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Hyperdontia: Overview, Causes, Types, Diagnosis & Treatment

Children grow up to 20 baby teeth while adults house up to 32 permanent teeth. However, there are people born with more than 32 teeth. Hyperdontia affects more than 200,000 Americans per year.

The cause of hyperdontia isn't known. There are several theories; one theory suggests that supernumerary teeth may result from the tooth bud's dichotomy, and another suggests it could be hereditary. 

Dentists can spot supernumerary teeth through a chance finding on a radiograph or due to an impacted central incisor's development. The spontaneous eruption can also lead to its discovery.

What is Hyperdontia?

Hyperdontia is a condition wherein an individual has supernumerary teeth or more teeth than regular that can appear in any dental arch area and can affect any dental organ.

What are the types of Hyperdontia?

When classified by shape, they have four categories: supplemental, tuberculate, conical, and odontoma.

  • The supplemental supernumerary has a standard shape and is the duplication of teeth in the regular series. This type is usually found at the end of the tooth series.
  • Tuberculate is barrel-shaped and possesses more than one cusp or tubercle. Often paired, tuberculate supernumeraries are commonly located on the palatal aspect of the central incisors. According to CDA, this type rarely erupts and is often associated with the delayed eruption of incisors.
  • Conical is peg-shaped and commonly found in permanent dentition. This type of supernumerary may occasionally be found high and inverted into the palate.
  • On the one hand, the fourth category of a supernumerary tooth, odontoma, refers to any odontogenic origin tumor. However, this category is not universally accepted. Odontoma is further sub-divided into two categories – complex composite odontoma and compound composite odontoma.

When classified by location, they have three categories, namely paramolar, distomolar, and mesiodens.

  • Paramolar is an extra tooth at the back of the mouth, next to a molar.
  • Distomolar is an extra tooth that grow in line with other molars.
  • Mesiodens, the most common type, is an extra tooth at the back or around the incisors.

What causes Hyperdontia?

According to the Canadian Dental Association (CDA), supernumerary teeth' cause remains to be incompletely understood. But, one theory suggests that supernumerary teeth may result from the dichotomy of the tooth bud.

Another theory proposes the hyperactivity theory which states that supernumerary teeth are formed because of local, independent, conditioned hyperactivity of the dental lamina. Heredity may also be a factor in these teeth, particularly certain hereditary conditions like Gardner's syndrome, Ehlers-Danlos syndrome, Fabry disease, cleft palate and lip, cleidocranial dysplasia.

How can Hyperdontia be diagnosed?

Supernumerary teeth may be detected through a chance finding on a radiograph or as the cause of an impacted central incisor. The spontaneous eruption can also lead to its discovery.

How common is Hyperdontia?

It affects more than 200,000 Americans per year. In a 2,000 school children survey, supernumerary teeth were found to have a 0.8 percent prevalence on primary dentitions and 2.1 percent on permanent dentitions.

Hyperdontia is more familiar with permanent teeth than baby teeth, affecting more individuals from ages 14 to over 60 than those below 13 years old. It is considered chronic, persisting for a long time or lifelong.

How is Hyperdontia treated?

It is usually is treatable by a medical professional. However, those with hyperdontia may experience crowding, failure of eruption, displacement, pathology, alveolar bone grafting, implant site preparation, and asymptomatic.

The treatment for hyperdontia is dependent on the type and position of the supernumerary tooth and how it affects the adjacent teeth. It is best to consult your dentist for the right treatment plan.

The Supernumerary Tooth May Require Removal Especially When:

  • Delayed eruption of the central incisor
  • Evident altered eruption or displacement of central incisors
  • Associated pathology
  • Proximity with an active orthodontic alignment of an incisor
  • Compromise the secondary alveolar bone grafting in cleft lip and palate patients
  • A tooth is in the designated bone for implant placement
  • The spontaneous eruption of supernumerary has occurred
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