2 rows of teeth in children. Molars grow second row behind milk teeth

In the human body, the process of developing teeth begins in the third month of intrauterine development. First baby tooth, as a rule, erupts when the baby reaches 5 or 6 one month old. By the age of three years, the child already has 20 baby teeth, which after 2 or 3 years will begin to change to molars. Sometimes, as shown in the photo below, a child grows a double molar behind the temporary ones that have not fallen out.

How are baby teeth replaced by molars?

Upon reaching the age of one, 12 molars begin to form in the child’s jaw, for which there was previously not enough space (see also:). Baby teeth differ significantly from permanent teeth in their size and structure (more details in the article:). Their roots dissolve over time, the gaps between the teeth grow, the tooth begins to loosen and falls out. There is a process of changing “content” oral cavity approximately in the following order:

From 6 to 7 years of age, the lower and upper central incisors fall out.
From 7 to 9 years, the lateral incisors change.
From 9 to 10 years old, canines are replaced lower jaw and after about a year - at the top (we recommend reading:).
From 11 to 12 years old, the “fives” of the top and bottom rows change.
By the age of 13, all four radical “sevens” and “sixes” must emerge.
From the age of 16, wisdom teeth begin to grow. It should be noted that “eights” can grow even after the age of 30 or even 40.

The formation of the bite and the period of replacement of primary teeth ends at approximately 14 years of age. It is important to remember that each child is individual, and the above sequence may be violated. At any stage of teething and growth, parents should monitor the condition of the child’s oral cavity. Sometimes it happens that a molar comes out while the baby tooth has not even begun to loosen (we recommend reading:).

A permanent tooth protrudes behind a baby tooth: symptoms and diagnosis

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In the oral cavity, each incisor or molar is assigned a clear location. There are cases when a molar grows behind a milk tooth that has not yet fallen out. Dentists have two explanations for the origin of the second row of growing teeth:

the child’s jaw is underdeveloped and there is not enough space for teeth to grow;
Availability supernumerary teeth(hyperdontia).

The appearance of supernumerary teeth in a newborn child will manifest itself as a disruption of the process breastfeeding. The child will be capricious, and injuries and cracks will form on the mother’s breast.

The situation with the development of “shark jaw” syndrome in older children is similar to the symptoms of the eruption of normal dental elements:

body temperature rises to 38-39 C;
swelling develops on the gum in the area of the growing tooth, accompanied by painful sensations;
profuse drooling;
short-term loosening of stool;
development of rhinitis against the background of swelling of the nasopharyngeal mucosa.

The presence of a supernumerary tooth can be diagnosed independently without any problems. However, in cases of impaired eruption due to hyperdontia, it will be necessary panoramic x-ray or computed tomography. These research methods help to clearly determine the location of all dental elements, both normal and supernumerary.

Causes of pathology in a child

The main reasons for the situation when a double permanent tooth grows:

genetic predisposition due to heredity;
pathology embryonic development, expressed by a violation of the activity of the dental plate, as a result of which more tooth germs are formed from it;
transferred during the period of active eruption of infection;
consequences of rickets.

Possible complications

Correcting the effects of hyperdontia may require a long period of time. Possible complications untimely or improper treatment are:

Treatment

What should you do if a double tooth element has grown? The main methods of treating hyperdontia are:

removal of a tooth that has grown outside the dentition;
orthodontic treatment;
the use of medications to relieve teething symptoms.

The main means to alleviate symptoms are:

Waiting period

Sometimes, if a double permanent tooth has emerged behind or next to a baby tooth that is already loose, you should wait and not seek help from a dentist. There is no need to pull it out if there is no malocclusion or cosmetic defect. Parents should ensure constant monitoring of the situation and, perhaps, help the temporary tooth fall out as quickly as possible.

Should I delete it?

If a tooth grows in the second row in the mouth, it often needs to be removed, since its growth can cause problems with the dentition and bite. Usually, removing supernumerary elements is not difficult, but sometimes there are exceptions.

Removal steps in simple cases:

X-rays are performed to determine the number and size of the roots of the second tooth;
after anesthesia is applied, the problematic element is removed;
if necessary, stitches are placed on soft fabrics gums.

Removal of impacted “shark teeth” occurs after thorough examination according to the following scheme:

For precise definition location impacted teeth a computed tomography or x-ray is performed;
the operation is performed as using local anesthesia, and under general anesthesia;
tooth extraction is carried out after peeling off the gum mucosa and opening the bone tissue;
if necessary, the cavities formed in the jaw bone are closed with osteoplastic materials.

The patient spends the rehabilitation period at home, continuing treatment, which includes taking antibiotics and rinsing the mouth with antiseptics and herbal infusions. During this period, you should avoid eating too cold, hot, hard or spicy foods, and carefully brush your teeth on the operated side.

In the human body, the process of developing teeth begins in the third month of intrauterine development. The first baby tooth usually erupts when the baby reaches 5 or 6 months of age. By the age of three years, the child already has 20 baby teeth, which after 2 or 3 years will begin to change to molars. Sometimes, as shown in the photo below, a child grows a double molar behind the temporary ones that have not fallen out.

How are baby teeth replaced by molars?

Upon reaching the age of one, 12 molars begin to form in the child’s jaw, for which there was previously not enough space. Milk teeth differ significantly from permanent ones in their size and structure. Their roots dissolve over time, the gaps between the teeth grow, the tooth begins to loosen and falls out. The process of changing the “contents” of the oral cavity occurs in approximately the following order:

From 6 to 7 years of age, the lower and upper central incisors fall out.
From 7 to 9 years, the lateral incisors change.
From 9 to 10 years of age, the canines in the lower jaw are replaced, and about a year later - in the upper jaw.
From 11 to 12 years old, the “fives” of the top and bottom rows change.
By the age of 13, all four radical “sevens” and “sixes” must emerge.
From the age of 16, wisdom teeth begin to grow. It should be noted that “eights” can grow even after the age of 30 or even 40.

