Supernumerary teeth. Hyperdontia. Ok, I’m using really big words. But there’s a big reason behind those big terms: a bigger number of teeth!
Did you know that it was possible to have extra teeth in your mouth? The typical adult has 32 permanent teeth, and kids typically have 20 primary teeth. But sometimes nature goes haywire, and we can wind up with more teeth than the norm.
While it’s totally possible to go through life without knowing you have any supernumerary teeth, most people figure it out sometime during their pre-teen or teen years. Why then? Because that’s when orthodontists are taking full-mouth X-rays to evaluate your bite, or a dentist is using the same images to evaluate wisdom tooth development.
When you have extra teeth in your mouth, you’ll hear a couple of different terms thrown around. “Hyperdontia” being one, with the root words “hyper-” meaning too much and “-dontia” referring to teeth. The other term is “supernumerary teeth,” with “super-” meaning beyond or more, and “-numerary” meaning the number of.
Hyperdontia or supernumerary teeth happen when your body produces more than the normal number of teeth. In most situations, dentists know that extra teeth typically grow in specific areas of a person’s mouth. But every now and then, you’ll see a totally atypical situation where a tooth doesn’t belong, such as a “teratoma,” which is a type of tumor with different tissues inside of it, including teeth! Those scenarios are really, really rare, and most extra teeth are always going to be somewhere in your mouth.
Supernumerary teeth don’t always erupt through the bone and gum tissues like your other teeth do. Some do, but most stay tucked inside your jaw and are only visible on a dental X-ray.
Not necessarily. Sometimes hyperdontia can be bad because it causes a major aesthetic issue. Like if you have a random, extra tooth erupting right between your top middle front teeth (yes, that can really happen!) Other times it could be a problem are if you have extra “wisdom teeth” (even though they’re technically not third molars.) In those scenarios, the supernumerary teeth may need to be removed at the same time as your regular wisdom teeth. Especially if they’re contributing to pressure or discomfort in the back of your mouth and jaw.
In dentistry, we typically tend to see extra teeth run in families. If one of your parents had supernumerary teeth, you have a higher chance of having them as well. And while genetics do play a factor, extra teeth may pop up unexpectedly for no reason or be due to some type of developmental condition or genetic abnormality. There’s not anything you can do to prevent it from happening. And sometimes it’s not technically even an “extra” tooth, but one that’s just erupting out of alignment, making it look like you have more teeth than you’re supposed to. That being said, here are a few conditions that can contribute to issues like extra teeth:
Gardner's syndrome is a rare genetic condition that is passed down through families. It can make certain people more likely to develop tumors or non-cancerous growths in their intestines. People with Gardner's syndrome may also get bumps or lumps on their skin or in other parts of their bodies and are known to experience problems with their bones or dental abnormalities, with multiple supernumerary teeth to develop. Because Gardner's syndrome can increase the risk of certain cancers, it's important for people with this condition to get regular checkups and tests to catch any problems early.
Ehlers-Danlos syndrome (EDS) is a group of inherited genetic disorders that affect the connective tissue in the body. This includes the structures of the skin, bones, blood vessels, and organs. In people with EDS, this tissue is weaker than normal, which can lead to a range of symptoms and complications. Some people with Ehlers-Danlos syndrome might have supernumerary teeth or even missing teeth. Other dental issues can include a higher risk of gingivitis and gum disease, and calcification of the pulp (nerve) dental tissue in their teeth.
Fabry disease is a rare genetic disorder that affects the body's ability to break down a certain type of fat which can lead to the buildup of fat in certain tissues and organs. Because Fabry disease is a genetic disorder, it can be inherited in families. Even though other symptoms may be more noticeable—such as hand and foot pain, rashes, or the inability to sweat—some people will also find that they’re more likely to have supernumerary teeth. Other oral symptoms of Fabry disease include teeth that are fused together, an enlarged tongue, not enough saliva production, and enlarged teeth.
A cleft lip or palate happens when the tissues of your upper lip and the roof of your mouth don’t grow together and fuse properly during fetal development. Even though it’s really common to see missing teeth in those scenarios (because your arch of teeth doesn’t develop properly), it’s also not uncommon for those individuals to have extra teeth. The missing teeth normally happen right where the line of the cleft is. They can also have malformed teeth or teeth that wind up being misaligned, rotated, or crowded. The good news is that oral surgery and reconstruction with restorations, such as dental implants and orthodontics, can help these patients have a fully functioning dentition (set of teeth.)
Cleidocranial dysplasia (CCD) is a rare genetic disorder that affects the development of bones and teeth. It is caused by mutations in a specific gene that’s important for the growth and maturation of bone and cartilage. People with CCD may have delayed or incomplete development of their skull and a small or absent collarbone. They may also have abnormalities in the development of their teeth, leading to overcrowding or extra teeth. If you’re a fan of Dustin on the popular Netflix series Stranger Things, the actor who plays him—Gaten Matarazzo—was born with CCD.
