Hyperdontia is a condition where people have more number of teeth in addition to the regular 32 teeth. Read the article to know about its causes, types, symptoms, diagnosis, and treatment.
Hyperdontia is a condition of too many teeth or the growth of extra teeth in the mouth additional to the regular number of teeth. They can be seen in various syndromes. There will be multiple supernumerary teeth, which are usually impacted. It will not be painful but can cause some complications. It is more commonly seen in permanent dentition than in deciduous dentition (milk teeth).
Hyperdontia can be caused due to hereditary factors along with environmental factors. Single tooth hyperdontia are more common, and multiple teeth hyperdontia is less common. Extra teeth will not erupt sometimes but may delay the eruption of the permanent teeth. It can be due to disorders like:
Cleidocranial Dysplasia- Is the disorder that causes abnormal formation of bones in the skull and the collar region.
Gardner's Syndrome - Is a rare disorder that causes benign growth in various areas of the body, and also increases the risk of colon cancer.
Cleft Lip - This is a congenital disorder where the baby's lips do not form properly in the uterus, resulting in a slit in the upper lip.
Cleft Palate - This is a congenital disorder caused when the baby's palate does not form properly in the uterus, resulting in an opening in the roof of the mouth.
Down Syndrome - This is a common genetic chromosomal disorder due to abnormal cell division, which causes learning disability in children, including gastrointestinal and heart abnormalities.
Ehlers-Danlos Syndromes - This is a group of connective tissue disorders.
Ellis-Van Creveld Syndrome - Is a rare disorder that causes extra toes and fingers and short limb dwarfism.
Rubinstein-Taybi Syndrome - It leads to short stature, distinctive facial features, intellectual disability, and problems with the teeth, heart, eyes, and kidneys.
Nance-Horan Syndrome - Additional to the dental abnormalities, this causes congenital cataracts that cause poor vision.
Trichorhinophalangeal Syndrome - This leads to joint and bone malformations, distinctive facial features, and abnormalities of the teeth, skin, and hair.
Fabry Disease - This occurs due to the deficiency in the enzyme alpha-galactosidase A. Many areas are affected, including the skin, teeth, nervous system, and brain.
Hyperdontia can be classified according to the shape and position of the teeth. According to the shape, they can be:
Supplemental (has the normal shape of the teeth).
Compound odontoma (multiple teeth-like structures).
Tuberculate or barrel-shaped
Conical or peg-shaped.
Complex odontoma (disordered mass of dental tissue).
According to the position of the teeth, they can be:
Distomolar: They are seen on the distolingual or the distal side of the third molar.
Paramolar: They can be present buccally, palatally, or lingually, most commonly between the second and third maxillary molars. But rarely seen in first and the second molars.
Mesiodens: These are present between the maxillary central incisors. They can be peg-shaped or conical in shape.
Parapremolar: It is an extra tooth in the premolar region.
Paramolar tubercle: It is an extra cusp on the permanent molar tooth.
Paramolar root: It is an extra root on the mandibular molars.
It can be either single or multiple, and it can occur on one or both sides of the jaws. There can be only one excess tooth, which can also be impacted in the jaw. Even if the extra teeth are not fully grown in the jaw, it can be seen with CT or x-rays. The symptoms include some pain or swelling according to the pattern of growth, and the people may experience some misaligned teeth, crowded teeth, or toothache. The additional teeth grow far from the dental arch or within the maxillary sinus, and they may also migrate from one place to another after the eruption. Supernumerary teeth may lead to the formation of any tumors or cyst. The extra molar teeth are rare, and it can be most commonly seen in the front tooth region (premaxilla).
Hyperdontia may cause a delayed eruption of the adjacent teeth or may cause overcrowding of teeth, which needs orthodontic treatment for correction. If it is retained or left untreated, it may lead to the development of tumors or cysts. The other complications of hyperdontia are:
Diastema (a gap between the teeth).
Pain and inflammation.
Infections like gingivitis (inflammation of the gums).
Delayed eruption of permanent teeth.
Impaction of the permanent teeth.
Abnormal root formation of the nearby teeth.
The common risk factors are genetic disorders, and even if there are no genetic disorders present, hyperdontia may be seen in many family members.
