We have two sets of teeth throughout our lives. These are milk (baby) teeth and adult teeth. Humans typically have 20 milk teeth and 32 adult teeth.
It is also possible to have an extra tooth. The most common type of extra tooth is called mesiodens.
A mesiodens appears in front of your upper jaw (premaxilla) between or behind your two front teeth (incisors). It is typically cone-shaped and is more common in adult teeth rather than deciduous 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 women.
When a mesiodens is present, it is important to treat it in a timely manner. This is because quitting it could potentially cause dental problems later on.
What causes mesiodens?
The exact cause of mesiodens is still unknown. It’s possible that genetics, environmental factors, and changes during tooth development all play a role.
Additionally, mesiodens formation has been associated with a variety of health conditions, such as:
.cleft lip and cleft palate
.gardner syndrome, a rare genetic disorder that causes growths in various parts of the body
.cleidocranial dysplasia, a rare genetic condition that leads to the unusual development of bones and teeth
.orofaciodigital syndrome, a rare genetic condition that affects the development of the mouth and teeth, as well as facial features, fingers, and toes
.although less common, it is possible for more than one mesiodens to appear. When this happens, they are called mesiodens.
Health risks of having mesiodens
Having a mesiodens can lead to a variety of potential dental complications. Let’s explore some of them.
Interaction with other teeth
One of the main complications of mesiodens is interaction with the surrounding teeth. This can happen in a variety of different ways, including:
.delayed eruption of surrounding teeth
.displacement of surrounding teeth
.increased crowding in the mesiodens area
.misalignment of teeth (malocclusion) or problems with biting
.the formation of a diastema or gap between your two front teeth
.Dilation of surrounding teeth in which the root or crown of a tooth has an abnormal curvature
.Root resorption of the surrounding teeth, where the root structure of the tooth is dissolved
.Interaction of a mesiodens with surrounding teeth may lead to the necessity of future dental or orthodontic treatment. Therefore, it is important to diagnose and treat mesiodens as early as possible.
A cyst is a sac of fluid that forms in the body. When a mesiodens remains unexploded (affected), it can lead to the formation of a type of cyst called a dentigerous cyst.
Generally speaking, a small dentigerous cyst does not cause symptoms. However, if the cyst begins to grow, it can cause problems such as swelling or displacement in the surrounding teeth.
Burst in the nasal cavity
In some cases, the mesiodens may erupt in the nasal cavity instead of the mouth. This is very rare.
When a mesiodens ruptures in the nasal cavity, it can cause a variety of problems. These may include pain, swelling, and nasal congestion.
When and how are mesiodens diagnosed?
Mesiodens are typically found in early childhood. In fact, they are often detected during routine dental exams and x-rays.
Mesiodens are typically associated with adult teeth rather than milk teeth. For this reason, they can often be observed during the eruption of these teeth, although not always. This can start at age 6.
A mesiodens erupting into the mouth can be detected by the dentist during a dental exam. You may even notice it on your own by visiting the dentist.
However, about 79 to 91 percent of the mesiodens continue to be affected. 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 using a dental x-ray. Your dentist may collect X-ray images from several different angles to diagnose a mesiodens.
Mesiodens pulling and other treatments
Mesiodens management typically includes extraction. However, if the mesiodens is a primary tooth and is not causing complications, in some cases the dentist may recommend monitoring instead.
During extraction, your dentist will carefully remove the mesiodens. There are two types of extraction:
Simple: In a simple extraction, the tooth is extracted without any incisions. The dentist usually uses a tool to grip and loosen the tooth. This type of procedure can usually be performed in your dentist’s office.
Surgery: In more complex cases, such as an impacted tooth, a surgical extraction is necessary. This is done by an oral surgeon and will include an incision and stitches. Since most mesiodens are affected, they will likely need to be surgically removed.
Generally speaking, extraction is performed shortly after diagnosis rather than waiting for a child to grow up. This is to prevent the mesiodens from causing future complications with the surrounding teeth.
However, early removal of a mesiodens is associated with its own risks. Extraction can potentially damage the area where the surrounding adult teeth will erupt. When this happens, the eruption of these teeth may be delayed.
For this reason, your dentist will continue to monitor your teeth carefully after the mesiodens extraction. This is to make sure other adult teeth in the surrounding area are properly engaged.
It is also not uncommon for people with mesiodens to need additional orthodontic treatment after extraction. This is typically to correct the alignment, positioning or spacing of the surrounding teeth.
What should you do if you have a mesiodens as an adult?
Meziodens is often detected and treated in childhood. However, it may be possible for a mesiodens to remain diagnosed or untreated until adulthood.
If you can’t see the mesiodens in your mouth, you can identify it if your front teeth have:
.grown at an abnormal angle or position
.a noticeable gap between
If you suspect you have mesiodens, make an appointment with a dentist. They may take a dental exam and X-rays to help determine if a mesiodens is present.
Because mesiodens are typically diagnosed and treated at an earlier age, you may need more extensive dental or orthodontic procedures to help correct dental problems caused by mesiodens.
As a result;
A mesiodens is an extra tooth located behind or between your two front teeth. It is usually identified in early childhood when adult teeth begin to erupt.
Left untreated, a mesiodens can lead to dental complications. This often interferes with nearby teeth, causing crowding, misalignment, and delayed eruption.
Mesiodens is typically treated using an extraction shortly after diagnosis. Additional dental or orthodontic treatments may be needed after the mesiodens is removed.
See a dentist if you believe you or your child has mesiodens. Prompt diagnosis and treatment can help prevent future dental complications.