Hyperdontia: Definition, treatment and types

Hyperdontia requires the insertion of extra teeth. It is not usually painful but it can cause discomfort which swelling complications.

People generally have 20 childhood-growing baby teeth, and 32 permanent teeth to replace them.

Though, people occasionally develop extra teeth. This is called hyperdontia, and may refer to the extra teeth as “supernumerary” teeth by the dentist.

One or more supernumeraries may develop within the mouth at one or more locations. Extra teeth are typically infant or permanent teeth.

The incidence of hyperdontia in permanent teeth varies from 0.1% to 3.8%. The frequency of baby teeth is 0.3 to 0.6 percent.

Hyperdontia is twice as common in males when it occurs in permanent teeth compared to females.

Read on the ways and causes of hyperdontia in this article. They identify therapies, as well as possible complications.

Types

Hyperdontia may cause pain if the teeth are overcrowded.
Hyperdontia may cause pain if the teeth are overcrowded.

Dentists categorize the supernumerary teeth by appearance and position.

An extra tooth may be “additional” and have the same shape and structure as a neighboring tooth. And, it might be “rudimentary,” in which case it has an irregular shape and is often smaller than the teeth around.

A dentist may also classify a rudimentary tooth as “tuberculate” if it has a shape similar to a tube and pipe. Instead a rudimentary tooth may be “conical,” with a wide base and a narrow tip.

In other cases, a dentist might discover that an extra tooth is an odontoma, a benign tumor consisting of irregularly shaped dental tissue.

An odontoma may be compound or complex, consisting of small tooth-like structures, consisting of a mass of tissue that does not resemble a tooth.

Extra teeth that develop all over the mouth. These can also be listed by position by the dentist as follows:

  • Mesiodens. This is an additional tooth growing between the two central incisors — the two flat teeth at the front of the upper jaw.
  • Distomolar. This refers to an extra tooth growing in line behind the molars — the large, flat teeth at the back of the mouth.
  • Paramolar. This is an additional tooth growing next to one of the molars, out of line with the other teeth.

Most extra teeth are mesiodens.

Causes

The origin of hyperdontia may be due to environmental or genetic factors. In some cases it is unknown what the cause is.

Genetic disorders and syndromes can be linked to having extra teeth, including:

  • Gardner’s syndrome. This rare disorder also causes benign growths to form in various areas, and it increases the risk of colon cancer.
  • Cleidocranial dysplasia. This disorder also causes the abnormal formation of bones in the skull and collar area.
  • Cleft lip and palate. These congenital irregularities occur when a baby’s lip or mouth does not form correctly in the uterus.
  • Fabry disease. This involves a deficiency of the enzyme alpha-galactosidase A. It affects many areas, including the teeth, skin, brain, and nervous system.
  • Ellis van Creveld syndrome. Another rare disorder, this causes short limb dwarfism and additional fingers and toes. It may also involve congenital heart abnormalities.
  • Nance-Horan syndrome. In addition to causing dental abnormalities, this involves congenital cataracts that result in poor vision.
  • Rubinstein-Taybi syndrome. This leads to distinctive facial features, short stature, and intellectual disability, as well as problems with the teeth, eyes, heart, and kidneys.
  • Trichorhinophalangeal syndrome. This leads to bone and joint malformations, distinctive facial features, and abnormalities of the skin, hair, and teeth.

Certain genetic syndromes may also be responsible for supernumerary teeth. For physicians, an important clue may be the appearance of extra teeth, which encourages early diagnosis.

Symptoms

Hyperdontia is the medical term for extra teeth. These teeth may develop:

  • singly or in multiples
  • on one or both sides of the mouth
  • in the upper or lower jaws, or both

If an extra tooth is apparent, it may be identified as “erupted” by the dentist. If it is hidden beneath the gumline, it may be identified as “impacted.” Most extra teeth are single and impacted. In 12–23 percent of cases of hyperdontia, only two extra teeth occur. There are more than two extra teeth in less than 1 per cent of all cases.

Also, the upper jaw comprises as many as 98 percent of supernumerary teeth.

Hyperdontia usually does not cause pain. But, if the teeth are overcrowded or other problems, pain and swelling may occur around the extra tooth or teeth.

Diagnosis

A dentist will diagnose hyperdontia by inspecting the mouth.

They will also take X-rays to check for any extra teeth that have not broken through the gumline.

Treatment

Treatment depends on the likelihood that the supernumerary teeth can cause complications.

Extra teeth usually do not cause any symptoms. A person can not have any idea they are there and a dentist can detect them on an X-ray only.

If supernumerary teeth do not trigger symptoms or complications, then care may not be required.

In most hyperdontia cases, however, the extra teeth need to be removed, even though they do not cause discomfort.

If additional teeth cause, a dentist may suggest removal:

  • difficulties chewing or eating
  • problems cleaning the teeth, which could lead to gum disease
  • overcrowding or crooked teeth
  • a delay in the eruption of permanent teeth
  • damage to unerupted permanent teeth
  • any discomfort

If additional teeth develop due to a genetic disorder, it may also be a good idea to remove them.

Risk factors

Many genetic disorders are the key risk factors for hyperdontia

Supernumerary teeth may run in families even when there is no genetic condition present.

Complications

The majority of supernumerary teeth cause complications.

Some complications of hyperdontia include:

  • diastema, a gap between teeth
  • overcrowding
  • crooked teeth
  • pain and inflammation
  • infections, such as gingivitis
  • delayed eruption of permanent teeth
  • impaction of permanent incisors
  • abnormal root formation in nearby teeth
  • cystic lesions around the teeth
  • baby teeth not coming out in time

When to see a dentist

If a person finds additional teeth, particularly those that don’t fit the surrounding teeth, they should see a dentist.

As a general rule, consult a dentist about any mouth swelling or discomfort.

A parent or caregiver should visit a dentist if they note the late growth of a child’s permanent teeth, or if there are large gaps between permanent teeth— especially the front incisors.

The attendance of routine dental exams is critical. During a regular checkup or an X-ray, a dentist will detect hyperdontia.

Outlook

An early diagnosis leads to a better outlook for individuals with hyperdontia, according to studies.

In children as young as 2 years old a dentist may be able to diagnose the problem.

After removal of the extra tooth usually any pain ceases. If the underlying teeth are crooked or otherwise affected, these may be fixed by additional dental and orthodontic research.

Summary

Hyperdontia requires the insertion of extra teeth. The origin is not always obvious, but some hereditary disorders can be characterised.

While complications are often caused by hyperdontia, many are minor. Typically a doctor recommends that the extra tooth be removed.

Anybody who has oral health issues can contact a dentist.

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