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The boy with the extra set of teeth

By Kavita Varma-White

At the age of 5, my son Jayan had a routine set of dental X-rays that showed a disturbing fact.

The X-rays revealed that he possessed not one, not two, but three sets of front teeth. There were his baby teeth, his permanent teeth and in between, an extra set. A bonus pair, if you will.

I reacted the way any parent would upon discovering their child has an extra body part:

I freaked. “He has what?!” I yelled at my husband, who had taken him to the appointment. (Having a general fear of dentistry, I avoid going whenever possible.)

Humans are normally born with 20 baby teeth and have 32 permanent teeth. As it turns out, Jayan is the proud owner of supernumerary teeth, which are teeth additional to the regular number of chompers and can be found in almost any region of the horseshoe-shaped dental arch. They are most common in the central incisors, or front teeth.

Supernumerary teeth are often hereditary, although pediatric dentist Patrick Arnold of Fort Lauderdale, Fla., says it’s hard to tell what causes them. “A portion of the developing tissue from early on may get pushed off and a tooth bud might split. Or, there also might be hyperactivity of the dental lamina, which is the precursor to a tooth.”

It's also unclear how common supernumerary teeth are in children. The American Academy of Pediatric Dentistry cites a 1999 report in the Journal of Canadian Dental Association, where in a survey of 2,000 British schoolchildren, researchers found that supernumerary teeth were present in 0.8 percent of kids who still had baby teeth. Of the children who already had their permanent teeth, 2.1 percent had supernumeraries.

Arnold, the dentist who diagnosed our son, has not seen a lot of supernumerary teeth in his eight-year practice. He estimates about 1 percent of his patients are affected.

After discovering Jayan’s sharklike extra row of teeth, the dentist explained the likely course of treatment.

First, Jayan’s baby front teeth would have to be extracted prematurely. Second, we’d have to wait for the supernumerary teeth to come in. Hopefully, they would appear before the permanent teeth. (An unappealing side effect: When the supernumerary comes in, it is commonly not a fully formed tooth, but rather a malformed, peglike tooth.) Once his ivories presented themselves, the supernumerary teeth would have to be pulled, making room for the permanent teeth.

If the permanent teeth edged ahead of the supernumeraries, Jayan would face a miserable operation of oral maxillofacial surgery to remove the extra teeth.

Fortunately, fate stepped in. A few months after the diagnosis, Jayan had a playground collision that loosened both of his front teeth. That afternoon, with my husband inconveniently out of town, I watched Arnold stick a huge needle in my son’s mouth to numb it, and then pull out both teeth.

It is truly amazing how losing the front teeth completely transforms a child’s face. The babyness leaves and they are instantly … older. I cried at the sight of my toothless boy, who I felt had to unfairly grow up too fast.

Meanwhile, Jayan, 5, enjoyed celebrity status in his kindergarten class, as no one had lost both front teeth yet. Most kids don’t lose their first tooth until age 6; they commonly don’t lose both front teeth before age 7.

It also helped that the Tooth Fairy, who is a sucker for dentist-extracted teeth, left $10 under the pillow, rather than her usual fare of $1 per tooth.

Shortly afterward, we moved to a new city and took Jayan to a new dentist. Fresh X-rays showed in the past year the supernumerary teeth had made significant movement. While one is coming down in the correct position, the other one seems to be pointing backwards, possibly requiring surgery. Only time will tell which direction it takes.

As we play the waiting game, we’ll celebrate yet another holiday season where the theme song in our house is the familiar tune, “All I Want for Christmas Is My Two Front Teeth.”