Humans are born with two sets of teeth: primary (baby teeth) and permanent (adult teeth). The primary set consists of 20 teeth, and the permanent set consists of 32 teeth. If you grow more than the normal set of teeth, these extra teeth are termed supernumerary (super = extra, numerary = number). The vast majority of single tooth supernumerary teeth are found the upper jaw (maxilla), particularly at the front of the jaw. The midline is the most common site, and when an extra tooth appears in this region it is termed mesiodens.

What are some clinical signs that might suggest your child is growing a mesiodens. The first thing that Dr. Perusini will look at is the eruption of the permanent incisors. If the pattern is asymmetric, delayed or if the primary incisors are over-retained, this could suggest the presence of a mesiodens. Dr. Perusini will also take an x-ray of the area to look for a mesiodens that may be unerupted or impacted in the bone.

If left untreated, a mesiodens can lead to delayed eruption, crowding, impaction and/or damage to the permanent incisors. Early diagnosis and appropriately timed treatment are important to avoid these complications. If the mesiodens is erupted, removing the tooth is relatively straightforward. If the mesiodens is impacted in the bone, Dr. Perusini will normally advise waiting until the adjacent incisors have at least two-thirds root development to minimize risk for damage, and to ensure normal eruption of the permanent incisors.

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