A permanent tooth protrudes behind a baby tooth: symptoms and diagnosis

the child’s jaw is underdeveloped and there is not enough space for teeth to grow;
the presence of supernumerary teeth (hyperdontia).

The appearance of supernumerary teeth in a newborn child will manifest itself as a violation of the breastfeeding process. The child will be capricious, and injuries and cracks will form on the mother’s breast.

The situation with the development of “shark jaw” syndrome in older children is similar to the symptoms of the eruption of normal dental elements:

body temperature rises to 38-39 C;
swelling develops on the gum in the area of the growing tooth, accompanied by painful sensations;
profuse drooling;
short-term loosening of stool;
development of rhinitis against the background of swelling of the nasopharyngeal mucosa.

Causes of pathology in a child

The main reasons for the situation when a double permanent tooth grows:

genetic predisposition due to heredity;
pathology of embryonic development, expressed by impaired activity of the dental plate, as a result of which more dental buds are formed from it;
transferred during the period of active eruption of infection;
consequences of rickets.

Possible complications

Correcting the effects of hyperdontia may require a long period of time. Possible complications of untimely or incorrect treatment are:

Treatment

What should you do if a double tooth element has grown? The main methods of treating hyperdontia are:

removal of a tooth that has grown outside the dentition;
orthodontic treatment;
the use of medications to relieve teething symptoms.

The main means to alleviate symptoms are:

Waiting period

Should I delete it?

Removal steps in simple cases:

X-rays are performed to determine the number and size of the roots of the second tooth;
after anesthesia is applied, the problematic element is removed;
If necessary, sutures are placed on the soft gum tissue.

Removal of impacted “shark teeth” occurs after a thorough examination according to the following scheme:

to accurately determine the location of impacted teeth, a computed tomography or x-ray is performed;
the operation is performed both using local anesthesia and general anesthesia;
tooth extraction is carried out after peeling off the gum mucosa and opening the bone tissue;
if necessary, the cavities formed in the jaw bone are closed with osteoplastic materials.

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Teething order

First, the child’s incisors are cut, their number should be 8, then fangs grow - 4 pieces, the last to appear are 8 molars. As for the time when teeth should begin to emerge, this is a very individual process. For some, milk begins to grow at 5–8 months, while for others only after a year. But the cutting order is the same for everyone, it looks like this:

6–12 months - lower central incisors;
8–14 months - upper central incisors;
9–15 months upper lateral incisors;
10–16 months lower lateral incisors;
16–24 months upper and lower canines;
2–5 years upper and lower second molars.

An acceptable deviation is considered to be 2–3 from the norm.

In the video, Dr. Komarovsky explains the sequence of teething:

Causes of curvature

One of the reasons may be a too strong and strong baby tooth, which is not yet ready to fall out, while an equally strong permanent one is already beginning to erupt.

Another reason may be incorrect intrauterine development, at the moment when the formation of rudiments occurred, for some reason another tooth developed, which in principle should not have existed. Then it grows second row, because it does not have its own place in the jaw. Dentists call this phenomenon a superset. Thus, by adolescence, a child has 29 or 30 teeth in his mouth, although there should be 28. Also, causes may include previous rickets, hereditary predisposition, a consequence of an infectious disease, perhaps the child’s jaw is underdeveloped, and there is simply not enough space for all the teeth.

The reasons may be as follows:

woman doesn't get sufficient quantity vitamins during pregnancy;
the child’s diet lacks calcium, fluoride and other elements that are needed for his normal height and development;
the consistency of the food is too soft, the baby must chew hard vegetables and fruits;
the child constantly breathes through his mouth, which is associated with diseases of the throat and nose;
a child who has reached the age of one year continues to suck a pacifier or finger; it is important to wean the child off the pacifier and teach him to eat solid food, use a spoon and drink from a cup;
hereditary predisposition.

Baby teeth are formed even before the baby is born. If at this moment any pathological processes, then they can grow crookedly forming, as it were, a second row.

Treatment methods

So that the baby does not have problems with growth in the future. permanent teeth, it is necessary to correct the curvature of the mammary breasts in a timely manner. In addition to subsequent abnormal growth of permanent breasts, distorted breasts can cause diseases. gastrointestinal tract, the occurrence of headaches and the development of complexes. The most effective way Correcting crooked teeth is the use of braces, mouthguards or trainers.

Braces are installed in adolescence, because at this age a child can take care of them independently, trainers and mouth guards are most often offered for children. These devices are not visible to others and can be easily removed if necessary. The sooner parents take care of correcting their child’s teeth, the less time it will take.

Certainly, serious problems curves for health permanent teeth They can’t bring it, so many dentists recommend waiting until the milk falls out on its own. However, if this for a long time does not occur, but a permanent one is already growing, then it is advisable to remove the milky one so that the root one grows and develops correctly without forming a second row.

TO pediatric dentist need to contact if:

The molar is erupting, but the molar does not fall out;
if the baby's milk wobbles for a long time, but does not fall out on its own, and the baby experiences discomfort;
if inflammation or pain occurs.

What to do if teeth grow in two rows? In this case, the dentist may suggest removing the milk, which is interfering with the proper growth of the permanent ones.