It is more common in permanent dentition than in deciduous dentition and twice more common in males than females. 98% of hyperdontia is commonly seen in the upper jaw than the lower jaw. Anterior teeth are more commonly affected than the posterior teeth or the molar teeth region.
The dentist diagnoses it by clinically examining the teeth. CT or x-ray can also be used to diagnose hyperdontia. Intraoral x-ray and a panoramic radiograph are the techniques of x-rays. X-rays should be taken from two different angles. These are all 2D x-rays and do not show the 3D view of the image.
Usually, hyperdontia does not cause any symptoms, and the patient may also be unaware of having those extra teeth. It could be diagnosed only by the dentist when he asks to take an x-ray or CT. The teeth are often extracted due to aesthetic reasons, orthodontic reasons, the eruption of other teeth, and any pathology. The treatment depends on whether the hyperdontia cause any complications like:
Difficulties in eating or chewing.
In the case of gingivitis, due to a problem in cleaning the teeth.
Crooked teeth or overcrowding of teeth.
Delayed eruption of permanent teeth.
In case of damage to the unerupted permanent teeth.
Discomfort due to the extra teeth.
The right time to see the dentist is when you have any:
Swelling or pain in the mouth.
Extra teeth not in line with the surrounding teeth.
Delayed eruption of the permanent teeth.
Any discomfort in the mouth.
Crowded or crooked teeth.
The maxilla and the anterior segment are most commonly affected. The reason for orthodontic treatment is also the presence of supernumerary teeth. A regular check-up with the dentist can prevent any complications due to hyperdontia. For more information, consult a doctor online.
Hyperdontia is characterized by the growth of extra teeth than the usual number of teeth. It is not a severe condition and is not painful; however, it pressurizes the jaws and gums of the individual and may cause swelling.
Extra or supernumerary teeth can be removed if it causes pain, discomfort while eating or chewing or produces complications to the individual. Nevertheless, it does not cause any problems; extraction of extra teeth may not be required.
Hyperdontia by itself is not a life-threatening condition. However, cysts and tumors developing from hyperdontia can pose risks. Hyperdontia is associated with problems in biting, alignment of the teeth and jaws, periodontal diseases, dental caries, and dental infection. In severe cases, it exhibits facial deformities and speech difficulties.
Extraction of the supernumerary teeth is the initial treatment for hyperdontia, which a dental x-ray should precede to determine if the teeth to be extracted are erupted, partially erupted, or impacted. Depending on that, standard forceps extraction or surgical disimpaction is decided. Following extraction, orthodontic treatment might be required.
Along with the influence of environmental factors, genetic factors are also associated with the incidence of hyperdontia. It is also correlated to specific genetic syndromes like Gardner's syndrome, cleft palate, Ehler-Danlos syndrome, etc.
In hyperdontia, the incidence of crooked teeth is high due to the extra teeth which push their adjacent regular teeth and cause malalignment. Therefore, orthodontic treatment with braces is essential in addition to the extraction of supernumerary teeth.
Hyperdontia is prevalent in about one to four percent of the total population and is particularly more common in males as compared to females. Of which, a single tooth hyperdontia is more common than multiple teeth hyperdontia, which is a rare condition.
The supernumerary teeth in hyperdontia can be removed if it causes any problems. Else, it does not require extraction. Also, if the individual has an underlying genetic condition that might increase the chance of developing supernumerary teeth, then extraction is highly recommended.
Hyperdontia in children is manifested clearly around the period when the milk teeth exfoliate, and the permanent teeth erupt into the oral cavity. They erupt anywhere in the oral cavity, like in between, behind, in front of the permanent teeth, or may sometimes be seen along the roof of the mouth.
Crooked or misaligned teeth, periodontal diseases, gum and tooth infection, tooth decay, discomfort while chewing, etc., may be present with hyperdontia. In severe hyperdontia, cysts, tumors, facial deformities, and speech difficulties may be associated.
Gardner's syndrome, cleidocranial dysplasia, cleft lip and cleft palate, Ehler-Danlos syndrome, and other genetic disorders may be linked with hyperdontia.
Extracting the supernumerary teeth can be painful, but it is eliminated by administering local anesthesia during the procedure. After removal, post-extraction pain can be managed by over-the-counter or prescription pain-relieving medications suggested by the dentist.
Last reviewed at:
01 Apr 2022 - 5 min read
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