Down syndrome.
The down syndrome varies in severity among individuals that can cause lifelong disability and developmental delays. This is the most common genetic chromosomal disorder and it causes the learning disabilities in the children.
This syndrome is also characterized by the distinct facial features and the birth defects which include the probability of having hyperdontia.
6. Fabry Disease
Fabry disease is also known as Fabry-Anderson disease. It is a rare genetic disease that can affect the many parts of the body including kidneys, skin, and heart.
It is one of a group of conditions known as lysosomal storage diseases. Fabry disease can involve a deficiency of the enzymes alpha-galactosidase.
It may also cause several signs and symptoms like hyperdontia, pain in feet and hands, dark red spots on the skin, hearing loss and it decreases the ability to sit.
7. Ellis van Creveld syndrome
Ellis van Creveld syndrome is also another rare genetic disorder that is characterized by the short limb dwarfism, additional fingers and toe, the abnormal development of fingernails, and in over half of the cases.
It is a congenital heart defect, but motor development and intelligence are normal. This rare disorder is inherited as an autosomal recessive condition.
8. Nance-Horan Syndrome
This condition is in addition to causing dental abnormalities, which involve congenital cataracts that can result in poor vision.
9. The Dichotomy Of The Tooth Bud
The before tooth forming and the erupting is called a tooth bud. A splitting of these buds is called a dichotomy of the tooth bud.
When the dichotomy happens two teeth can form rather than one that causes hyperdontia.
10. Rubinstein-Taybi Syndrome
This disorder can lead to distinctive facial features, intellectual disability, and short stature. As well as it also causes problems with the kidneys, heart, eyes, and teeth.
11. Hyperactivity Theory
The hyperactivity theory is one of the most widely accepted theories for hyperdontia when it is not linked with other conditions. The dental lamina is where the new teeth form and grow.
The area of hyperactive is present in those people who have more than normal set of teeth. Hyperactivity of the dental lamina causes more teeth to grow.
How Is Hyperdontia Diagnosed?
Early diagnosis is important for the treatment. The detections that can occur as early as two years of age of the child.
If the clinicians can note any abnormalities with the tooth eruption and then they link these abnormalities with the possible presence of the extra teeth.
For the adults, it is relatively simple for the dentists to diagnose the hyperdontia in the patients.
Sometimes the extra tooth is already erupted and visible in the mouth of the patient so it can easily be seen by the naked eyes.
But if the supernumerary teeth are not detected by the naked eyes, then they can be detected by X-rays and by the examination of the mouth.
The healthcare practitioners can also thoroughly evaluate the family and medical history along with the clinical examinations. The presence of extra teeth can be suspected easily if there is no eruption of permanent teeth.
What Problem Does Hyperdontia Cause?
Supernumerary teeth can cause many cosmetic and functional problems in a healthy mouth. From a functional perspective, the hyperdontia tooth can prevent an adult tooth from erupting properly.
In some cases, it can also fuse with the adult tooth. Another problem that the double teeth cause is crowding. Straight teeth start to overlap with the presence of new teeth.
Treatment Of Hyperdontia
The treatment of hyperdontia depends on the cause and the complications of the extra teeth. Some of the cases of hyperdontia do not need any treatment while others require removing the extra teeth.
Usually, supernumerary teeth do not cause any symptoms. So the person may have no idea that they have extra teeth. In these cases, dentists are likely to recommend an X-ray to detect them.
If hyperdontia does not cause any symptom or any complication, then it does not require any treatment.
But in most cases, dentists recommend removing them even if it does not cause any discomfort. These cases include:-
- Having underlying genetic conditions that cause the extra teeth to appear.
- If you can’t chew properly, the extra teeth can cut the mouth when you chew.
- Feeling pain or discomfort in teeth due to overcrowding.
- If you have a hard time to brush your teeth or flossing.
It is normal to feel self-conscious or uncomfortable when you have extra teeth.