In the video, a pediatric dentist talks about what to do if teeth grow in the second row:

Preventive actions

Some parents are concerned about the gap between the child's upper incisors; they believe that this is a defect in the upper row, which will subsequently cause the tooth to grow into a tooth. This is wrong. The gap, which seems very wide, will after some time decrease or disappear completely. This normal phenomenon, which will not in any way influence the teeth to grow crookedly or out of place.

To prevent curvature, you need to follow preventive measures:

Don't let your baby put it in his mouth foreign objects and suck fingers;
teach your baby to breathe only through his nose;
monitor growing teeth and prevent caries;
diversify your child’s diet, be sure to include foods that develop the chewing reflex;
if the tooth begins to grow, do not allow the child to touch it with either his hands or tongue;
Visit the pediatric dentist regularly.

If parents with early years Once every few months they take the child for an examination to the dentist and ask him all the questions they are interested in about the growth and development of the child’s teeth, then the doctor will be able to notice the anomaly in time and eliminate the defect in a timely manner. Then the baby will not have problems with the growth of teeth in the second row.

Molars and eights

At the age of 5 years, sometimes a little later, children begin to erupt the first and second molars. The first pair appears first on upper jaw, after which the lower ones erupt. Eights appear after 16 years of age, but modern people Retention of wisdom teeth is becoming increasingly common. The fact is that they are designed to be chewed very solid food, which was the main one in ancient times.

Now the diet has changed, and eights to modern man not really needed. Scientists believe that it is a change in diet that provokes their retention - they do not appear after the 2 molars, but remain in the gums.

In general, eights are considered problematic in dentistry. This is primarily due to the fact that the bone that forms the jaw is not long enough, and wisdom teeth begin to erupt after all the others. Accordingly, if the entire jaw is already occupied, they begin to grow at an angle inside the oral cavity or inside the cheek. At the same time, the tooth is not yet visible, but the pain is already disturbing.

In this case, treatment is only surgical. After x-ray examination the doctor decides to either correct the growth without resorting to surgery, or remove it (which happens most often).

In addition to the eights, both fangs and incisors can remain in the gums. It happens that impacted teeth are not only not visible, but cannot even be felt - they are so tightly covered with jaw tissue. In this case, they speak of complete retention. Moreover, the tooth itself can be located in the gum not only vertically, but also horizontally. When it grows with the crown inside the oral cavity, its location is called lingual-angular, and if the crown is directed towards the cheek, then it is buccal-angular.

Most often, retention is incomplete. That is, part of the crown rises above the surface of the gum. In any case, impacted teeth require special treatment, because, in addition to a cosmetic defect, they can cause the appearance of purulent cysts and will worsen the process of resorption of milk roots that are located nearby.

To determine the problem and find out exactly how the tooth is located, you need to do X-ray. It gives all the information the dentist needs about the processes inside the gums, the condition of the tissues around it, whether cystic formations and granulomas.

The symptoms are as follows:

The defect is visually visible - the tooth may be missing, or it may be erupting, deviating from the place where it should be.
The gums are swollen and hyperemic, the child feels pain if you press on the mucous membrane.
Weakness and fever.
If the second tooth is partially impacted, then the crown is visible above the gum or can be easily felt by palpation. The tissues that are nearby are painful and inflamed.

Provided that the only thing that prevents the tooth from coming out of the gum is that the gum tissue has an increased density, an incision is made on the gum under local anesthesia. If it has already partially erupted, and also to correct the bite, the child is given braces, but before that dental crown exposed surgically.

If it is positioned incorrectly, or an inflammatory process has developed around the gums, which has led to destruction of the neck, then the tooth is removed. This must be done to avoid complications. If it is not treated and, if necessary, not removed, it can provoke the formation of a cyst. In addition, an unaesthetic cosmetic defect in the smile is possible.

dental

Why do shark teeth appear?

A child’s second row of teeth occurs if the baby tooth has not yet fallen out, and the permanent tooth in its place is already erupting, but since the baby tooth interferes with it, the permanent one grows nearby or stands in the second row. Why does this happen?
Normally, the buds of permanent teeth should exert pressure on the roots of baby teeth when they erupt.
As a result, the root of the baby tooth begins to slowly dissolve, the baby tooth becomes mobile and then falls out on its own or is removed by a doctor.
But sometimes it happens that topographically, the germ of a permanent tooth and the root of a milk tooth are located in two parallel planes. As a result, when a permanent tooth erupts, there is no proper pressure on the root of the milk tooth. Then the permanent tooth has no other choice, and it grows near or above the milk tooth.

Why is it harmful for a child to breathe through his mouth all the time?

It would seem, what does “shark” teeth have to do with it? However, the connection here is the most direct - impaired breathing can lead to problems in the development of the jaws, which also results in the appearance of a double dentition.
Here's how it happens.
The fact is that permanent teeth may turn out to be bigger size than milk teeth, respectively, the jaw must also increase in size so that permanent teeth can be placed on it in correct position.
If the child’s jaw does not expand naturally, then due to lack of space, permanent teeth erupt in completely different places than they should.
At the age of 6-10 years, the child begins to exhibit physiological trema and diastema. These are gaps between the teeth that form as a result of the jaw itself preparing for the eruption of permanent teeth and expanding. An important factor The extension of the jaw is the tongue, which puts pressure on both the upper and lower jaws. As the child grows, the tongue also grows, and its pressure on jaw bones, and they are expanding.
But when a child has a disorder nasal breathing, for example, when frequent colds, and the mouth is constantly slightly open, since he breathes through the mouth, the tongue is positioned incorrectly: it is located at the bottom of the oral cavity and does not exert proper pressure on the upper jaw, thereby not stimulating its development. Then trema and diastema between the baby teeth do not occur, and thus permanent teeth are simply forced to erupt where there is free space for them - above or inside the gums: for example, fangs can grow very high due to lack of space.

