What do you know about Supernumerary teeth? By default, 52 elements of dentition are considered standard equipment for the human body. The first “batch” (in the amount of twenty) erupts in childhood and is replaceable (or milk), in fact, preparing a place for the formation and growth of the main crowns. However, the individual features of the anatomical development of the jaw do not always meet expectations. In dentistry, there are cases when, during a planned or extraordinary diagnosis, a child is diagnosed with the presence of additional units in the jaw structure, which in itself is a symptom of a pathology known as polyodontia. What is the disease of supernumerary teeth, what are the reasons for the presence of extra elements in the mouth of an adult, and how can the treatment of this anomaly eliminate the associated functional and aesthetic problems?
In dental terminology, the concept of “overcompleteness” is used to determine the presence of dentition rudiments that exceed the standard limit for the human body. In recent years, it has been observed more and more often and, according to studies, in 9 out of 10 cases, it becomes the cause of incorrect development of dentition. Pathology leads to the formation of a stable deformity, provokes inflammatory processes in periodontal tissues, and is usually localized in the frontal area of the alveolar process, or in the area between the incisors and canines of the maxillary region.
The disease, when a person has a lot of extra teeth growing in his mouth, is called hyperdontia and, as a rule, occurs in an average of 2% of people. In this case, a specific number of additional units is usually considered as a differentiating criterion – in most cases (about 50%), the pathological condition is characterized by the presence of a supernumerary pair of incisors displaced towards the palate. The second category includes the growth of duplicate canines and premolars, and the rare is the clinical picture in which the number of elements in the series exceeds four or more.
What does it look like
It is obvious that the main sign of pathology is the presence in the structure of the dentoalveolar apparatus of elements that have already erupted or are in the embryonic stage. In the early stages, it can be identified by the formation of painful swelling. If you suspect the growth of extra milk or supernumerary wisdom teeth, hyperdontia is confirmed by photos taken using an X-ray machine or a digital tomograph.
Practice shows that eruption can occur in parallel with the usual schedule for the development of the jaw section, according to which units appear in the first months of a baby’s life. This situation causes inconvenience to both the baby and the mother, since it is accompanied by discomfort during feeding, interferes with proper nutrition, and provokes respiratory dysfunction, abundant salivation, and inflammation.
With the formation of a removable bite, the presence of additional incomplete teeth becomes the cause of impaired diction, occlusal displacement, and periodic injuries of the mucous tissues of the oral cavity. The most difficult situations are considered when the anomaly is localized in the region of the upper palate since the tongue does not have enough space to master articulation. In addition, the pathology, which is formed in the frontal part and is noticeable to others, provokes the development of psychological complexes.
At an older age
Adult patients are characterized by all the same problems that occur in children and adolescents, however, prolonged adaptation to the abnormal structure reduces the inconvenience experienced in everyday life. However, the completion of the tissue formation cycle can cause the manifestation of the following negative symptoms.
The presence of additional elements, due to the limited space, erupt outside the main row – in the lingual part of the gum or in the palate. Such units usually grow at an atypical angle, are twisted or rotated, and disrupt the root structure in adjacent areas. As a result, without proper medical intervention, the patient has to face regular inflammation of the gums, as well as diseases of the gastrointestinal tract and nervous system.
The term for crowns that remain inside the bone tissue due to the impossibility of eruption. Often, patients are not even aware of the presence of a problem, because they do not experience pronounced discomfort or pain – until the development of complications begins, leaving no choice but extraction – the surgical removal of an additional element of the dentoalveolar apparatus.
Types of hyperdontia
There are several varieties of pathological conditions, which differ not only in the degree of manifestation of negative symptoms but also in possible consequences. Let’s consider the main ones.
An anomaly is characterized by the presence of crowns that grow without actually going beyond the main structure and having smaller dimensions. Often due to a hereditary factor.
A typical appearance
The situation when extra teeth in people are formed outside the row boundaries, usually located in the sky. In critical situations, units can fill the entire free space, including the lingual surfaces of the arches, but such precedents in dental practice are extremely rare.
The formation of supernumerary dental crowns from excess rudiments, as well as as a result of the splitting of the root structure at an early stage. It does not cause significant inconvenience under the condition of health conditions of the “additional” pair, however, if one of the elements is affected by caries, treatment or extraction is difficult due to the interlacing of the roots.
The least severe, from the point of view of the resulting consequences, is the option in which the prerequisites ultimately do not lead to a real pathological state. It is observed when the bite changes when the root unit begins to erupt before the milk precursor falls out. Eliminated naturally or by extraction, depending on the indications of the clinical picture.
Types of Supernumerary teeth in hyperdontia
Classification based on the location of supernumerary elements also allows us to distinguish a couple of varieties:
- Spiny. They are formed in the structure of the maxillary region, mainly between the incisors and on the lateral sections of the arches. They have pointed ends, hence the name.
- Additional premolars and canines. Formed from the side of the cheeks in the area of the main root units.
In the process of development, crowns can merge – dentists note four types of such a fusion:
- Root – characterized by splicing only the inner part of the Supernumerary teeth.
- Bedding – the growth of the enamel coating of adjacent crowns in the form of bumps.
- Crown – the roots remain separated, while the outer structure is covered with a single layer of enamel.
- Full – the union of the main and additional elements in all areas.
Pathologies arising from hyperdontia
Pathological manifestations include:
- Violation of occlusion and the formation of malocclusion.
