Supernumerary teeth

The additional teeth in the dental arch, apart from the deciduous or permanent teeth is termed as supernumerary teeth. This creates a condition called hyperdontia. The origin of the word is Latin which means having multiple teeth alongside the normal teeth.

What causes supernumerary teeth?

Not much is known about the causes of supernumerary teeth. According to one theoretical finding, the tooth bud being dichotomous can give rise to this condition. Some opine it might have to do with genetics and is actually hereditary. The hyperactivity theory suggests that the dental lamina being subjected to local hyperactivity which in turn leads to supernumerary teeth. According to the site of occurrence, there are two types of supernumerary teeth –

1. Amongst front teeth
2. Towards the back

Different types of supernumerary teeth:

Based on their morphology and site of occurrence, they can be divided into the following sub sections:

1. Conical:

The development of the conical tooth coincides with that of the permanent incisors during root formation. The permanent incisor may face displacement owing to the conical supernumerary. In usual situations, the vertical axis of the tooth is inclined.

2. Tuberculate:

The tuberculate is generally barrel-shaped. They are usually found in pairs located alongside the central incisors.

3. Supplemental:

Supplemental tooth, in other words, is duplication of teeth. The lateral incisor is the most common tooth to be duplicated. However, supplemental pre molars and molars also exist.

4. Odontoma:

There are two types- Complex composite Odontoma and Compound composite Odontoma.

Odontoma is not universally accepted as a classification. The two types are categorized according to their resemblance with normal tooth – complex composite ondotoma is a diffuse mass and has no striking resemblance while the compound composite ondotoma has a degree of anatomical resemblance to the tooth. Since more than one type of tissue constitutes this condition, it is called composite.

Problems associated with supernumerary teeth:

Supernumerary teeth can lead to a number of problems.

1. Eruption dysfunction:

The most alarming situation is the failure of eruption of the central incisor. The primary incisor may also face similar resistance. Depending on the location, different teeth might be similarly affected.

2. Displacement:

Another consequence is the displacement of the permanent tooth. The crowns of the incisor teeth are the most susceptible to such deformity. It can range from mild twist to a 100 % displacement.

3. Crowding:

Supplemental teeth usually gives rise to this condition and crowding can be resolved by removing the most displaced tooth.

4. Cysts:

Cysts might also result from supernumerary teeth

People who have extra teeth go through a lot of issues in relation with their teeth formation and development. The extra teeth hence need to be removed for proper teeth alignment. Delays in eruption from the gum can be avoided if the supernumerary teeth is extracted. If the roots are affected, immediate removal becomes inevitable. In many cases however, they also can exist in harmony with the normal teeth. These cases do not require extraction measures.

How to find out indications of extracting supernumerary teeth:

It is best to be aware:

• Delay in central incisor eruption.
• Displacement has become conspicuous.
• Cyst formation is accompanied.
• The bone intended for implant has been affected.
• Crowding has occurred.
• Grafting might have to be compromised.

In other cases when eruption is not hindered and no associated medical conditions arise, the supernumerary teeth need to be only monitored. Also when the current structural strength of the teeth is put into question, extraction is not necessary.