If you feel that your extra tooth is starting to affect your dental hygiene like delaying the eruption of a permanent tooth, it’s better to remove it as soon as possible because it will help you to avoid any lasting effects such as crooked teeth or gum disease.
If the hyperdontia only causes mild discomfort, then your dentist will recommend you take only nonsteroidal anti-inflammatory drugs such as ibuprofen for the pain. Some other treatment options are:-
1. Extraction Or Removal
If the child is experiencing the pain, speech problem or the other issues with the extra teeth, then extraction or removal of them is required.
As long as these extra teeth are not causing any eruption of a child’s actual teeth, then the permanent harm from the supernumerary teeth is not without other symptoms.
In some cases, pediatric dentists can extract these hyperdontia and it is removed as soon as possible.
When the roots of the teeth are adjacent, the teeth are being restored, the only way to save these teeth is to remove the double teeth naturally.
Dentists suggest the extraction or removal of the hyperdontia in the following cases:-
- Having a complication in the supernumerary
- Delay in the eruption of a permanent tooth.
- Having a risk of infection because the extra teeth make it difficult to maintain oral hygiene.
- Displacement, rotation, or misalignment of a neighboring tooth
- Supernumerary teeth may cause aesthetic or functional issues.
2. Continue Monitoring
After the extraction of the supernumerary teeth, it’s important for the dentist to continue to monitor their patient throughout, because sometimes these extra teeth may come back.
If you notice that hyperdontia has returned then take immediate steps and extract them again or simply to be more proactive in the treatment of the teeth.
3. Endodontic Therapy
When the hyperdontia has fused with a permanent tooth, then the doctors may recommend you for root canal treatment, because root canal treatment is a straightforward procedure to give you relief with dental pain and save teeth.
Typically the patient will need a root canal when there is inflammation of the infections in the roots of the affecting teeth.
During the root canal treatment, your dentist may carefully remove the pulp inside the tooth and clean it. They disinfect teeth and shape the root canals, then place the filling to seal the space.
4. Clinical Follow-up
In some cases of hyperdontia, doctors may not recommend the extraction of extra tooth, but keep it under observation until the eruption of extra tooth adjacent to it.
If your child does not face any problem with supernumerary teeth such as pain and swelling and if there is no risk of future complications like infections, then the dentist may leave the extra tooth to remain in the mouth.
5. Orthodontic Approach
The extra teeth probably affect the alignment of the teeth, therefore after the extraction of teeth orthodontic measures like dental braces are used to shape the teeth and strengthen them.
Crooked teeth can occur in people who have extra teeth, because the extra teeth can push the other teeth out of the line.
Once the hyperdontia teeth get removed, then your dentist may suggest you the orthodontic treatment with the braces to align the teeth and make your smile more beautiful.
Well, there are various types of braces available that are considered for orthodontic treatments. One type is fixed braces that consist of metal or clear brackets that are attached to the teeth
They are also connected with wires and bands. The braces can gradually move your teeth into the desired position and also they need regular adjustments.
One of the other options is an invisible brace such as Invisalign. These are removable clear aligners that fit over the teeth like the mouthguard.
These invisible braces are very hard to notice. This is a convenient and inconspicuous option for the teens and also for the adults who don’t want braces.
What Are The Complications Of Supernumerary Teeth?
Certain genetic disorders can lead to the risk factors of hyperdontia. The supernumerary teeth may cause the delay or eruptions of the adjacent teeth or the significant crowding that can require the correct orthodontic treatments.
If it is retained then the teeth can lead you to the development of the cysts or tumors.
But generally, it’s not necessary to remove all natal teeth unless the supernumerary teeth lose and present a risk of aspiration because of the passage into the lung.
Here are some complications of the supernumerary teeth which include:-
1. Failure Of Eruptions
Hyperdontia teeth interfere with the normal eruption of the permanent tooth.
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2. Displacement Or Rotation
The extra teeth can cause displacement or the rotation of permanent teeth because when more teeth are added to the mouth, then it leads to overcrowding.
It can also cause the teeth to move throughout the mouth and they may simply rotate and turn sideways to accommodate the new teeth.
