Hyperdontia

Hyperdontia is a rare pathology caused by a person having teeth that are too big. But, one way or another, about two percent of people on Earth suffer from this disease. And if so, you need to know about this disease.

A normal average person should have thirty-two teeth. Hyperdontia involves the appearance of one or more "extra" teeth, i.e. in excess of the set. Oddly enough, but more often there are cases when they grow in the area of the upper incisors and canines, although there are also cases of lower growth of such teeth. Anomalous teeth can differ from "normal" ones in shape and overall size (usually smaller).

Causes of hyperdontia

It is quite difficult to clearly and categorically name the causes of hyperdontia. Doctors assume that the etiology of this pathology may be hidden in a failure of the genetic program or pathology of intrauterine development of the fetus, which entailed the laying of more than the required number of tooth rudiments.

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Symptoms of hyperdontia

"Extra" teeth are found both with anatomically usual shapes and structures, and pathologically abnormal ones. Based on the anatomy and localization of the "patient's" extra teeth, a specialist can easily predict the defects that the dentition will acquire. Dentists have noticed that victims more often have cone-shaped teeth and smaller ones. And another amazing paradox - this disease is much more common in representatives of the stronger sex than in women. Such neoplasms look quite unaesthetic, traumatizing both psychologically and physically their owner.

What are the symptoms of hyperdontia:

• The vast majority of people diagnosed with hyperdontia suffer from speech impairment, or, to put it simply, they lisp.
• As a rule, supernumerary teeth are not endowed with wide, powerful roots, but are content with a compact, small root.
• When an extra tooth appears, healthy teeth also suffer. They have to move slightly.
• As a consequence of the displacement of healthy teeth, a significant distance (diastema) appears between the central incisors.
• Hyperdontia can significantly slow down the eruption of new teeth.
• The eruption of supernumerary teeth quite often provokes the curvature of the roots of permanent teeth.
• This same fact can lead to healthy teeth rotating around their axis.
• The “extra” teeth themselves are often shifted, turned outward, tilted, or located horizontally, in contrast to normal teeth.
• Well, as a result of all the above, this is a malocclusion, which entails not only an aesthetic defect, but also the development of pathology of the gastrointestinal tract and the entire digestive system as a whole.

Based on their location, in hyperdontia, dentists divide excess teeth into several types:

• Awl-shaped teeth, which appear beyond the norm. They erupt in the maxillary zone, near the dental arch, in the space between the central and lateral incisors. They have a conical shape, pointed upwards, resembling an awl. With their sharp ends, they are capable of injuring the oral mucosa quite severely, which can subsequently lead to pathogenic flora getting into the wound and, as a result, an inflammatory process begins with all the ensuing consequences.
• Additional paramolars. They are usually located in the cheek area, in the space between the normal molars.
• Supernumerary canines. Localization area – upper jaw.
• "Extra" premolars. Localization area – lower jaw.

Diagnosis of hyperdontia

As a rule, supernumerary premolars and canines are located quite deeply, as if recessed into the soft tissues of the oral cavity. Therefore, in order to detect them, it is necessary to make an X-ray.

A dentist diagnoses hyperdontia based on:

• Visual examination of the dental arch by a specialist.
• Laboratory research.
• X-ray examination of the patient's jaw.

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Treatment of hyperdontia

Regardless of whether the supernumerary teeth appeared in the newborn in the first months of life, or the patient acquired them at a later age, the verdict is the same - removal. After all, even in infancy, these teeth can injure the tongue and mucous membrane of the baby. And they will also interfere with breastfeeding, injuring the mother's nipple.

Having received an X-ray, the dentist pays attention not only to the supernumerary teeth, but also to the impacted teeth. Those that will not be able to erupt normally as they are partially or completely covered by bone tissue. They are also subject to removal.

• If the tooth rudiments are located deep enough in the direction in which the tooth will erupt, then, first of all, it is necessary to undergo a course of alveolar process massage (or electrical or vibration-vacuum stimulation) for their eruption.