Why is the appearance of “shark” teeth dangerous?

There is nothing scary or dangerous about this phenomenon: as a rule, you just need to go to the doctor and have a baby tooth removed. Then the permanent tooth will move on its own to the place of the removed one. As already mentioned, there is such a powerful muscle in the mouth as the tongue. Under the influence of its pressure, all the teeth will fall into a normal row, and will not remain where they erupted.
This takes about a month, and no additional equipment or effort is needed.
Although, of course, a consultation with an orthodontist is necessary to find out if there are any problems with the placement of permanent teeth.

Why is an orthodontic examination important?

So, the pediatric dentist removed the baby tooth, leaving room for the permanent one. Why then consult an orthodontist?
This is necessary for the orthodontist to determine whether the child has a lack of space for permanent teeth.
If there is not enough space, the doctor will make a special orthodontic device to optimize the position of the permanent tooth.
Now there are quite a large number of them, and different devices are used in different cases. For example, trainers are silicone two-jaw devices that the child puts on at night, an hour before bedtime. Due to their elastic properties, they contribute to the expansion of dental arches and the formation correct bite. Trainers also act as additional factor rigidity, which stimulates the jaws to widen and prepare for the eruption of permanent teeth.
In addition to trainers, the doctor may suggest plates with an expansion screw or, as an option for more late age, – braces. This depends on the results of the examination and the age of the young patient, however, if the orthodontist recommends a certain device for the optimal solution to the problem, then it is better not to neglect his advice.
Only a doctor can determine what causes the appearance of “shark” teeth:
due to the location of the permanent and primary tooth buds in different parallels or due to the fact that there is little space in the jaw. In the latter case easy removal A baby tooth may not be enough, and then measures should be taken to widen the jaw.

What not to do

“Why worry and drag your child to the doctor, baby teeth will fall out on their own anyway,” careless parents think and leave everything as it is, especially when baby teeth don’t even wobble. However, this is a misconception.
If a child has grown a second row of permanent teeth, but the milk ones are still firmly in the gums, then in no case should you wait until they loosen and fall out.
If a baby tooth tenaciously holds on to its place, this means that its root is not resolving, since the germ of a permanent tooth has developed in a different plane. As long as the baby tooth takes up space, the permanent tooth will not move to its normal position! That is why milk teeth must be removed when permanent ones appear, without waiting for them to fall out.

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What to do?

Before you figure out what to do if your baby teeth haven’t fallen out, you need to general outline understand how the change process occurs, what its features are and when it’s time to start sounding the alarm. In fact, the change begins long before the moment of loosening. At about the age of 4 years, the roots begin to gradually dissolve. The process lasts about 2 years, so by the age of 6 the teeth no longer have anything to hold on to the jaw and they are pushed out.

Before the age of 10, a child will lose two pairs of upper and lower incisors, as well as first molars. From 10 to 11 years old, the upper and lower canines change. The last to fall out are the large molars. All the child’s suffering ends, as a rule, at the age of 14, and the residual bite is formed at the age of 16-18. Changes occur most often in this order, but such dates are more conditional than mandatory. If the teeth fell out in a different order or the timing has shifted a little, it’s okay.

There are several reasons why a child’s baby teeth did not fall out on time. First of all, parents need to remember the moment of teething. If a baby’s first teeth appear around 8-10 months, it is not at all surprising that they will also fall out late, creating problems for their native brothers. It is also important to consider the issue of heredity. Remember when your baby teeth fell out and how your permanent teeth appeared. Perhaps you will be able to trace some pattern.

The opposite situation also happens, when new permanent teeth begin to appear prematurely at 4-6 years of age; accordingly, they grow behind the milk teeth, at inside jaws. This anomaly is called “shark teeth”. Sometimes a child may grow a whole second row. Such failures can be caused by frequent infectious diseases or programmed at the genetic level.

If you notice such a defect in your child, show it to the dentist, although in this case doctors recommend not to panic and leave everything as it is. IN right time The baby teeth will fall out, and the new molars will move into their intended place. However, it is still important to keep the process under control and undergo periodic examinations by a pediatric dentist.

If you notice that there is a splinter or fragment of a root that has not completely resolved in the jaw, also seek help from a dentist. Often it is necessary to mechanically remove the remaining fragment that interferes with the new molar and massage the gum so that growth proceeds in the right direction.

When the baby tooth is already loose and the permanent tooth is growing right under it, give the child more solid food (apples, carrots, nuts, pears). So the loosening will go faster and the change will happen naturally. If the delay is observed from year to year, check the child for sufficient micro- and macroelements in the body. Sometimes the cause of the problem lies in rare disease Rickets, which occurs due to a lack of calcium and vitamin D.

If the teeth have not fallen out after the baby is 9 years old, it is worth checking the child for the presence of molars. Again, due to genetic failures, it may happen that the permanent teeth have not yet fully formed, so the body does not allow the baby teeth to fall out.

As you can see, in most cases, nothing drastic needs to be done if the baby still has a baby tooth, and a new molar is growing under it. The main thing is to monitor the development of the situation in order to take the necessary measures in time. Try to interfere as little as possible natural process. Mechanical removal It should be done only if there are clear indications and only in a doctor’s office.

There is no need to pull out teeth yourself; you can damage the tissue and cause an infection that is dangerous to the baby’s health.

