Having what appears to be extra teeth growing on your gums can be a surprising discovery. This unusual phenomenon is a recognized dental condition affecting a small percentage of the population. This article explores what these extra teeth are, why they develop, the problems they can cause, and the appropriate steps to take.
Understanding Extra Teeth in the Mouth
Extra teeth, formally known as supernumerary teeth or hyperdontia, are those that form in addition to the typical number of teeth. Children usually have 20 primary (baby) teeth, while adults generally have 32 permanent teeth. Any tooth exceeding these counts is considered supernumerary. These additional teeth can manifest in various forms and locations within the mouth.
They are often classified by their shape and position. Some supernumerary teeth might resemble normal teeth and are called “supplemental.” Others can be peg-shaped, conical, barrel-shaped, or have an undefined shape. These extra teeth can emerge anywhere in the dental arch, but they are most commonly found in the upper jaw, particularly between the two upper front teeth. They can also appear alongside or behind molars or remain entirely within the gum tissue, unable to erupt.
Causes of Extra Teeth
The exact reasons behind the development of supernumerary teeth are not fully understood, but several contributing factors have been identified. Genetic predisposition is a significant element, with these teeth sometimes running in families. Overactivity of the dental lamina is another proposed cause. This hyperactivity can lead to the formation of extra tooth buds, which then develop into supernumerary teeth.
Supernumerary teeth are also linked to certain genetic syndromes and conditions. For example, they are more common in individuals with Gardner’s syndrome and cleidocranial dysplasia. Other associated syndromes include cleft lip and palate, Down syndrome, Ehlers-Danlos syndrome, and Fabry disease. While these conditions increase the likelihood of hyperdontia, extra teeth can also appear in individuals with no history of such medical issues, suggesting environmental factors might also play a role.
Potential Problems from Extra Teeth
The presence of extra teeth can lead to a range of dental complications, impacting both oral health and function. One common issue is crowding, where the additional tooth occupies space needed by normal teeth, resulting in misalignment and malocclusion. This crowding can make proper oral hygiene challenging, increasing the risk of tooth decay and gum disease.
Supernumerary teeth can also prevent or delay the eruption of permanent teeth, especially if they are impacted, meaning they are fully or partially trapped within the jawbone. In some cases, a fluid-filled sac, known as a dentigerous cyst, can form around an unerupted extra tooth, potentially leading to bone destruction. The pressure from an extra tooth can also cause root resorption, which is damage to the roots of adjacent healthy teeth. This can weaken the affected teeth and, in severe cases, lead to tooth loss.
Additional complications include abnormal spacing between teeth or the displacement and rotation of neighboring teeth. Pain, discomfort, or localized swelling can occur if the extra tooth puts pressure on surrounding tissues or becomes irritated. While less common, supernumerary teeth can migrate into unusual locations like the nasal cavity or maxillary sinus. Aesthetic concerns are also common, particularly if the extra tooth is visible in the front of the mouth.
What to Do About Extra Teeth
If you suspect or know you have extra teeth, consulting a dentist or oral surgeon is the recommended first step. A thorough clinical examination will be performed, often supplemented with imaging techniques to precisely locate and assess the extra tooth. X-rays are often used for initial screening to visualize the teeth and surrounding bone. For more detailed information, especially for impacted teeth and their proximity to other structures, three-dimensional imaging like cone-beam computed tomography (CBCT) scans may be recommended.
The management approach for supernumerary teeth varies depending on factors like the tooth’s type, location, and whether it’s causing complications. For asymptomatic extra teeth that are not interfering with normal tooth development or alignment, a “watch and wait” approach with regular monitoring might be suitable. However, if the extra tooth is causing issues, removal is usually recommended. Surgical extraction is a common procedure, particularly for impacted teeth or those causing pain, crowding, or preventing the eruption of permanent teeth.
Following extraction, orthodontic treatment may be necessary to correct any alignment issues caused by the extra tooth or to help guide delayed permanent teeth into their proper positions. Early diagnosis and intervention can minimize the need for extensive surgical or orthodontic procedures and reduce the risk of long-term complications. The decision on when to extract, especially in children, considers factors like the stage of root formation of adjacent permanent teeth. Early removal is often advocated to promote natural eruption and potentially reduce the need for orthodontics.