Something behind...

I have here is a photo of an 8 year old girl's dentition. The parents were amazed, how come there's another tooth behind the left permanent maxillary central incisor? and then I said," that is called a supernumerary or accessory tooth. In Dentistry, some called it Hyperdontia.

Supernumerary teeth can be classified by shape and by position. The shapes include:

• Supplemental(where the tooth has a normal shape for the teeth in that series);
• Tuberculate (also called "barrel shaped");
• Conical (also called "peg shaped");
• Compound odontome (multiple small tooth-like forms);
• Complex odontome (a disorganized mass of dental tissue)

When classified by position, a supernumerary tooth may be referred to as a mesiodens, a paramolar, or a distomolar.

The most common supernumerary tooth is a mesiodens, which is a mal-formed, peg-like tooth that occurs between the maxillary central incisors.

Fourth and fifth molars that form behind the third molars are another kind of supernumerary teeth

Periapical Radiograph showing translucency within the left permanent maxillary central incisor, that is the supernumerary tooth of the child patient.

Since the supernumerary tooth is pushing the central incisor forward resulting to malalignment of the arch, extraction is the best solution.( as seen in the image below)

Extracted supernumerary tooth

Actually, what I have here is just a simple case, only one extra tooth is present. In some cases, they have more than one extra teeth just like what is shown below:

Image from a fellow dental blogger.