Mamelons are small, rounded ridges found on the biting edge of newly erupted adult front teeth, appearing as three distinct bumps on each incisor. These formations are a normal part of tooth development and are composed entirely of enamel. They are common, pose no health risk, and often give the incisal edge a slightly scalloped appearance. While mamelons are naturally temporary for most people, certain structural factors can cause them to persist well into adulthood.
Identifying Mamelons
Mamelons are a developmental remnant, forming while the permanent incisors grow inside the jawbone. Each incisor crown develops from three distinct lobes of enamel that fuse together before the tooth breaks through the gumline. The junctions where these three lobes meet create the three small mamelons visible on the tooth’s edge.
These features are confined exclusively to the eight incisors—the four central and four lateral front teeth. Their composition is solely enamel, meaning they contain no underlying dentin or nerve tissue. This lack of nerve tissue is why the natural wearing process or future dental procedures to smooth them are typically painless. Mamelons are most noticeable when the permanent incisors first erupt, usually between the ages of six and eight.
Why Mamelons Typically Vanish
The disappearance of mamelons is a natural process driven by functional dental wear, known as attrition. Attrition is the mechanical wearing away of tooth surfaces caused by tooth-to-tooth contact during everyday activities. When a person chews and bites food, the upper and lower incisors come into contact, generating friction that gradually smooths the enamel ridges.
This natural smoothing process typically begins almost immediately after the teeth emerge. For most individuals, the constant friction from normal biting and chewing is sufficient to wear away the mamelons completely. The incisal edge of the tooth becomes flat and straight over a period of months or a few years. Mamelons are therefore a transient feature for the vast majority of the population.
Factors Causing Mamelons to Persist
The primary reason mamelons persist into adolescence or adulthood is a failure of the natural attrition process. This failure occurs when the upper and lower incisor teeth do not make functional contact during chewing and biting. When there is no opposing tooth contact, the enamel bumps are never subjected to the friction needed to wear them down.
The most common structural issue leading to this lack of contact is an anterior open bite, a form of malocclusion. An open bite is a condition where the front teeth do not overlap when the back teeth are closed, creating a structural gap. This gap prevents the incisal edges from meeting, effectively preserving the mamelons. Other bite discrepancies, such as rotational misalignment or a severe deep overbite, can also prevent the necessary edge-to-edge contact.
While mamelons themselves are harmless, their persistence often signals an underlying bite alignment issue. The presence of mamelons in an adult is a strong indicator that the person has a non-functional incisal relationship and may need orthodontic evaluation.
Dental Procedures to Remove Mamelons
When mamelons persist or a patient finds them aesthetically undesirable, dental intervention offers straightforward solutions. The most common procedure for removal is enamel contouring, also known as cosmetic reshaping or enameloplasty. This process involves the dentist using fine files, discs, or specialized drills to gently smooth the enamel protuberances.
The procedure is quick, often taking less than 30 minutes, and is virtually painless because mamelons consist only of enamel with no nerve endings. Since only a minimal amount of the outer layer is removed, the structural integrity of the tooth is maintained. Patients may experience temporary sensitivity to hot or cold temperatures immediately following the procedure.
A less common alternative is dental bonding, typically reserved for cases where the incisal edge needs substantial reshaping or repair. Bonding involves applying a tooth-colored composite resin material to the tooth surface. Simple mamelon removal usually only requires the minimally invasive approach of enamel contouring.