While some children are born without certain teeth, others develop one or more extra ones. These are called supernumerary teeth, and they are found in roughly 0.1 to nearly 4 percent of children depending on the population. The most common type is a mesiodens, a small extra tooth that sits in the midline between the two upper front teeth. Extra teeth are a little more common in boys, and most are picked up between the ages of about six and nine, often on a routine X-ray rather than because anything is visible.
If your child's dentist has found an extra tooth, the natural questions are whether it matters and whether it needs to come out. This guide explains the types, the problems they can cause, and how the decision to remove or monitor is made.
Key takeaways
- A supernumerary tooth is an extra tooth beyond the normal set. The commonest is a mesiodens, between the upper front teeth.
- Extra teeth affect roughly 0.1 to 4 percent of children and are more common in boys.
- Most are found on an X-ray, because many are impacted and never erupt into view.
- The most common problem they cause is blocking or delaying the eruption of the permanent front teeth.
- Whether an extra tooth is removed depends on whether it is causing, or likely to cause, a problem.
- Removing a problem mesiodens early often lets the front teeth straighten on their own.
The key decision: is it causing a problem?
The single question that drives management is whether the extra tooth is causing, or is likely to cause, a problem. Some supernumerary teeth sit quietly and never cause trouble, in which case a dentist may simply watch them. Others block a permanent tooth from coming through, push neighbouring teeth out of line, or rarely form a cyst. When an extra tooth is interfering, the usual recommendation is to remove it, and the timing is chosen to give the permanent teeth the best chance to settle into place.
Types of extra teeth
| Type | Where it sits |
|---|---|
| Mesiodens | The most common, in the midline between the two upper front teeth |
| Extra premolar | In the premolar region, towards the back |
| Extra molar (paramolar or distomolar) | Beside or behind the back molars |
| Supplemental tooth | A duplicate that looks like a normal tooth, often an extra lateral incisor |
Problems an extra tooth can cause
A mesiodens or other supernumerary tooth can cause several issues, which is why they are taken seriously even when hidden. The most common is delaying or blocking the eruption of the permanent front teeth, reported in close to half of mesiodens cases. Others include pushing the front teeth apart to create a gap, crowding or rotating nearby teeth, and, less often, forming a cyst around the unerupted extra tooth or causing the roots of neighbouring teeth to resorb. Because many of these happen out of sight, an X-ray is often the only way to find the cause when a permanent tooth is slow to appear. If one front tooth has come through but its partner has not, an extra tooth is one of the things a dentist will look for. Our guide to when adult teeth come in explains the normal timing.
How extra teeth are managed
If an extra tooth is causing no problem and is unlikely to, a dentist may choose to monitor it with periodic checks. When it is blocking a permanent tooth or causing crowding, the usual treatment is surgical removal. Removing a problem mesiodens at the right age often allows the permanent front teeth to drift into place on their own, reducing or avoiding the need for braces later. Sometimes a tooth that was blocked needs a gentle nudge with orthodontics once the obstruction is gone, and occasionally a gap left behind is closed with aligners or braces. The procedure to remove an extra tooth is usually straightforward, though a deeply buried one may need a short day-surgery visit. Costs depend on the position and complexity, and the team at Lumi Dental does not list its own prices here. We are happy to provide a written quote, and current information is on our offers page.
Frequently asked questions
Does an extra tooth always need to be removed?
No. If it is causing no problem and is unlikely to, it can sometimes be monitored. Removal is recommended when it is blocking a permanent tooth, crowding others, or forming a cyst.
How is an extra tooth found if I cannot see it?
Most are found on a dental X-ray, often taken because a front tooth is slow to come through or because teeth are spaced or crowded. Many supernumerary teeth never erupt into view.
Will removing a mesiodens fix my child's smile?
Often it allows the blocked front teeth to come through and straighten on their own, especially when done at the right age. Some children still need braces afterwards, but removal early gives the best chance of a simpler outcome.
Is surgery to remove an extra tooth a big deal?
Usually not. A tooth that has erupted is simple to remove. A deeply buried one is a slightly bigger procedure, sometimes done as day surgery, but recovery is generally quick.
An extra tooth sounds unusual, but it is a common and very treatable finding in children. If your child has a front tooth that is slow to appear, or you have been told there is an extra tooth, the team at Lumi Dental in Melrose Park can investigate and advise on whether to watch or remove it. See our companion guide on missing adult teeth, our overview of teeth that erupt in the wrong place, and our first dental visit guide. Current new patient information is on our offers page.
This article is general information and is not a substitute for personal dental advice for your child.