Parents should also remember that they should visit the dentist every two years, regardless of the condition of the oral cavity. start doing preventive examinations It is necessary when the baby’s first teething begins, that is, from the first year. In this case, you will clearly understand how your child is developing.

All parents know that over time, baby teeth must be replaced by permanent ones. But sometimes, looking into the child’s mouth, mom or dad discovers that they are growing second in line. This frightens many people: why did the teeth grow like that? Is this really irreparable? Perhaps this is dangerous to health? And what will be the consequences?

“Letidor” turned to Marina Kolesnichenko, dentist-therapist, chief doctor of the Beauty Line clinic. The doctor hastened to reassure the parents: nothing fatal was happening. But parents should still know why the “shark row” occurs and how to deal with it.

Why do shark teeth appear?

iconmonstr-quote-5 (1)

Normally, the buds of permanent teeth should exert pressure on the roots of baby teeth when they erupt.

As a result, the root of the baby tooth begins to slowly dissolve, the baby tooth becomes mobile and then falls out on its own or is removed by a doctor.

But sometimes it happens that topographically, the germ of a permanent tooth and the root of a milk tooth are located in two parallel planes. As a result, when a permanent tooth erupts, there is no proper pressure on the root of the milk tooth. Then the permanent tooth has no other choice, and it grows near or above the milk tooth.

Why is it harmful for a child to breathe through his mouth all the time?

Here's how it happens.

The fact is that permanent teeth may be larger than baby teeth, and accordingly, the jaw must also increase in order for permanent teeth to be placed on it in the correct position.

iconmonstr-quote-5 (1)

If the child’s jaw does not expand naturally, then due to lack of space, permanent teeth erupt in a completely different place than they should.

At the age of 6-10 years, the child begins to exhibit physiological trema and diastema. These are gaps between the teeth that form as a result of the jaw itself preparing for the eruption of permanent teeth and expanding. An important factor in jaw expansion is the tongue, which puts pressure on both the upper and lower jaw. As the child grows, the tongue also grows, its pressure on the jaw bones increases, and they expand.

But when a child has impaired nasal breathing, for example, with frequent colds, and the mouth is constantly slightly open, since he breathes through the mouth, then the tongue is positioned incorrectly: it is located at the bottom of the mouth and does not exert proper pressure on the upper jaw, thereby not stimulating it development. Then trema and diastema between baby teeth do not arise, and permanent teeth are simply forced to erupt where there is free space for them - above or inside the gums: for example, fangs can grow very high due to lack of space.

Why is the appearance of “shark” teeth dangerous?

iconmonstr-quote-5 (1)

This takes about a month, and no additional equipment or effort is needed.

Why is an orthodontic examination important?

So, the pediatric dentist removed the baby tooth, leaving room for the permanent one. Why then consult an orthodontist?

This is necessary for the orthodontist to determine whether the child has a lack of space for permanent teeth.

iconmonstr-quote-5 (1)

If there is not enough space, the doctor will make a special orthodontic device to optimize the position of the permanent tooth.

Now there are quite a large number of them, and different devices are used in different cases. For example, trainers are silicone two-jaw devices that the child puts on at night, an hour before bedtime. Due to their elastic properties, they contribute to the expansion of dental arches and the formation of a correct bite. Trainers also act as an additional rigidity factor, which stimulates the jaws to expand and prepare for the eruption of permanent teeth.

In addition to trainers, the doctor may suggest plates with an expanding screw or, as an option for a later age, braces. This depends on the results of the examination and the age of the young patient, however, if the orthodontist recommends a certain device for the optimal solution to the problem, then it is better not to neglect his advice.

Polyodontia is an abnormal number of teeth. In medicine, this disease is often called hyperdontia, and “extra” dental elements are called supernumerary teeth. Research is still being conducted into why this pathology occurs. Most scientists associate it with disturbances in the formation of tooth germs.

ICD-10	K00.1
ICD-9	520.1
MeSH	D014096

Nature provides that a person grows no more than 20 milk teeth and 32 permanent teeth in a lifetime, but exceptions occur, and in our time quite often. According to statistics, on average, dental anomalies occur in 2% of the world's population, most often in men.

The most common hyperdontia (anomaly in the number of teeth) is the anomaly upper incisors. Supernumerary teeth are less common among the lower incisors and in other parts of the jaw. They can come in a wide variety of shapes and sizes. Usually this small teeth in the shape of a cone.

Extra teeth lead to deformation of the dentition, so it is recommended to remove supernumerary elements. Another reason for removal is that most patients with this pathology have a lisp.

In 2014 alone, two operations were performed, in one of which 80 teeth were removed, and in the other, a record 232 teeth. Until this time, the maximum figure was 37 teeth.

Causes

Medicine has not yet found an exact answer to the question of what are the causes of supernumerary teeth. Scientists put forward several hypotheses:

Atavism. Supernumerary teeth are explained by the fact that dental system strives to return to the original quantity of elements laid down by nature. There is evidence that our ancestors had 6 incisors on both the lower and upper jaws. As a result, many doctors consider atavism to be the cause of the development of polyodontia in humans.
Splitting of the tooth germ. Also in embryonic period The child’s dental plate activity is disrupted, resulting in the formation of hyperdontia. Violations can be caused by viruses, poor ecology, drugs, medications prohibited during pregnancy, alcohol and other factors. This hypothesis is increasingly supported today, because in Lately the disease progresses rapidly due to bad habits and bad ecology.

The causes of hyperdontia continue to be researched. Scientists cannot give an exact explanation for this anomaly, but most of them are inclined to the second hypothesis - the splitting of the tooth germ at the embryonic stage.