Depending on the extent of your hyperdontia and where your extra teeth are situated, you may not need to do anything at all. For example, if you have tiny extra molars right behind your wisdom tooth and you don’t need a wisdom teeth removal, they can stay right there. But on the flip side, if you have teeth erupting in spaces that interfere with aesthetics, you’ll probably want to schedule treatment stat.
What is the best treatment for hyperdontia? Dental extractions. Physically removing those teeth will get rid of them once and for all—they won’t grow back! These tooth removal visits can usually be completed with just a little bit of local anesthetic and maybe some laughing gas if you want it. However, if you require a surgical extraction, your dentist or an oral surgeon will use a stronger sedative medication so that it feels like you’re napping through most of the appointment.
Who knew there could be more than one type of extra tooth? Here are some of the most common supernumerary and tooth-like growths that you might see in the human body:
One of the most common types of supernumerary teeth that people develop is a single tooth positioned right between their two front upper teeth. Most individuals have their mesiodens teeth extracted due to the cosmetic issues they can cause.
Sometimes referred to as “milk teeth,” some infants are born with tiny, non-functional little baby teeth that feel quite loose in their gums. Most pediatric dentists will extract these teeth as soon as possible because they often interfere with bottle feeding or breastfeeding and can be uncomfortable for nursing mothers.
Extra molars that grow on the cheek side or toward the roof of your mouth side of your molars are called paramolars, because they’re parallel to those teeth.
These are some of the most common types of supernumerary teeth you’ll see. They grow behind the very back of your third (and normally last) permanent molars. That’s why some people refer to distomolar supernumerary teeth as “extra wisdom teeth.)
Additional teeth that are smaller and peg-shaped are referred to as “conical.” They can easily interfere with the alignment or placement of permanent teeth while they push them out of the way. Their narrow shape makes it easier for them to slip between other teeth, and you might see them presented as a mesiodens.
Tuberculate teeth are extra teeth that have “tubercule” shapes to them with more than one cusp (the raised, pointed edge on the chewing surface.) They tend to be extremely rare, so when they do show up, it’s a pretty neat thing for dentists to see in their offices.
A supplemental supernumerary tooth is basically a carbon copy of one of your regular teeth. It’s not a smaller tooth that just grew because of a fluke. Instead, it’s like you have two of the same teeth trying to come in. The most common supplemental teeth are the upper teeth on either side of the middle teeth, called lateral incisors.
An odontoma is a type of benign (non-cancerous) tumor that can grow in your mouth. It’s made up of the same types of cells that form teeth. The only thing is that when you look at them on an X-ray, they don’t exactly take the form of a natural tooth. Odontomas can sometimes cause pain, infection, and shifting teeth, so they usually need to be removed. While they are usually not harmful, it is important to have them evaluated by a dentist or oral surgeon to prevent complications and ensure proper dental health.
It looks like something out of a sci-fi movie, but teratomas can grow anywhere in the body and contain things like tiny teeth as well as tissues that make up hair and fingernails.
While some of us may not experience any symptoms with our supernumerary teeth, others may encounter a range of oral health issues.
One of the most common problems caused by supernumerary teeth is overcrowding, which can lead to misaligned or crooked teeth. This can affect aesthetics, cause difficulty with speaking, make chewing and difficulty brushing your teeth, and increase your risk of developing cavities and gum disease. In severe cases, overcrowding can also require orthodontic treatment, which can be expensive and time-consuming.
Delayed eruption of adjacent teeth can lead to crowding of the permanent teeth, potentially necessitating orthodontic intervention. In extreme cases of hyperdontia, the additional teeth may erupt quite a distance from the dental arch and will require surgical removal.
Supernumerary teeth may also cause other issues, such as cysts, infections, and impaction, where the extra teeth remain inside the gums and bone. These complications could potentially be painful and result in an infection. If left untreated, the cysts and infections can lead to damage in your surrounding tissues, including bone, and contribute to tooth loss.
If you know you have extra teeth or you’re concerned that you may have hyperdontia, be sure to talk with your dentist. Sometimes people think they have too many teeth or hyperdontia because a tooth is erupting out of alignment or “on top of” another tooth. If that’s the case, your dentist or an orthodontist can help alter the eruption patterns and bring those teeth into the correct alignment. But if you do have supernumerary teeth, your dental team can let you know whether or not it’s necessary to do anything about it. In most cases, they’ll probably just take a “watch and wait” approach to monitoring them at your checkups.
Having extra teeth or double teeth in your mouth is called hyperdontia, and those teeth are called “supernumerary” teeth. Hyperdontia can be a random thing that happens on its own or part of a genetic or developmental condition. There’s no treatment to prevent hyperdontia, but your extra teeth can be removed if they’re getting in the way or interfering with your smile. Your dentist can tell if you have hyperdontia by looking at a panoramic (full mouth) X-ray of your jaws and evaluating all of the structures around your smile.
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