Where extra teeth appear
| Type | Location | Relative frequency |
|---|---|---|
| Mesiodens | Between the upper central incisors | Most common |
| Distomolar | Behind the third molar | Common |
| Paramolar | Beside a molar, toward the cheek | Uncommon |
| Supplemental incisor or premolar | A duplicate of a normal tooth | Uncommon |
Extra teeth occur more often in the upper jaw than the lower and more often in boys than girls. Many are shaped abnormally — small, cone-shaped, or peg-like — which is one reason a supernumerary is often recognisable on a radiograph even before its position is clear.
Why it is usually discovered by imaging rather than by symptoms
Problems an untreated supernumerary can cause
- Failure of eruption — the permanent incisor is physically obstructed and becomes an impacted tooth.
- Deflection — the tooth erupts but in the wrong position or angle, producing malocclusion that then needs correction.
- Crowding and midline shift — the extra width has to go somewhere.
- Root resorption of the adjacent permanent tooth from sustained pressure.
- Cyst formation in the follicle around the buried extra tooth.
- Plaque trap if it does erupt, since an oddly placed tooth is difficult to clean and invites gingivitis and decay.
How the decision is made
- Remove it when it is blocking or deflecting a permanent tooth, resorbing a neighbouring root, associated with a cyst, or creating an uncleanable position. Timing is chosen to protect the developing roots of the neighbouring teeth, so this is a judgement about the child's stage of development rather than simply their age.
- Monitor it when it is deeply buried, causing no obstruction, and has no cyst — with periodic imaging rather than assumption.
- Keep it in the occasional case where a supplemental tooth is well aligned, functional, and cleanable, or where it can substitute for a genuinely missing tooth.
Removal is frequently only the first half of the plan. Once the obstruction is cleared, the delayed incisor often needs orthodontic guidance into position, so the surgical and orthodontic phases are planned together rather than sequentially by accident.
Associated conditions worth knowing about
Isolated supernumerary teeth are the norm, but multiple extra teeth can be associated with syndromes such as cleidocranial dysplasia or Gardner syndrome, and extra teeth are also more common in cleft lip and palate. Finding several extras is therefore a reason for a broader assessment, not just a dental one. A single mesiodens, by contrast, is usually an isolated finding with no systemic implication.
Notes for families based in Korea
If your child is around seven or eight and one upper front tooth has not appeared while the other has, ask for a radiograph rather than waiting another year. Detected early, the usual outcome is one small surgical procedure and a straightforward orthodontic phase; detected after the incisor is fully impacted and the neighbours have closed the space, treatment becomes considerably longer. We are about 30 minutes from Camp Humphreys, consultations are in English, and we provide copies of imaging and a written treatment summary so care can continue elsewhere after a PCS. Book an assessment.