The formation of extra teeth is quite common today. According to statistics, 70% of patients have only one extra incisor, in 25% of cases - 2 supernumerary elements, and only 5% of all patients have 3 or more teeth during examination.

Locations of supernumerary teeth

Usually, supernumerary teeth are discovered as early as milk bite, but they are often found much later, when a permanent bite has already been formed.

The most common place where polyodontia appears is in the middle upper incisors, as well as molars, premolars and canines. Much less commonly, this problem affects the lower jaw. Extra teeth may appear on the dental arch, as well as in the area upper sky or in the vestibule of the oral cavity.

What does polyodontia look like?

Quite often, extra teeth are almost indistinguishable from normal ones. It is not uncommon for them to grow in the form of a drop or a thorn. These dental elements can appear either individually or fused with permanent ones. They can form tooth-like formations and entire arrays of teeth.

also in medical practice There are cases when polyodontia was hidden and was detected only by radiography. Below are the photos different cases abnormal development of the number of teeth.

Types of disease

Polyodontia in the oral cavity manifests itself in different ways. By studying the statistics, signs and symptoms of the disease, dentists were able to classify the types of this anomaly.

Depending on the origin, the disease is divided into two types:

False polyodontia. Provides for a baby tooth that does not fall out, regardless of the person’s age. At the same time, it fulfills its functions, does not create discomfort to the bite, and is firmly fixed in the patient’s jaw. In addition, teeth fused together and other anomalies are classified as a false type of disease.
True polyodontia. It can be caused by genetic predisposition, as well as terogenic factors. At the same time, extra molars begin to form in the human jaw.

Science knows of cases where baby teeth were found in people aged 50-60 years. However, they did not bother them and functioned normally.

As for the placement of extra teeth, dentists distinguish the following types of disease:

Typical hyperdontia. Applies to those patients in whom extra teeth appear only in the dentition and do not extend beyond it. Many scientists are confident that this is simply heredity, because our ancestors had a more developed dental system than modern people.
Atypical hyperdontia. It occurs much less frequently and is characterized by the appearance of teeth outside the dentition.

In case of anomalies with baby teeth, the latter pose almost no threat. On the contrary, such a tooth can last a lifetime. But the permanent molars, over which the supernumeraries grow, should be removed, if only because it is not aesthetically pleasing.

Often, the patient grows extra fangs or incisors, or even several front teeth at once. In addition to a ruined smile, the disease can cause serious complications, if the necessary measures are not taken in time.

Symptoms of the disease in children

The first supernumerary teeth in children appear before birth or in the first six months of life. The main inconvenience they cause is difficulty in feeding.

Polyodontia of primary teeth in older children occurs with symptoms similar to the eruption of regular teeth. In this case it is observed:

temperature increase;
swelling of the gums in the place where the tooth should erupt;
pain;
excessive salivation;
swelling of the nasal mucosa;
loose stool.

Symptoms are especially severe when extra teeth appear in the upper palate.

If hyperdontia makes itself felt in a two-year-old child, this can interfere with the formation of normal speech. In turn, due to injury to the tongue and mucous membranes, some kind of inflammation constantly appears in the oral cavity.

When supernumerary teeth appear in very visible places in children school age, ridicule towards the patient may occur, which is fraught with the development of psychological problems and complexes in the future.

Symptoms of hyperdontia in adults

Polyodontia affects permanent teeth more often than baby teeth. An adult usually develops dystopic and impacted supernumerary teeth.

Dystopic are teeth that appear outside the dental arch. Most often they erupt on the lingual surface of the gums and in the palate. With this form of the disease, the patient typically:

poor pronunciation of sounds;
noticeable malocclusion;
change usual location teeth: curvature of the angle at which they grow, as well as their rotation around their axis;
frequent injury to the oral mucosa and, as a result, its inflammation;
violation chewing processes, resulting in digestive problems.

Among other things, dystopic teeth often cause psychological problems. Due to a non-aesthetic, and sometimes completely unattractive smile, the patient becomes withdrawn and uncommunicative. Psychological problems, in turn, cause chronic diseases endocrine, digestive and nervous systems.

Impacted Supernumerary teeth are teeth that do not erupt, but continue to remain in the bone tissue of the human jaw. Often they hardly make themselves felt until complications begin. Dentists diagnose this anomaly during a routine examination of the patient.

This abnormality in the number of teeth is accompanied by the following symptoms:

normal teeth begin to loosen (the condition is considered pathological);
the bone begins to protrude (if the impacted tooth is too close to the edge of the jaw);
Aching pains appear periodically.

One of the most difficult situations is when extra teeth grow in place of impacted third molars. Wisdom teeth cannot grow and begin to negatively affect the roots of other teeth, which in turn can lead to serious complications.

Consequences of the disease

Polyodontia in humans can often be the cause of retention. This is a phenomenon in which normal teeth are unable to erupt due to the interference of supernumerary teeth. The former may remain in the jaw or take an abnormal position.

In addition, even if the complete incisor grows before the supernumerary one, the latter will be able to displace it. This will lead to the person being unable to chew food normally. And if several extra incisors grow at once, they can cause the loss of permanent teeth.

Polyodontia disease can lead to the following pathologies:

permanent teeth shift and their roots become curved;
an incorrect bite is formed or the correct bite is disrupted;
teeth erupt with delay or remain in the jaw;
dentition is deformed;
cracks appear, a deep or open bite is formed;
the mucous membrane is often injured;
the person begins to lisp and slur words and phrases.

