Supernumeries- Identifying them and managing unerupted supernumeraries in the front maxilla Giving Sydney Great Smiles

How considerations and the management plan differ in children, teenagers and adults. A podcast between orthodontist Dr Andrew Chang and pediatric dentist Dr Diane Tay that covers the issues in detail.   Dr.Andrew Chang: Diane, welcome, it's nice to have you back on our podcast. Dr. Diane Tay: Hi Andrew. Very good to chat to you again. As always. Dr.Andrew Chang: Well, what we'd like to talk to our audience of dentists today and if there is any interested parents out there as well, but mainly for dentists. The topic of supernumeraries or what we call,extra teeth types. And we were going to focus on the area of the upper front maxilla, the upper front teeth region. So maybe Diane, if you could provide our audience an outline of the different classifications or types of uninterrupted supernumeraries that we're going to talk about. Dr. Diane Tay: Yeah, absolutely Andrew, thank you. And yes, you are right for the benefit of the audiences. We know there's many different types of supernumeraries they can be in different positions, different numbers. And so just to clarify to be, particularly, you know, a really interesting topic and there's so much to say about that, but we're just going to limit it to unerupted teeth and anterior maxilla, which is something really common and has an impact. And I think can be reasonably,picked out and you know, and noticed and managed early by dentists. So as we were saying, souvenir is basically it's just a type of dental normally in the numeric form in terms of the number. So there are different types of supernumeraries and generally overall we divide them into what we call supplemental tooth or supervisor supplemental tooth is where it actually has the exact same form, the exact same function as adjacency. Dr. Diane Tay: So they pretty much don't really have any difference in anatomical differences versus supernumerary. More so where is the tooth? It's characterized by an atypical anatomic form and sometimes they can be smaller or different in the anatomy, very very briefly and a very old classification. You can classify them into the more conical shape form, you can classify them as tuberculate or supplemental form. So it's just a different sort of classification depending on the roots. Obviously there's other kinds of which I won't go into, such as composite odontomes etc. But really important to look at them and also determine the position. So it's not just what type of supernumerary it is, but the position of the supernumerary. So sometimes they can be just in a normal position they could be inverted. Dr. Diane Tay: So those ones tend to, and we'll talk about them more but inverted do generally and very rarely they don't erupt by itself. So hence sometimes the management does become different. And being aware that generally these ones will not erupt. We need to decide whether we need to remove them pending other things, which Andrew and I will discuss, just to clarify for a lot of our dentists, because we hear commonly misused terms, but strictly speaking, mesiodens is a tooth that's located between the central upper incisors. So a supernumerary say, you know, how little or to the 11. So that would not necessarily classify as a mesiodens. So it means it's actually one that's located between the upper incisors. Dr. Diane Tay: But I guess most irrelevant in classifications. While important, I guess like you and I, Andrew are very interested in the clinical management. So what are some of the signs that are important to know? And I know from my point of view, I always think the picking up, sort of knowing our, again going all where I was going back to first principles, knowing our dental development, knowing when teeth erupt, when should they exfoliate, always will help us lead to picking up these things early. And again, the earlier these things are picked up, then management always becomes, easier, less complicated. So the first thing I always think about when I'm looking at a patie