Q. Can someone with supernumerary teeth in the lower jaw get Invisalign in the upper jaw?

Answered by
Dr. Mayank Khandelwal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 20, 2023

Hi doctor,

I have supernumerary teeth in my lower jaw and unless I get them removed, I will not be able to get braces. However, one tooth in my upper row is protruding and it makes me feel insecure; it also causes me to breathe through my mouth. I want to get Invisalign aligners for my top row first, please help.



Welcome to

I have read your query and understand your concern.

As per the x-ray attached (attachment removed to protect the patient’s identity), you might have a condition known as lower third premolar. In normal situations, every human is supposed to have two premolars on both sides of the upper and lower jaw. But it seems you have a 3rd premolar on the lower right side and may be on the left side as well. It is not clear as it is being shadowed in the x-ray. You would require to get your extra premolar on the left side removed as it is horizontally placed and the chances of it coming to occlusion in the correct position are very minimal. In the longer run, it might cause more harm to the existing teeth and may even develop pain. It should be removed therapeutically rather than waiting for the pain to come. There are excess teeth in the lower jaw which are occupying more space than required. As a result, some of them are not able to erupt and have got stuck in the bone (called impacted teeth). This will have to be sorted by making space for them or forcing them to erupt. This decision should be made after discussing and assessing the pros and cons of all possible treatments. Coming to the Invisalign option, you can go for a single arch to correct the upper jaw but that would not be very useful as it would involve time and finances while the overall smile and dentition would still not be corrected completely. I would suggest you get the lower jaws treated first followed by Invisalign which will coordinate both arches. This would give you long-term stable occlusion and enhanced results. Since the x-ray on the middle part is unclear, I would like to have a look at your teeth. If you could provide some images of your teeth and face as described, it would give a better idea to suggest you a precise treatment option. Please share the following images

Hope this helps.

Thank you and take care.

Differential diagnosis:

Supernumerary teeth.

Regarding follow up:

Please share the following photos for further evaluation:

1. Face frontal.

2. Face smiling.

3. Face side profile.

4. Teeth frontal with a smile.

5. Occlusal uppers.

6. Occlusal lowers.

You can search on the internet under the name orthodontic photos and see how to take those images.

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