What is Hyperdontia?
The oral condition or tooth pathology that causes the development of teeth, over and above the normal 32 permanent teeth is known as hypodontia. The condition fuels the emergence and growth of extra teeth on the dental arches and is usually referred to as supernumerary teeth. A newborn develops 20 deciduous or primary teeth as he grows up and by the time he attains adulthood, he has a set or 32 permanent teeth.
When is it likely to occur?
You’re more likely to be diagnosed with hyperdontia during your puberty than in your adult life. So, the likelihood of having supernumerary teeth or additional adult teeth is higher than the incidence of extra primary teeth. The contrary condition where you have less than the regular number of teeth is called ‘hypodontia’ which tends to be more prevalent.
Supernumerary teeth could be few in number or numerous, occurring symmetrically or inconsistently anywhere in the dental arches. The adult incisors in the maxilla or upper jaw are most susceptible to having supernumerary teeth followed by the fourth molars both in the mandibular and maxillary arches.
Different Types of Hyperdontia
Supernumerary teeth are of different types and are categorized regarding their position on the dental arch and shape. Classification by shape is as follows:
- Complex-compound odontoma: Odontoma is the most prevalent and common of all benign odontogenic tumors. There are two basic kinds of odontoma, depending upon the extent of morpho differentiation or their structural similarity to regular teeth-complex odontoma and compound odontoma.
When the supernumerary tooth consists of an agglomeration of dentin and enamel, without having any anatomical resemblance to a normal tooth, it is an instance of complex odontoma. Alternatively, the formation of numerous tiny dental structures bearing a resemblance to actual teeth is defined as compound odontoma.
- Conical: This supernumerary tooth tape is the most common amongst all.
- Tuberculate: It is also known as barrel-shaped mainly because it has over one tubercle or cusp.
- Supplemental: the Supplemental supernumerary tooth is so called as its shape and structure bears a close resemblance to regular teeth.
Occurrence and Predominance
Since the primary teeth shed and give way to permanent teeth, it is evident that hyperdontia is more predominant during the adult phase than the adolescent stage. The chances of supernumerary teeth developing in males are two times higher compared to females. Hyperdontia is prevalent in 1%-4% of the population with most individuals reporting the development of a solitary tooth.
The incidence could vary based on the individual’s ethnic traits, associated syndromes or risk factors, and physical location. The prevalence of hypodontia is higher in Asians than Caucasians. At the same time, people with a familial or inherited history of hypodontia are more indisposed to hyperdontia.
Medical scientists and researchers have not been able to pinpoint a single cause attributable to hyperdontia. Consequently, they have classified the most common causes under two broad categories:
- Genetic: A person is at high risk of having supernumerary teeth if either of their parents suffers from the condition.
- Environmental: The environment, ethnicity, and lifestyle could have a bearing on whether one will grow supernumerary.
Some common syndromes and conditions usually associated with Hyperdontia are:
- Cleidocranial Dysplasia: Some individuals at birth have no clavicles or have them partially. The absence of the collarbone or its partial presence leads to hearing impediment, increased distance between the two eyes, cleft palate, and enhanced vulnerability to infections.
- Ehler-Danlos Syndrome: It is a sporadic genetic syndrome associated with connective tissues that are responsible for promoting healthy teeth development.
- Down Syndrome: Children diagnosed with this Syndrome, a somewhat rare hereditary disorder are increasingly susceptible to having supernumerary teeth.
- Gardner Syndrome: It is a syndrome which mostly affects children where they have numerous skin cysts, benign tumors in jaws, and nodules in the intestines.
- Cleft palate or lip: Children with cleft palate or lips have supernumerary teeth that are conical in shape.
Side-Effects of Hyperdontia
- Formation of cysts or polyps
- The growth of extra teeth lead to overcrowding and the teeth will start appearing disproportionate and might get dislodged.
- The child will suffer from toothaches and may have problems biting into foods and masticating the morsels properly.
- The presence of additional teeth will come in the way of the child talking in a normal manner.
- The facial appearance will be anomalous
- Too many teeth in an oral cavity mean higher chances of food particles getting lodged in between them.
Surprisingly enough, it has no noticeable symptoms as the condition comes to the fore only when the individual complains of aches or is diagnosed with the syndromes listed above. Some common symptoms are:
- Non-appearance of permanent or adult teeth
- Teeth crowding
- Permanent teeth getting displaced
- Unnatural facial appearance
- Speech related issues
Detecting & Diagnosing Hyperdontia
Diagnosing the condition at early stages will enable the clinician to suggest best possible treatment to prevent further complications. Most dentists and orthodontists are of the opinion that it is possible to detect it when an individual is just two years old.
- A routine X-ray of the dentitions will reveal supernumerary teeth even if there are in a primary stage.
- A CT scan offers a detailed view of the internal structure of the upper and lower jaws.
- Panoramic and periapical radiographies are the most recommended diagnostic processes.
Moreover, the parallax radiographic technique, the mesiodens’ buccolingual position that is yet to erupt can be reviewed.
The dentist may suggest any of the following procedures for establishing clinically and diagnostically:
- Teeth removal or extraction: Extracting the supernumerary tooth is the most common as well as the most straightforward process of getting rid of the same. The patient does not experience any pain during extraction owing to the application of local anesthesia.
- Orthodontic treatment: The extraction might influence the typical arrangement of the teeth in the dental arch. Therefore, the patient, following the removal is advised to put on dental braces until the teeth become naturally aligned.
- Endodontic treatment: Endodontic treatment is very much the same as root canal procedure and is only resorted to if the dentist sees that the extra tooth is merging with the adult teeth. The dentist waits for the root of the supernumerary to fully develop after which he does away with the tissue surrounding the fused tooth. Finally, the extra tooth is extracted via a surgical procedure.