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Dentistry/Supernumerary permanent tooth -when it should be removed?

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Expert: - 5/18/2005


Question
Hi-
My son will be 8 on 7-4-05. He got his baby teeth very late and finally just lost his 2 bottom teeth.
We had a check up today and his x-rays showed that he has an extra tooth on the top between the two front permanent teeth. The dentist (not pediatric) had his assistant come back and tell us to wait until his two top teeth came out naturally and then he would refer us to an oral surgeon. I am wondering if this is the right timeline and if not when exactly it should be removed.
Thank you for your help.  

Answer
You ask a very good question, and the answer is a resounding "it depends".  Certainly, a supernumerary permanent tooth will have to be removed at some point.  If the extra tooth is going to emerge by itself without interfering with or delaying any other teeth then it should be left alone since a tooth that has emerged is much easier to remove than one which requires surgery to uncover and remove.  However, it needs to be determined just how long the supernumerary can be left in place before it interferes with normal development.  This is often difficult to determine, but x-rays are important in the evaluation of this situation.  It is quite possible that the best course is to wait until the two upper primary central incisors are gone before proceeding.  If that's the case, they should be loosening up shortly since the two lower incisors have recently been lost.  Since you have questions regarding this important decision, perhaps you should get a copy of the relevent x-rays and have a second opinion with a pediatric dentist or orthodontist.

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Dr. Randolph Myerson

Expertise

Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.

Experience

I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

Organizations
I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

Education/Credentials
I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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