Massage the upper and lower jaws in turn (if necessary). Massage is done with elastic pressure, mainly on one side, placing the fingers so that they are perpendicular to the surface of the bone. In the canine cavity, which is located between the upper cheekbone and the wing of the nose, if you go down closer to the dental row, the dental roots are located - in medicine, this area is called the alveolar process (in this case, the upper jaw). Having gained this experience, it will now not be difficult to find the alveolar process on the lower jaw.

Grasping the jaw from both sides in the area of the corresponding processes (one finger is on the outer side of the jaw, and the second in the mouth), massage, squeezing and releasing the location of the alveolar process. This functional irritation leads to improved blood circulation in this area, the tooth seems to wake up and begin to grow. Similar manipulations can be done using additional equipment (vibration or electric massager). Recently, infrared and red rays have begun to be used for this irritating therapy. There is evidence that in order to obtain the desired result, doctors injected prostaglandin E1 under the mucous membrane of the oral cavity. Getting into the area of the alveolar process, this drug accelerates the growth of the teeth of interest by 1.6 times.

Any retained supernumerary teeth, especially if they have not grown in the direction of the main eruption, as well as if they interfere with the anatomically normal growth of primary or primary teeth, must be removed. If such teeth do not interfere with the growth of normal teeth, do not lead to a defect in the bite, do not cause pathological changes in the oral cavity, then they can be left alone.

• Often, hyperdontia treatment can be limited to just removing the unnecessary tooth. This procedure is performed by a dental surgeon on an outpatient basis in a specialized clinic. The tooth is removed quickly and almost painlessly under local anesthesia.
• Then, postoperative therapy is carried out. After the extraction, a thrombus is sure to form in the socket – a blood clot that kind of seals the wound, allowing it to heal faster. But if something goes wrong during the extraction: a splinter remains in the wound, or the alveolus is severely injured, then this clot loses its integrity, which can provoke the development of suppuration. Pieces of food that get into the wound can also lead to the formation of an abscess. Another problem may arise. If the patient rinses the mouth too vigorously, the thrombus is washed out of the socket and, as doctors say, a “dry socket” is obtained.

In both the first and second scenarios, pain in the gum area may appear in the next three days, which will eventually spread to the entire jaw, sending pain impulses to the head. The patient's body temperature may rise to 37.5-38°C. Such symptoms are a clear sign of an inflammatory process that has affected the mucous membrane of the socket walls. In order to prevent further development of the disease (purulent-necrotic processes), it is necessary to start treatment immediately.

• The wound and adjacent tissues are disinfected. Disinfection is carried out with a solution of furacilin, chlorhexidine or hydrogen peroxide.

Furacilin. Used for rinsing: dissolve 1 tablet of the medicine in 100 ml of water. This drug is contraindicated: in case of allergic dermatosis or if there are foci of sufficiently severe bleeding.

Chlorhexidine. Use a 20% solution of this drug. It is prepared by diluting one part of chlorhexidine in forty parts of ethyl alcohol (70%). Treat the wound with this solution. It should be used very carefully in the case of small children, pregnant and nursing mothers.

• For more thorough cleaning of the wound, a tampon soaked in an antiseptic enzyme medicine is placed into the alveolus.
• Trypsin. Immediately before use, moisten 50.0 mg of crystals of the drug in 5 ml (0.9% solution) of sodium chloride or sterile water for injections, or in a 0.5-2% solution of procaine. In rare cases, use powder of this drug. It is better not to prescribe this drug for cardiac and pulmonary insufficiency, liver dysfunction, tuberculosis. It cannot be applied to a surface with malignant neoplasms.

Chymotrypsin. After surgery, 10 mg of the drug diluted in 3 ml of novocaine is administered intramuscularly once a day. For preventive purposes (antibacterial therapy) - 30 mg pleurally, once a day. For purulent wounds, the drug is applied to a napkin and applied to the wound. It is advisable not to prescribe the drug in case of hypersensitivity to the components included in its composition; in case of cardiac and renal failure, liver cirrhosis, complex diseases of the gastrointestinal tract, hepatitis, pregnancy, breastfeeding; children under 18 years of age.

