Supernumerary teeth are extra teeth that develop beyond the normal count of 20 baby teeth or 32 permanent teeth. While they might sound harmless, these extra teeth can block permanent teeth from erupting properly, cause severe crowding, create painful cysts, or damage neighboring teeth. At Dental Sedation Ottawa, we specialize in the gentle, precise removal of supernumerary teeth using comprehensive sedation options—from mild relaxation to complete sleep—ensuring your child receives expert surgical care without fear or anxiety.
Supernumerary means 'extra' or 'more than the standard number.' These additional teeth develop when tooth buds form incorrectly during early childhood dental development. About 1-4% of children develop at least one supernumerary tooth, and they occur about twice as often in males as females.
These extra teeth can appear anywhere in the mouth, but they most commonly develop in specific locations: between the upper front teeth (called a mesiodens), behind the upper molars (fourth molars or distomolars), or occasionally beside the canines. Some supernumerary teeth erupt normally into the mouth and are visible, but many remain hidden beneath the gums (impacted) and are only discovered through dental X-rays.
Supernumerary teeth come in various shapes and sizes. Some look almost identical to normal teeth, while others are small, peg-shaped, or oddly formed. They might be oriented normally, or they can be rotated, inverted, or angled in unusual directions. Some children develop just one extra tooth, while others have multiple supernumeraries.
The cause isn't fully understood, but genetics play a significant role—supernumerary teeth often run in families. They're also more common in children with certain conditions like cleft lip and palate or specific genetic syndromes.
At Dental Sedation Ottawa, we understand that the idea of surgical tooth removal can feel frightening for both children and parents. We prioritize comfort through comprehensive sedation dentistry options.
Not all supernumerary teeth require immediate removal, but most eventually need extraction because of the complications they cause.
Small supernumerary teeth positioned well away from permanent teeth, showing no signs of pathology (cysts), not interfering with eruption, and unlikely to erupt themselves can sometimes be monitored with periodic X-rays (every 12-18 months) rather than immediately removed. However, most orthodontists and pediatric dentists recommend extraction because problems tend to develop eventually.
Before surgery, we conduct thorough examination and take detailed X-rays or 3D imaging to precisely locate the supernumerary tooth and plan the safest surgical approach. We discuss sedation options based on your child's age, anxiety level, the tooth's complexity, and whether other treatments are needed simultaneously.
On surgery day, we begin by administering your chosen sedation option. Once your child is comfortable and relaxed (or peacefully asleep with general anesthesia), we ensure complete numbness of the surgical area. Throughout the procedure, our team continuously monitors your child's vital signs and comfort for safety.
For erupted supernumerary teeth visible in the mouth, removal resembles a standard extraction—the dentist carefully loosens the tooth and removes it, similar to pulling a baby tooth.
For impacted supernumerary teeth beneath the gums, surgery is more involved. The surgeon makes a small incision in the gum tissue and gently reflects it back to expose the underlying bone. Using specialized instruments, we carefully remove enough bone to access the impacted tooth. The supernumerary tooth is then sectioned (cut into smaller pieces if necessary) and removed carefully to avoid disturbing adjacent permanent teeth.
If the procedure involves exposing a permanent tooth for orthodontic treatment (when the supernumerary tooth was blocking its eruption), we may bond an orthodontic bracket and chain to the impacted permanent tooth at the same appointment. This chain helps the orthodontist later guide that tooth into its proper position.
After removing the supernumerary tooth, we smooth the bone, thoroughly irrigate the area, and close the incision with dissolvable stitches. We place gauze over the surgical site to control bleeding and provide detailed post-operative instructions.
Simple erupted supernumerary tooth removal takes 15-20 minutes. Complex impacted extractions require 30-60 minutes per tooth, depending on position, depth, and proximity to important structures.
First 24-48 Hours: Expect some swelling, discomfort, and minor bleeding for the first 1-3 days after surgery. The amount varies by surgical complexity—simple extractions cause minimal swelling, while deeply impacted tooth removal may result in moderate facial swelling that peaks on day 2-3 before gradually improving. Children's ibuprofen manages pain effectively for most children. Some may need prescription pain medication for the first 1-2 days after complex surgery. Apply ice packs to the face (20 minutes on, 20 minutes off) during the first 24 hours to minimize swelling. Stick to soft, cool foods for 3-5 days: yogurt, smoothies (no straws—suction can dislodge blood clots), mashed potatoes, pasta, eggs, ice cream, applesauce. Avoid hot, spicy, crunchy, or chewy foods. Stay well-hydrated with plenty of water.
Long-Term Healing: Your child can usually return to school within 2-3 days, though you might prefer scheduling surgery before a weekend for more recovery time. Avoid strenuous physical activity and contact sports for 5-7 days to prevent bleeding and protect healing. Stitches dissolve on their own within 7-14 days—no removal appointment needed. The surgical site heals completely within 2-4 weeks, though complete bone regeneration takes 3-6 months. We schedule a follow-up appointment 7-14 days after surgery to check healing.
Orthodontic Implications: If the supernumerary tooth was blocking a permanent tooth, that permanent tooth often begins erupting naturally within 6-18 months after removal, especially if the child is under age 10. For older children or teeth that don't erupt spontaneously, orthodontic treatment with braces guides the tooth into position.
Call us at (613) 482-0501 if: Severe pain not controlled by prescribed medication, heavy bleeding that doesn't stop after applying pressure for 30 minutes, significant swelling that worsens after day 3, fever above 101°F (38.3°C), signs of infection (pus, foul odor, increasing pain), or difficulty breathing or swallowing.
Supernumerary tooth extraction costs vary based on complexity. Simple erupted extractions start at $200-350. Impacted surgical removals range from $400-800 per tooth depending on depth and complexity. 3D imaging (CBCT) when needed costs $150-250. Multiple extractions under general anesthesia range from $1,500-3,500 including anesthesia fees.
Most dental insurance plans cover supernumerary tooth extraction at 50-80% when medically necessary to prevent complications like impaction, crowding, or cyst formation. We provide direct billing to major insurance carriers and accept the Canadian Dental Care Plan (CDCP).
When you consider that untreated supernumerary teeth often lead to expensive complications—orthodontic treatment for severely impacted permanent teeth ($5,000-8,000), surgical exposure and bonding procedures ($1,500-2,500), or cyst removal surgery ($2,000-4,000)—early removal represents sound preventive investment.
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