Diagnostics

Examining supernumerary teeth during an x-ray is not as easy as it seems. They can be superimposed along the contour onto the permanent ones and remain invisible. In such cases, patients are recommended to do computed tomography, which shows a more accurate picture of the disease.

If the extra dental elements have already erupted, the dentist can easily detect them. In practice, the erupted supernumerary teeth are found by the patients themselves and are already initial appointment The dentist complains of pathology.

Treatment of polyodontia

If a person is diagnosed with polyodontia, then in most cases it is necessary to begin treatment, which directly depends on the severity, type and form of the disease, as well as on the location of the supernumerary teeth.

The patient may be offered the following treatment options:

procedures to facilitate teething (relevant for children);
orthodontic treatment;
removal of supernumerary teeth.

Symptom relief

Most often, adults erupt extra teeth without special symptoms, but for children this can be a problem that needs to be addressed.

Supernumerary teeth erupt with the same symptoms as regular teeth, so the treatment for them is the same.

To lower the temperature, it is recommended to give your baby Paracetamol or Ibuprofen. If the child is very small, you can use these drugs in the form of suspensions or rectal suppositories. In addition to lowering the temperature, these medications do an excellent job of treating pain and inflammation.
Used to relieve gum pain local anesthetics– ointments and gels (for example, Kalgel, Dentinox, Solokoseryl). These remedies cope well with painful sensations and slightly relieve inflammation.
Adults and children over 2 years of age can be treated folk remedies: propolis, honey, decoctions of calendula, chamomile and lemon balm. Some decoctions help reduce pain and relieve inflammation. Traditional methods Treatment should be used only after consultation with your doctor.
If primary supernumerary teeth have partially erupted, stimulation of eruption is prescribed. For this purpose, vibration and electrical stimulation, as well as special massage, are used.

Removal of abnormal teeth

Treatment of hyperdontia does not always involve the removal of excess teeth. TO mandatory deletion subject only to:

teeth in primary dentition, which impede the growth of permanent teeth and have a negative impact on the development of the jaw system;
dystopic and impacted teeth.

located within the dental arch and does not affect the bite in any way;
does not spoil the aesthetic appearance of the smile and has the shape of a permanent tooth;
is formed correctly, but the nearby permanent tooth is destroyed.

Normal deletion

If the dentist decides that in a particular case, polyodontia can only be treated by removing extra tooth, the patient should count on the following procedures:

First of all, the patient should be sent for radiography. This is necessary in order to determine the size and number of roots, as well as the ratio of supernumerary and normal teeth.
After collecting research, the doctor gives the patient anesthesia and removes excess teeth.
In some cases, soft tissue sutures may be necessary after surgery.

Removal of impacted teeth

In order for the operation to be successful and polyodontia to be cured without any complications, the doctor must fully examine the patient and plan his further actions.

To begin with, X-rays and/or computed tomography are performed to determine the exact topography of the anomaly.
Removal is carried out under local anesthesia, but there are cases where general anesthesia may be used on the patient.
First, the mucous membrane peels off, then opens bone tissue and the root and crown parts of the tooth are removed.
If necessary, bone defects are covered with osteoplastic material, and the mucous membrane is sutured.

After tooth extraction, the patient continues treatment at home: takes antibiotics (if prescribed by the attending physician), rinses the oral cavity with antiseptic solutions.

Until the wound heals after surgery, it is not recommended to eat too hot, hard or spicy food. You should also brush your teeth carefully, especially on the operated side.

Orthodontic treatment

The need for orthodontic treatment after removal of supernumerary teeth is determined by the doctor. Often, both children and adults tolerate surgery well and do not require further treatment, but there are exceptions. In severe cases, the help of an orthodontist is required to:

the jaw could develop correctly and grow normally (if this is a child);
over the age of six years, the child has not encountered problems with the eruption of molars;
correct and straighten the teeth.

Today, bite correction and dental alignment are very successfully performed using special mouth guards and braces.

Polyodontia is a fairly common disease that can be successfully treated in most cases. The earlier the disease is detected, the lower the risk of developing negative consequences. At the first symptoms of the disease, you should immediately consult a doctor.

With proper development of the jaw, milk and then permanent teeth appear gradually, in a certain sequence. But sometimes the order of their eruption and growth is disrupted, causing deviations in the structure of the dentition. Why does a child's teeth grow in the second row? Similar violation leads to the appearance of a cosmetic defect and spoils the smile. Usually the cause of the anomaly is that the molars begin to erupt before the milk teeth fall out. In this case, their retention is observed when molars, canines or incisors remain completely or partially in the gum.

Features of correcting dental defects

If a permanent tooth erupts under a still firmly standing milk tooth, the direction of its growth is bent. Because of this, children and parents will subsequently have to face the need to straighten their teeth, remove a problematic incisor or molar, treat caries or gum diseases, which arise in this case more often than usual.

The reasons why children's teeth cut and grow incorrectly may be as follows:

hereditary predisposition;
deterioration of health weakened by infection or chronic disease;
unbalanced diet, lack of vitamins and other useful elements in the diet;
disturbances in the development of baby teeth, leading to early removal, late resorption of roots and late replacement with permanent incisors or molars;
presence of obstacles to growth in the right direction;
violations of the structure of the jaw, incorrect location of tooth germs.

What to do if the baby tooth has not yet fallen out, but the molar is already growing? If you notice that your baby's teeth are growing in two rows, contact your pediatric dentist. Usually the doctor advises removing the first, milky one, to ensure proper development the germ of a permanent The procedure is easy and painless, since the roots of baby teeth are less developed and do not go deep into the gums. To eliminate the sensitivity of the mucous membrane, a special gel containing an anesthetic drug is applied to it.