Your child’s mouth and gum line is designed to hold the same number of teeth that generally occur. But having additional teeth can cause them to move closer and overlap and it becomes the congestion of teeth.
This can dislodge and distort the teeth, which can lead to having trouble chewing and biting the food properly. The overcrowded teeth can lead to an uncomfortable situation and it is hard to brush and floss them well.
So the growth of the double teeth can result in overcrowding that can cause functional or aesthetic problems.
The hyperdontia teeth may also cause the space or gap between the teeth. Usually, these extra teeth can cause the space in the front teeth of the upper jaws.
5. Development Of Odontogenic Cyst
11% of cases of hyperdontia lead to the formation of cysts. These cysts lead to more pain and cause inflammation.
These cysts are becoming more painful and inflamed. If the supernumerary teeth result in cysts or tumors, then they should be removed as soon as possible.
6. Root Abnormalities
Rare hyperdontia teeth can cause tooth resorptions or neighboring teeth. But having less room for the tooth to fully develop the root of each tooth can have the difficulty to develop properly.
Rather than developing fully and straight extra teeth can cause the roots to twist, bend, and short than the normal teeth.
These abnormalities can affect the jaw or mandible that cause discomfort and pain.
7. Hyperdontia Cause Nasal Cavity
In some cases, the extra tooth may cause an eruption in nasal activity and it can be seen as a white mass in the nasal area.
The irregular shape and the size of the supernumerary teeth can increase the chances of tooth decay. Because there are more chances of food particles being stuck between the teeth and the proper brushing is painful in the extra teeth.
8. Hyperdontia Can Affect Teeth
If the hyperdontia teeth cannot find a way to come into the mouth, then they remain affected or unerupted under the gumline.
This is similar to having supernumerary wisdom teeth. That’s why these teeth are needed to be removed so to prevent complications later on.
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9. Hyperdontia Cause Issues With The Speech
The clarity of the speech can be affected due to the abnormal increase in the number of teeth in the oral cavity.
Extra teeth can unfavorably affect the children’s learning capacities as they won’t have any desire to talk because of the abnormal sound they make or having issues with articulating words.
10. Irregular Facial Appearance
The teeth play a major role in defining facial appearance. Having many teeth in the mouth can affect facial appearance, which may affect the confidence level.
What Will Happen When You Leave The Hyperdontia Untreated?
Every case of hyperdontia is specific to individual patients. So if your doctor will recommend you orthodontic treatment, or extraction, but the condition remains untreated, then it will become a host of other issues.
Ultimately leading to the loss of more all functioning teeth. Untreated supernumerary teeth can cause:
- It becomes impacted
- Fuse with existing primary teeth
- Increase the risk of infections such as gum disease and decay
- It causes teeth crowding or malocclusion
- Prevent the primary teeth from erupting the normally
- Affects the appearance
- Cause the tumors or cysts
When To See A Dentist
When the person will notice the extra teeth, especially it is not in a line with the surrounding teeth, then they should consult with a dentist.
If you also feel swelling or any pain in the mouth then immediately consult with the doctor.
If you also notice that your child’s permanent teeth are late to grow in or there are large gaps in between the permanent teeth especially in front then you should consult with your doctor.
It is important to attend the routine dental examinations, so the dentist spots the hyperdontia during the regular checkups or X-ray.
Hyperdontia involves having extra or double teeth in the mouth. The cause of extra teeth is not clear, but it characterizes by certain genetic conditions.
Hyperdontia can cause many complications, some are minor. In severe complications, doctors can recommend removing the extra tooth.
According to the study, an early diagnosis can lead to a better outlook for people who have hyperdontia.
A dentist is able to diagnose the issue in children as young as they are 2 years old. Once the extra tooth removes, any discomfort typically ceases.
But if the surrounding teeth crook or have been otherwise affecting, then the additional dental and orthodontic can work to resolve these issues.
So if anyone who have concerns about their oral health then they should contact a dentist.