Hyperdontia

  • Medical Author:
    Steven B. Horne, DDS

    Dr. Steve Horne began his career at Brigham Young University obtaining his BA in English. He earned his doctorate of dental surgery in 2007 from the University of Southern California where his pursuit for academic excellence landed him on the dean's list. He was recognized for his superior clinical skills and invited to help teach other dental students in courses on restorative dentistry, prosthodontics, and tooth anatomy. During dental school, he provided dental care for underserved populations of Los Angeles and Orange County, Mexico, and Costa Rica with the international volunteer organization AYUDA. After graduation from USC, Dr. Horne entered active duty with the U.S. Army and practiced dentistry at Fort Knox, Kentucky, for four years. During this time, in 2010, he was deployed as part of a medical unit to Baghdad, Iraq, to provide dental and triage support to military and civilian workers who were involved in the effort there. During his military service, he received multiple Army Achievement Medals, the Army Commendation Medal, and served as company commander. After leaving the Army in 2011, Dr. Horne joined a private practice in La Jolla, Calif., and became credentialed with Scripps Memorial Hospital La Jolla as a dental consultant. Health and education are of paramount importance to Dr. Horne, and since 2012, he has been writing dental articles for MedicineNet and WebMD to provide accurate information about oral health to the public. He is a member of the American Dental Association (ADA), Academy of General Dentistry (AGD), California Dental Association (CDA), and the San Diego County Dental Society and American Academy of Cosmetic Dentistry (AACD). He is a preferred provider with Invisalign and spends countless hours each year pursuing continuing education in order to maintain a standard of excellence in dentistry. Dr. Horne has been married for 15 years to his wife, Christy. They have 3-year-old twins, Camille and Trent, and very recently welcomed their third child, Colette Elise, on July 6! The heart and soul of the family is Roscoe, their chocolate Labrador.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is hyperdontia?

Hyperdontia is an oral condition characterized by having an excess number of teeth. The standard number of primary teeth is 20 and the standard number of permanent teeth is 32. Primary teeth are the first set of teeth that erupt in a person's mouth, generally by the age of 36 months of age, and are shed by the time the person is about 12 years old. The permanent teeth then take the place of the primary teeth and usually erupt completely by the time the person reaches 21 years of age. A person who develops more than 20 primary teeth or more than 32 permanent teeth has hyperdontia. The additional teeth are referred to as supernumerary teeth.

Supernumerary teeth can occur in any part of the dental arch, but the most common supernumerary teeth are permanent, anterior incisors, in the maxillary (upper) arch. After maxillary incisors, maxillary and mandibular (lower arch) fourth molars are the next most common supernumerary teeth. These generally appear as extra impacted wisdom teeth. An extra maxillary incisor is called a mesiodens, and an extra fourth molar is referred to as a distodens or distomolar. Extra primary teeth present at or shortly after birth are called natal teeth.

How common is hyperdontia?

The prevalence of hyperdontia is between 1% and 4% of the population with a male to female ratio of 2:1; the majority of cases are limited to a single tooth. There have been reported cases of over 30 supernumerary teeth in one person, but such large numbers are rare.

What are risk factors for hyperdontia?

When a person does develop multiple supernumerary teeth, it often is associated with a variety of conditions or syndromes such as cleidocranial dysplasia, Ehler-Danlos syndrome, Gardner syndrome, and cleft lip and palate.

Quick GuideCosmetic Dentistry Before and After Photos

Cosmetic Dentistry Before and After Photos
Cleft lip and palate are risk factors for hyperdontia.

Hyperdontia Risk Factors

Cleft Lip and Palate

A cleft lip is an opening extending through the upper lip. It may be in the midline (center) or left and/or right side of the lip. A cleft palate is an opening of the hard palate (the bony front portion of the roof of the mouth) or the soft palate (the muscular non-bony region in the rear of the roof of the mouth. Similar to a cleft lip, a cleft palate may be midline and/or to either right of left side of the palate. A cleft palate may extend from the upper jawbone to the rear of the throat.

Since development of the lip and palate occur at different times during gestation, an infant may have either a cleft lip or cleft palate or clefting of both regions.

What is the cause of hyperdontia?

The cause of hyperdontia is not entirely clear. It is believed that there may be a genetic factor in hyperdontia consisting of an autosomal dominant trait with low penetrance (only sometimes producing supernumerary teeth in a carrier of the mutated gene). Other possible causes are environmental factors and overactivity of the dental lamina during tooth development. The dental lamina is a zone of cells that initiates the formation of the tooth germ, which forms the tooth.

What is the treatment for hyperdontia?

It is important to detect, evaluate, and treat supernumerary teeth as soon as possible since the additional teeth will present both cosmetic and functional problems for the affected individual. As a majority of supernumerary teeth cause clinical problems, treatment generally consists of removal of the teeth when possible.

What are complications of hyperdontia? What is the prognosis of hyperdontia?

Supernumerary teeth may cause delayed eruption of adjacent teeth or significant crowding that will often require orthodontic treatment to correct. If retained, the teeth can lead to the development of cysts or tumors. It is generally not necessary to remove natal teeth unless the supernumerary teeth are loose and present a risk for aspiration due to passage into the lung.

Medically Reviewed on 11/21/2017
References
REFERENCES:

Mossey, Peter A. "The heritability of malocclusion: part 2. The influence of genetics in malocclusion." British Journal of Orthodontics 26.3 (1999): 195-203.

Neville, Brad W., et al. Oral and Maxillofacial Pathology, Second Ed. St. Louis: Saunders, 2001.

Pereira, M. N., et al. "Multiple hyperdontia: Report of an unusual case." American Journal of Orthodontics and Dentofacial Orthopedics 140.4 (2011): 580-584.
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