Missing Teeth, Extra Teeth, Unusual Teeth
Some people have extra teeth, some have too few teeth. For other people, a few teeth just don’t look right. They have an odd shape or a few of the teeth are too yellow. Below, we discuss these issues and suggest what can be done to improve esthetics.
The age at which missing or extra teeth become noticeable:
As children grow into their teen years it becomes obvious that some of the adult teeth are not growing in and it doesn’t appear that they ever will. Other teens may have the opposite problem. They have more than the usual number of adult teeth. Some teens will show yet another problem. Certain teeth will grow in deeply yellowed and strangely shaped.
Percent of young adults missing teeth and why they are missing:
The average adult has 32 teeth. As often as one in every ten individuals, however, have at least one, and sometimes more than one, adult teeth fail to develop at all - they are missing. Women may be affected with missing teeth slightly more often than men.
Sometimes when an adult tooth is missing, a space is left in the mouth. Other times when the adult tooth is missing a baby tooth will be left behind permanently in the mouth.
No one knows why some adult teeth fail to grow, it is a mystery - perhaps it is from genetics.
A missing tooth, or teeth, can cause problems with your appearance. Over time nearby teeth begin to slide into the space left behind by the missing tooth. There are potentially other problems. If a bottom tooth is missing - the top tooth just above may begin to grown down into the space. The opposite can happen if a top tooth is missing. Then the bottom tooth will grow up into the top space.
Missing lateral incisors. It is common for these adult teeth (located next to the middle teeth) to be missing. If the baby teeth fall out and no lateral incisor is present, there will be spaces like above. If the baby teeth fail to fall out they also are a cosmetic problem and may have to be taken out and replaced.
How do we fill in spaces left by missing adult teeth? Treatments include:
Braces to move teeth together and fill the space.
A permanent cemented bridge or an implant will place a tooth in the space (see link below).
In certain instances when a tooth is missing in the back of the mouth, the dentist may suggest to do no treatment at all. This is particularly the case if the rest of the teeth are stable and won’t move into the space.
About baby teeth left behind when adult teeth are missing:
Sometimes we learn that an adult tooth has failed to form and grow because a baby tooth continues to stay in the mouth and doesn’t fall out. A baby tooth with no adult tooth underneath may stay for life and many adults continue to eat very comfortably with these ‘permanent’ baby teeth.
Each year, the dentist must evaluate a baby tooth that fails to fall out. If the bone and gums are healthy and the baby tooth is strong then it can be left alone. If the patient doesn’t like the way the baby tooth looks - then that baby tooth should be removed and an implant or permanent cemented tooth placed.
A tooth might not be missing… it might just be stuck in the bone:There are times when you may think a tooth is missing but it is in fact there, it is just stuck in the bone and won’t grow into the mouth. These are called impacted teeth. These teeth can sometimes be brought into the mouth by an oral surgeon, however, in many cases these teeth are better left alone in the bone. The most common teeth to be stuck permanently in bone are the wisdom teeth.
A yearly x-ray picture is sufficient to check on the health of teeth left in the bone. Remember, a dentist might leave an extra tooth in the bone for life.
Extra, or ‘supernumerary’, teeth:
Between three and six percent of individuals have more than the normal 32 teeth.
The reason for extra teeth, known as supernumerary teeth, is unknown.
The usual locations for extra teeth are: between the front teeth on the top (called a mesioden); near the palate; on the bottom near the tongue. (See image below.)
Should extra teeth be taken out?
A very common place for an extra tooth to appear is next to the palate or tongue (see picture below). These teeth are very strong and it takes quite a bit of effort to extract them (to take them out). Removing them, however, is not painful. A simple shot (local anesthesia) is sufficient. The dentist might use the drill to loosen the tooth and if necessary place a little medicine (eugenol) to ensure a comfortable healing.
Do not leave extra teeth in the mouth. They are often a serious source of gum disease and cannot be properly cleaned. Your dentist will advise you.
Sometimes x-rays will find not just one, but many, extra teeth that are impacted, or stuck in the bone, and will never grow into the mouth.
These extra teeth are invisible to the eye and should be left untouched unless x-rays show signs of infection.
Supernumerary (extra) premolar in the lower jaw near the tongue. Bacteria collects here and bone loss is common. The tooth should be taken out.
Abnormal teeth:
A peg lateral
Two teeth can grow together and look like one tooth. That’s called ‘fusion’. On the other hand, one tooth can sometimes look like two teeth but still have just one root. This is called ‘gemination’. Either way, fusion or gemination, if the cosmetics of these teeth bother you then either crowns or extractions with cosmetic replacements can be done.
Peg laterals are common. These are thin cone shaped teeth located in the front of the mouth. They may be corrected by placing a crown, however, they often are too thin and delicate to repair and need to be removed and replaced with an implant.
Gemination. This is one tooth but it looks like two.