Your Child Has Mesiodens. Now What?

All normal, healthy people receive two sets of teeth in their lifetime. Primary teeth, also known as baby teeth, come first. They are replaced a few years later with adult teeth, also called permanent teeth.

Kids typically have 20 baby teeth. Adults enjoy 32 teeth. But in some cases, an extra or supernumerary tooth grows in children and adults. These extra teeth are called mesiodens.

Having mesiodens is rare, and it happens more to males than females. This dental oddity is when you have an extra tooth that appears at the front of your upper jaw. The extra tooth grows behind or between your two front teeth and is typically conical in shape. This extra tooth typically comes in with your adult teeth, rather than with baby teeth.

How Does Mesiodens Occur?

It is not known exactly how mesiodens happen, but they are believed to be the most common dental anomaly, occurring in up to 2 percent of the population. Some believe genetics are responsible, and others believe environmental factors are the cause. Still, others attribute the growth of this extra tooth to changes in dental development. Other occurrences that may contribute to mesiodens are various health conditions:

• Cleft palate or cleft lip
• A rare genetic condition known as Cleidocranial Dysplasia leads to unusual development of teeth and bones
• A rare genetic disorder known as Gardner's Syndrome results in growths appearing on different parts of the body
• A rare genetic syndrome is known as Orofaciodigital Syndrome impacts the development of the teeth and mouth, along with other facial features, toes, and fingers

In some rare cases, it is possible for multiple mesiodens to grow, which are referred to as mesiodentes.

What Are the Risk Factors with Mesioden?

If your child has mesiodens, there are certain health risks they may experience.

Interfering with other teeth

One of the main concerns with mesiodens is the impact it causes on surrounding teeth. It can cause:

• Displacement of the surrounding teeth
• A delayed eruption of other teeth
• Misalignment of teeth resulting in problems with biting foods
• An increased crowding in the area the mesioden grew
• A space occurring between the two front teeth
• An abnormal bend occurs where the root or crown of a tooth grows
• The root structure of the tooth dissolving

It is important to identify and treat mesiodens in your child's teeth as it will interfere with their surrounding teeth and lead to future orthodontic or dental treatments in the future.

Formation of cysts

If a mesiodens remains un-erupted or impacted in your child's mouth, it can lead to a dentigerous cyst. This cyst is a sac of fluid. A dentigerous cyst is usually small and won't cause symptoms, but it can grow larger if unattended, leading to the displacement of surrounding teeth and swelling. Cysts form in conjunction with mesiodens in 4 to 11 percent of cases.

Eruption in nasal cavity

In some cases, untreated mesiodens have erupted inside the nasal cavity, instead of a patient's mouth. It is rare for this to occur, but if it does, it will include nasal obstruction, swelling, and pain.

Treatments and Removal of Mesiodens

Treatment for mesiodens typically requires removal or extraction. In rare cases when the mesiodens is a baby tooth, it shouldn’t present complications, although your dentist will want to keep monitor it, wary of any unwanted developments or complications.

An extraction is a removal of the mesiodens and can be performed in one of two ways:

• Surgical. In more complex cases of mesiodens, such as if it is impacted, a surgical extraction is necessary. This surgery is performed by an oral surgeon and involves an incision and stitches. 
• Simple. In a simple extraction, the mesiodens is removed without surgery, so no incisions are made in your mouth. Your dentist will use a tool to grip and loosen the mesiodens until it comes out of your mouth. 

When a child is diagnosed with mesiodens, dentists want to treat it as soon as possible to prevent future dental problems. Removing this tooth does present certain risks to the surrounding area where adult teeth need to come in. Extraction of the mesiodens could result in a delay of adult teeth erupting.

After extraction of a mesiodens, your dentist will want to watch the growth of other teeth carefully to ensure they come in properly. It is not uncommon for those who have had an extraction of mesiodens to require future orthodontic treatments to correct positioning or alignment of the surrounding teeth.

Why Regular Dental Visits Are Important

Most people do not put dental visits at the top of their to-do lists. The dentist’s office can seem like a scary place, but there are numerous advantages to seeing your dentist regularly and these reasons explain why you should schedule your visit today.

References

Diagnosis and Management of Supernumerary (Mesiodens): A Review of the Literature. (March 2010). Journal of Dentistry of Tehran University of Medical Sciences.

Mesiodens – etiology, prevalence, diagnosis and management. (2013). Pakistan Orthodontic Journal.

Diagnosis and Treatment of Mesiodens in a Patient with Special Needs: Case Report. (January 2020). Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.

Mesiodents / Mesiodentes (midline supernumerary teeth). (May 2019). Animated Teeth.

The Importance of Regular Dental Visits. (February 2019). Oral Health Foundation.