Imagine expecting two upper front teeth to erupt, but instead, an extra tooth decides to come inbetween, exactly right in the middle. That’s called a mesiodens.
It may be small, but it can have a great impact on aesthetics, smile design and occlusion.
A mesiodens can block the eruption of permanent front teeth, push them out of position, create unwanted spacing or crowding, and can even affect the way the upper and lower teeth meet. In some cases, if it remains impacted for years, it can also be associated with cyst formation.
What’s interesting is that many people don’t even know they have one. Quite often, a mesiodens stays hidden inside the jaw bone and is discovered only when an X-ray is taken for another reason. Others erupt into the mouth, usually as a small, cone-shaped tooth between the upper front teeth.
So, why does it happen?
There’s no single answer yet. Researchers believe it’s mainly related to genetics and an overactivity of the dental lamina during tooth development, leading to the formation of an extra tooth.
The good news is that not every mesiodens needs immediate treatment. Some are removed early, if they’re preventing the eruption of permanent teeth. Others can simply be monitored if they’re not causing any problems. The right approach always depends on patient’s complaint followed by a careful clinical and radiographic evaluation.
Clinical reminder: If a child’s upper front teeth are taking longer than expected to erupt, don’t assume it’s just a delay. Some studies say that it can be due to a hidden mesiodens underneath.
Have you ever diagnosed a mesiodens unexpectedly?
MBH/PS
