Hyperdontia | 9 Interesting Causes of Excess Number of Teeth

Hyperdontia is a disorder in the growth of extra teeth. In this article, you will learn its classifications, causes, and treatments.

In general, human beings have two types of dentition. The first occurs in children between 6 months and 6 years approximately. This dentition is temporary and replaced by permanent teeth.

Adult dentition begins at age 6 with the appearance of the first permanent tooth, which is generally the lower central incisor. The permanent dentition is completed at approximately 12 or 14 years of age and, as its name indicates, it is the final dentition, the one that accompanies the person for the rest of life.
The number of teeth also varies depending on whether it is an adult or a child. 

In the temporary dentition, the number of teeth is 20: 2 central incisors, 2 lateral incisors, 2 canines, and 2 molars. On the other hand, for permanent dentition people have 2 central incisors, 2 laterals, 2 canines, 4 premolars, and 4 molars.

However, the number of teeth can vary and more or fewer teeth can be present than normal. If you have fewer teeth, it is called anodontia, but if you have more teeth, it is called hyperdontia, although some professionals may call it supernumerary.

What is Hyperdontia or Supernumerary Teeth

Hyperdontia, a dental anomaly, refers to the presence of supernumerary teeth beyond the regular dental count. This condition arises due to irregular dental development, resulting in extra teeth that can vary in size and form. These additional teeth can lead to complications like misalignment and overcrowding, potentially impacting oral health. Genetic factors, environmental influences, and certain syndromes contribute to its occurrence.

Diagnosis involves dental examinations and imaging, while treatment ranges from observation to orthodontic intervention or tooth extraction, depending on severity. Understanding hyperdontia is crucial for effective dental management and maintenance of oral well-being. The condition affects approximately 1 to 4 percent of the world’s population.

Classifications of Hyperdontia  

Supernumerary teeth can erupt anywhere in the mouth; however, finding them in the dental arch is more common. According to their location, they are classified as:

1. Mesiodens: a tooth that forms between the central incisors

2. Distomolar: teeth that grow behind the molars

3. Paramolar: a tooth grows alongside the molars outside of the dental arches

4. Natal tooth: teeth that present at birth or shortly after birth. The most common are mesiodens.

The supernumeraries can also be classified according to shape:

1. Supplementary: The shape of this tooth is the same or similar to the teeth that surround it.

2. Conical: They are usually wide at the base and narrow at the tip. are very similar to canines and have a root. Of note, this type of tooth is the most common.

3. Tuberculate: The tooth is either barrel-shaped or tube-shaped. They have normal roots and rarely erupt. This type of t00tth can delay the eruption of normal teeth.

4. Compound odontoma: This is a formation of different small teeth wrapped in a bag. These teeth do not erupt, but they can interfere with the eruption of normal teeth.

5. Complex odontoma: The tooth is formed from a tissue similar to normal teeth. They are irregular and there are usually several, not just one.

6. Molariform: The shape of this tooth is similar to premolars; they are fully rooted and usually erupt close to the molars.

If the redundant tooth or teeth are visible, they are classified as “erupted”; conversely, if the teeth are not visible, they are classified as “impacted”.

What Causes Hyperdontia?

Hyperdontia does not have an apparent cause; however, theories propose that the development of supernumerary teeth is due to the hyperactivity of the dental lamina cells, the precursors of tooth formation, although it can also be related to hereditary syndromes such as:

1. Cleft lip/palate

This is a condition characterized by a cleft or opening in the roof of the palate and upper lip.

2. Gardner syndrome

A genetic disorder that can cause the growth of the colon and skull and/or cysts on the skin.

3. Endocranial Dysplasia

A condition characterized by abnormal development of the clavicle and skull.

4. Faray’s disease

This syndrome presents with skin rashes, pain in the stomach, pain in the feet and hands, and inability to perspire.

5. Ehlers-Danlos Syndrome

This congenital condition causes loose joints, scoliosis, and pain in the joints and muscles.

6. Down syndrome

This condition is associated with growth retardation, very marked facial characteristics, and some intellectual disabilities.

7. Ellis van Creveld syndrome

This syndrome is characterized by dwarfism in the extremities fingers and toes, It is also associated with cardiac abnormalities.

8. Nance-Horan Syndrome

This syndrome involves the development of cataracts affecting long-term vision.

9. Rubinstein-Taybi syndrome

This syndrome is characterized by short stature, intellectual disability, and some facial features, as well as problems with the teeth, heart, and kidneys.

Trichorhinophalangeal syndrome: This syndrome leads to bone and joint malformations, abnormalities of hair, teeth, and skin, as well as characteristic facial features.

Hyperdontia Symptoms

Supernumerary teeth can develop singly or in multiples on both sides of the jaw and on both upper and lower dental arches. Supernumerary teeth are asymptomatic, that is, they do not generate any type of discomfort or pain.

One of the most common characteristics is the shape of the teeth, they can be very similar to normal teeth, although the vast majority of supernumerary teeth have an atypical conical shape.

These teeth can cause problems or diseases in the mouth such as crowding of the teeth and caries (due to the accumulation of plaque due to dental malposition caused by the supernumerary tooth). They can prevent the normal eruption of the teeth or in the worst case with complex or compound odontomas, they can make the roots of the teeth erupt.

In addition to the above complications, the following may also occur:

• Delayed eruption

• Crowding of the teeth present in the mouth

• Development of cysts and tumors

• Fusion with other erupted teeth

• Difficulty eating or chewing

• Problems  performing optimal dental hygiene

• Gum disease

• Displacement of teeth

How to Diagnose Hyperdontia? 

If the teeth are visible, diagnosis is very easy based on what the dentist sees with the naked eye. For unerupted teeth, the diagnosis is made using X-rays, preferably panoramic X-rays.
In some cases, other types of diagnostic means such as computerized axial tomography can be used. (CT)

Hyperdontia Treatments

In some cases, hyperdontia does not need treatment, although in most cases, it is suggested to be done.
The most common treatment is extraction or removal of the tooth; however, extraction is also recommended when you

1. Have a genetic condition that predisposes the appearance of more teeth

2. Have a genetic condition

3. Cannot chew properly.

4. Feel pain or discomfort in the case of dental crowding

5. Have difficulty performing adequate oral hygiene

6. Feel uncomfortable or self-conscious about the way your extra teeth look.

7. Think affects your aesthetics

Extraction of supernumerary teeth, which is the same as tooth extraction, is performed under local or general anesthesia depending upon the location and development of the extra tooth. The age to perform the extraction of supernumerary teeth is also relative. It is preferred to be done as an adult; however, it must be evaluated how much it could affect neighboring teeth and structures.

To discover advice on expediting the healing process following a tooth extraction, click here.