- Delay and limitation of eruption.
- Displacement of units and curvature of root sections.
- Deformities of the dentition.
- Mechanical damage to the mucous tissues of the oral cavity.
- Fissures in open or deep bite.
- Difficulties with diction and articulation.
One of the main problems for patients who are diagnosed with the disease in question is psychological discomfort caused by a violation of the aesthetics of a smile and facial symmetry. In severe cases, curved elements are visible from the side, even when the mouth remains closed, protruding lips or protruding through the cheek. Constant pressure leads to painful sensations and also provokes deformation, against which the likelihood of destruction of the tissues of the jaw region increases. Location outside the row provokes crowding, which interferes with the implementation of hygiene procedures, increases the amount of accumulated plaque, and leads to the formation of multiple caries, periodontitis, and pulpitis.
The abnormal formation of the tissue structure also entails an incorrect distribution of the masticatory load, which ultimately contributes to the development of periodontal diseases. Overcompleteness is often associated with gingivitis and periodontitis, against which the ligaments weaken, and the likelihood of tooth loss increases. In addition, pathology limits the possibilities of prosthetics, necessitating a preliminary course of orthodontic correction.
Characteristic symptomatology is the eruption of extra elements outside the structure, as well as the formation of painful tissue areas – in cases where additional units remain inside and cannot go out on their own. To determine the severity of the disease allow diagnostic procedures offered by the specialists of the Dentika dental clinics.
Diagnosis of hyperdontia
The basic features mentioned above are confirmed during a routine visual inspection. To clarify the diagnosis, as well as to conduct a differential examination, an x-ray is prescribed. An orthopantomogram allows you to assess the root structure, and computed tomography is used to study the clinical picture in several planes.
Treatment of supernumerary teeth
The choice of a particular technique is determined by several factors, including the patient’s age, the type of anomaly, the characteristics of the anatomical structure, and so on. In cases where we are talking about milk units that interfere with the full formation of adjacent elements, extraction is recommended that does not adversely affect the developing maxillary region. With a permanent bite, painful sensations and inflammatory processes make recovery difficult, necessitating an integrated approach.
Relief of unpleasant symptoms
Painkillers that relieve inflammation and bring down the temperature help to relieve symptoms. The most common and affordable options are paracetamol and ibuprofen. It is more practical for children to replace tablets with suppositories that ensure complete and rapid absorption. Suppose the problems are related to the fact that the extra tooth has not grown out of the bone tissue structure. In that case, special gels alleviate the general condition, and physiotherapy is also prescribed, including massage stimulation.
Help with teething
The children’s body is sensitive and receptive to medications and folk remedies, which necessitates an accurate choice of methods to help crowns form and erupt. In such cases, a prerequisite is a professional medical consultation, considering each specific situation’s peculiarities. A history of chronic or acquired pathologies limits the list of drugs available for prescription and can provoke negative consequences in self-medication.
Extraction of supernumerary teeth
Solving inflammatory processes and drug-induced temperature reduction is a positive but short-term effect that does not eliminate the main problem. Extraction is required to restore the normal state of the body. In childhood, its practicality is determined by the negative influence of supernumerary elements on the formation of the jaw section, and in adults – by aesthetic and functional inconveniences that interfere with the patient daily. Due to the peculiarities of the structure, milk units are removed without any special consequences, freeing up sufficient space for the growth of the main crown. At the same time, a detailed diagnosis is required in the case of molars.
After the extraction, a therapeutic course is prescribed, primarily focused on the alignment of the dentition. The correctness of occlusal closure determines the quality of food processing, aesthetic characteristics, and the likelihood of developing pathological processes. In orthodontics, various caps and braces models are used, making it possible to do without surgical intervention.
Additional therapeutic methods
Suppose the impacted element has not erupted completely. In that case, it is recommended to use traction prostheses that stimulate growth and help to quickly reach a state in which it becomes possible to remove an extra unit. When an x-ray photo reveals a lot of Supernumerary teeth, which implies a complex operation, the recovery cycle takes much longer. It will probably be necessary to make changes to the permanent diet and adhere to strict rules of hygienic care – in childhood, control over the implementation of medical prescriptions rests with the parents.
Consequences of poor treatment
The basis for forming a treatment plan is the indications of the clinical picture obtained during the preliminary diagnosis. Incorrect identification of key factors and violation of the protocol are circumstances that can lead to new problems. It is especially important to pay attention to the correction in the early stages of the development of the jaw region since after the structure of the bone tissue is finally formed, it is much more challenging to make changes.
Prevention of complications
Taking into account the fact that in most cases the source of hyperdontia is a genetic predisposition, or a violation of the natural cycle of the formation of the rudiments of the elements of the dentition, which takes place in the uterine period, it is rather problematic to compile a list of recommendations that unambiguously exclude the possibility of developing an anomaly. Regular visits to the dental clinic allow you to avoid negative consequences – a scheduled examination will help to detect pathological signs in a timely manner and take appropriate measures to eliminate them.
Summing up on Supernumerary teeth
Supernumerary teeth are a problem that is much less common in medical practice than caries or pulpitis. Nevertheless, it is important to pay attention to the condition of the oral cavity and consult a doctor not only at those moments when the pain becomes unbearable – diagnosing the pathology at an early stage greatly simplifies its treatment and helps prevent complications.