The formation of baby tooth buds occurs before the baby is born. Most often, crooked growth is caused by a discrepancy between the area required for their placement and the size of the jaw bone.

Also, crooked teeth can be caused by:

poor nutrition of a woman during pregnancy;
insufficient calcium, fluorine and other necessary elements in the child's diet;
the baby's consumption of food that has a soft consistency - babies should also be allowed to chew on hard foods;
mouth breathing, characteristic of some ENT diseases;
sucking a one-year-old baby pacifiers or fingers (the child should be taught to drink from a cup, eat solid food, use a plate and spoon);
genetic predisposition.

Correcting crooked teeth

Aligning crookedly growing primary teeth reduces the risk of disturbances in the development of molar rudiments. In addition, their improper growth leads to such negative consequences such as diseases of the gastrointestinal tract, headaches, the appearance of complexes. Growing teeth that are crooked are much easier to straighten in childhood than in childhood. mature age. Dentists have effective methods correction of their growth using mouth guards, braces or trainers.

Installation of braces is used in adolescence and young adulthood. Teenagers are able to care for the system independently and wear it for a long time after installation. For children younger age Correction of the bite is ensured by installing a mouth guard or trainer. The advantage of these devices is that they are not visible to others and can be easily removed if the need arises. The speed of teeth straightening is higher, the earlier it is started. When the teeth are in the gum, they are not yet fully formed, which makes the task of straightening much easier. At an older age, the roots are better developed, so the difficulty of straightening increases, and the process itself takes longer. a long period time (at least a year).

Eights are often the reason dental problems. Let's look at why this happens. In most cases, this is due to insufficient length of the bone that forms the jaw. Wisdom teeth begin to erupt after the appearance of the second molars and other units of the dentition. If they do not have enough space, they do not grow upward, but at an angle, towards the 2nd molar, cheek or inside the oral cavity.

In this case, the figure eight itself is not visible, but the child is worried strong pain. What to do if the eighth tooth grows in the second row - treatment of such disorders is usually surgical. To diagnose the condition, an X-ray examination is prescribed. If a wisdom tooth is in the formative stage, the direction of its growth can be corrected without resorting to surgery. In cases where the 3rd molar has already grown, the only option is to remove it.

Sequence and timing of molar eruption

Around the age of five or a little later, children grow the first pair of molars on the upper jaw. Then the corresponding pair of teeth in the lower jaw area is replaced. The second molars are cut in the same order. The period of appearance of eights can cover the period from 16 to 26 years. But increasingly, retention of wisdom teeth occurs - they do not appear after the second molars, but remain inside the gums. One of the explanations for this phenomenon, scientists believe, is the lack of need to eat solid food, which constituted the predominant part of the human diet in previous centuries.

Types of retention

Not only figure eights, but also fangs or incisors of the upper jaw can be hidden in the gums. In some cases, impacted teeth are completely invisible, as they are covered with soft or hard tissues jaws and are not felt by fingers when palpating. This type of retention is called complete. The tooth can be positioned vertically or horizontally relative to the jaw. If it is directed with the crown inside the oral cavity, this arrangement is called lingual-angular; if it grows in the outer direction, it is defined as buccal-angular.

The second type of retention is partial; it is manifested by the elevation of part of the crown above the surface of the gum. Impacted and semi-impacted teeth require compulsory treatment, since they are not only cosmetic defect, but can also lead to the appearance of purulent cysts and worsen the resorption of the roots of adjacent baby teeth.

What can cause retention?

Expanded dentition often occurs because permanent teeth grow in before the temporary teeth fall out. Retention may also be associated with improper development jaws with insufficient area for the formation of dentition. Sometimes the reason for the appearance of the second row is too early removal primary molar or premolar. This leads to displacement of the tooth germs and leads to the fact that the molar canine grows onto the tooth located nearby.

In some cases, overcompleteness of the child’s dentition occurs. This is manifested in the fact that in addition to the required 28 teeth, one or two more grow. Disease and destruction of an incisor can lead to getting stuck in the gum, features anatomical structure jaw bones, lack of constant parental control over the condition of the teeth, which have been cutting and growing since the first year of the baby’s life.

An X-ray examination of the dentition helps to identify complete retention. X-ray diagnostics allows you to find out in detail all the necessary information about an impacted tooth, in particular how it is located, in which direction it grows, the condition of the surrounding tissues, the presence of granulomas or cysts.

Symptomatically, retention manifests itself as follows:

a defect is visible in the dentition - either the tooth is missing or is cut with a significant deviation from the place where it should appear;
swelling and hyperemia (redness) of the gums are noticeable, the child feels pain, and when pressing on the mucous membrane it increases;
fever, weakness;
if the tooth is semi-impacted, it top part slightly visible above the gum, palpable with fingers, the surrounding tissues are inflamed and painful.

Treatment of retention

Decide what to do with impacted tooth, and choose the best way treatment should be carried out by a doctor after examining the patient and studying the results of radiography. If its location and direction of growth are not changed and exit from the gums is prevented only by increased density tissue, an incision is made on it with local anesthesia. In the case of partial eruption of incisors or canines, a brace system is installed to correct the bite with preliminary exposure of the dental crown through surgery.

If the tooth is incorrectly positioned, coverage inflammatory process gums and signs of destruction of the dental neck appear, its removal is indicated to prevent the development of complications. Lack of treatment threatens the formation of cysts, slower resorption of the roots of adjacent baby teeth that are impacted, and a decrease in the aesthetics of the smile area. Therefore you should contact qualified assistance when the first symptoms of dental development disorders appear.