• If the suppuration process has gone too far and areas of necrosis have appeared, then you have to resort to the help of antibiotics.

Rifampicin. This medicine is perfectly absorbed into the walls of the gastrointestinal tract, reaching the maximum amount in the blood plasma after 2-2.5 hours. And when administered intravenously - already by the end of the dropper. It easily seeps into tissue cells and accumulates in them. It is perfectly excreted from the body with urine. It has a positive effect on the body for 8-12 hours.

Preparation of the solution: 0.15 g of the drug is diluted in 2.5 ml of sterile water. Before use, the solution must be shaken well. Next, the resulting mixture is diluted in 125 ml of 5% glucose solution. The daily dose of this drug should not exceed 0.45 g of the drug. If the disease is severe enough - 0.6 g.

This drug is contraindicated: for children, with individual intolerance to one or more components included in the composition of the drug. Its use is not recommended for people who suffer from impaired liver and kidney function, cardiopulmonary insufficiency, including if the patient suffered from hepatitis of infectious genesis less than a year ago.

Heliomycin. Before introducing this drug into the treatment protocol, it is worth conducting a sensitivity test for pathogens, causative agents of the inflammatory process. The ointment is distributed over a tampon and applied to the infected area for 20-30 minutes. Treatment is carried out for a week or more. No side effects or contraindications have been identified.

• If there are no such terrible consequences after the removal of impacted supernumerary teeth in hyperdontia, then the dentist recommends that the patient, in order to bring his oral cavity into proper condition faster, make warm baths in the oral cavity at home. Do not rinse, but only take the solution in the mouth and hold for some time, then spit it out. Prepare a solution of baking soda at the rate of one teaspoon per glass of water or make a weak solution of potassium permanganate.
• Painkillers and vitamins are also prescribed.

Grippostad. The main active ingredient is paracetamol. The patient takes one to two capsules three times a day, with subsequent doses no more than 6-8 hours apart. Do not take for more than five days. Contraindications: pregnancy, individual intolerance to the components of the drug, diabetes, renal and hepatic insufficiency, disorders of the hematopoietic and urinary systems, as well as patients suffering from cardiovascular diseases. This drug should be avoided for children under 12 years of age and the elderly, as well as those whose work requires increased attention.

Ketanov. Today, this is one of the most popular painkillers. The main active ingredient is ketorolac. The patient takes one tablet (10 mg) every 4-6 hours. The course of treatment should not exceed a week. If the patient is over 65 years old or his weight does not exceed 50 kg, a lower dosage is prescribed.

The drug has a systemic effect. This medicine should be prescribed with great caution, as it has contraindications and side effects: drowsiness, constipation, headache and abdominal pain, nausea, diarrhea, dizziness... Contraindications: pregnancy, breastfeeding, children under 16, bronchial asthma, ulcerative diseases of the gastrointestinal tract, problems with blood clotting, renal failure...

Prevention of hyperdontia

Prevention of hyperdontia is not difficult. It is impossible to prevent it, since medicine cannot clearly state the etiology of this disease. Therefore, just be more attentive to yourself and your children. And at the slightest suspicion of supernumerary teeth, without wasting time, hurry to the doctor.

Prognosis of hyperdontia

With timely detection of retained supernumerary teeth and immediate treatment at a specialized clinic, the prognosis for hyperdontia is usually favorable. If a patient with this pathology has already contacted a specialist with an advanced form of the disease, then the patient will receive medical care in any case, it will just take much more effort and money. After all, if the eruption of supernumerary teeth has led to a change in bite, then the work here is not only for a dental surgeon, but also for an orthopedist.

If you are one of those two percent of the population that have supernumerary teeth in their cavity, do not worry and do not panic. Your problem can be solved. Today, hyperdontia is not a death sentence. And the sooner the patient seeks examination and consultation with a specialist, the sooner the long-awaited time will come when you can feel “like everyone else” and fully enjoy all the colors of life.