Causes of mesiodens (extra teeth) and why they should be treated

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We have two sets of teeth in our lifetime. These are the primary (baby) teeth and adult teeth. People typically have 20 primary teeth and 32 adult teeth.

It is also possible to have an extra or supernumerary tooth. The most common type of extra tooth is called mesiodens.

A mesiodens appears in the front of your upper jaw (premaxilla) between or behind your two front teeth (incisors). It is usually conical in shape and occurs more often with adult teeth than with baby teeth.

Mesiodens is rare. Although its prevalence may vary by location and community, it is estimated to affect between 0.15 and 1.9 percent of the general population. It is also more common in men than in women.

When a mesiodens is present, it is important that it is treated in a timely manner. Indeed, leaving it can potentially cause dental problems later.

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Mesiodens, also known as the supernumerary tooth. Varun Pratap Singh, Amita Sharma, Sonam Sharma, via Wikimedia Commons.

The exact cause of mesiodens is still unknown. It is possible that genetics, environmental factors, and changes during tooth development all play a role.

Additionally, the appearance of mesiodens has been linked to a variety of health issues, such as:

  • cleft lip and cleft palate
  • Gardner syndrome, a rare genetic disorder that causes growths to appear on various parts of the body
  • cleidocranial dysplasia, a rare genetic disorder that leads to unusual development of bones and teeth
  • orofaciodigital syndrome, a rare genetic disorder that affects the development of the mouth and teeth as well as facial features, fingers and toes

It is also possible that several mesiodens appear, although this is less common. When this happens, it is called mesiodentes.

Having a mesiodens can lead to a variety of potential dental complications. Let’s explore some of them.

Interference with other teeth

One of the main complications of mesiodens is interference with the surrounding teeth. This can happen in a number of ways, including:

  • delayed eruption of surrounding teeth
  • displacement of surrounding teeth
  • increased overcrowding in the mesiodens area
  • misalignment of teeth (malocclusion) or bite problems
  • formation of a diastema, or space, between your two front teeth
  • laceration of surrounding teeth, where the root or crown of a tooth has an abnormal curvature
  • root resorption of surrounding teeth, where the root structure of the tooth is dissolved

Interference of a mesiodens with surrounding teeth can lead to the need for future dental or orthodontic treatments. This is why it is important to identify and treat a mesiodens as early as possible.

Formation of cysts

A cyst is a sac of fluid that forms in the body. When a mesiodens has not erupted (impacted), it can lead to the formation of a type of cyst called a dentigerous cyst.

Usually, a small dentigerous cyst will not cause symptoms. However, if the cyst starts to grow, it can cause problems like swelling or displacement of the surrounding teeth.

Rash in the nasal cavity

In some cases, mesiodens can burst in the nasal cavity instead of the mouth. It’s very rare.

When a mesiodens bursts in the nasal cavity, it can cause several problems. These can include pain, swelling, and nasal obstruction.

Mesiodens are usually found during infancy. In fact, they are often detected during routine dental exams and x-rays.

Mesiodenses are usually associated with adult teeth instead of milk teeth. As such, they can often, but not always, be seen as these teeth are growing. It can start as soon as 6 years.

A mesiodens that has burst in the mouth can be detected by a dentist during a dental exam. You may even notice it for yourself, prompting a visit to the dentist.

However, approximately 79 to 91 percent mesiodens remain impacted. Some signs that an impacted mesiodens may be present include crowding, misalignment of teeth, and delayed eruption of surrounding teeth.

When a mesiodens is impacted, it can be found through the use of dental x-rays. Your dentist can collect X-ray images from several different angles to diagnose a mesiodens.

Management of mesiodenses generally involves extraction. However, in some situations, such as if a mesiodens is a baby tooth and isn’t causing complications, a dentist may recommend monitoring it instead.

During an extraction, your dentist will carefully remove the mesiodens. There are two types of extraction:

  • Simple. In a simple extraction, a tooth is removed without any incision. The dentist will usually use a tool to grab the tooth and loosen it. This type of procedure can often be done in your dentist’s office.
  • Surgical. In more complex situations, such as an impacted tooth, surgical extraction is necessary. This is done by an oral surgeon and will involve an incision and stitches. Since most mesiodens are affected, it is likely that they will need to be removed surgically.

Usually, extraction is done soon after diagnosis rather than waiting until the child is older. This is to prevent the mesiodens from causing future complications with the surrounding teeth.

However, early elimination of a mesiodens comes with its own risks. The extraction can potentially damage the area where the surrounding adult teeth will enter. When this happens, the eruption of these teeth may be delayed.

For this reason, your dentist will continue to carefully monitor your teeth after the extraction of a mesiodens. This is to ensure that other surrounding adult teeth are entering properly.

It is also not uncommon for people with mesiodens to need additional orthodontic treatment after extraction. This usually involves correcting the alignment, positioning or spacing of surrounding teeth.

The cost of an extraction can vary and is highly dependent on your location. According to Consumer guide to dentistry, average costs can range from $ 130 to $ 400.

A simple extraction of an already erupted tooth can cost between $ 100 and $ 250. Surgical extraction of teeth that are still impacted costs more, between $ 180 and $ 400, but deeply embedded teeth can increase the cost to as much as $ 600 or more.

Many dental insurance plans will cover an extraction if it is considered medically necessary. Contact your dental insurance provider before an extraction to get an idea of ​​the amount you may be required to pay.

Most of the time, mesiodens are detected and treated during childhood. However, it is possible that a mesiodens remains diagnosed or untreated into adulthood.

If you can’t see mesiodens in your mouth, you may be able to identify it if your front teeth have:

  • developed at an abnormal angle or position
  • a notable gap between them
  • misalignment
  • overcrowding
  • not at all cultivated

If you think you have mesiodens, make an appointment with a dentist. They may do a dental exam and x-rays to help determine if a mesiodens is present.

Since mesiodens are usually diagnosed and treated at an earlier age, you may need more extensive dental or orthodontic procedures to help correct dental issues that have arisen due to a mesiodens.

A mesiodense is an extra tooth located behind or between your two front teeth. It is usually identified during infancy, when adult teeth begin to grow.

When left untreated, a mesiodens can lead to dental complications. This often interferes with neighboring teeth, causing crowding, misalignment, and delayed eruption.

Mesiodens is usually treated with an extraction soon after diagnosis. Additional dental or orthodontic treatment may be required after mesiodens removal.

See a dentist if you think you or your child has mesiodens. Prompt diagnosis and treatment can help prevent future dental complications.


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