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Pediatric Dentistry Preventive Dentistry Restorative Dentistry

How do you manage double teeth in children and teenagers?

This summary is based on the article published in the International Journal of Pediatric Dentistry: management of double teeth in children and adolescents (November 2012)

Purvi Shah, June M. L. Chander, Joseph Noar & Paul F. Ashley


  • Abnormally large teeth are often referred to as ‘double teeth’. 
  • Double tooth anomalies pose numerous management challenges for the clinician especially if they involve anterior teeth. Most significantly, they will result in very poor aesthetics, partly because of their appearance but also because they will cause significant anterior crowding. They may also be associated with caries and periodontal problems, if the fissure or union line extends sub-gingivally making cleaning difficult5. Double teeth can also be a feature of syndromes such as KBG syndrome.
  • There is no robust evidence-based research on the effective management for this dental anomaly to date.

Purpose of the Review

To review the published literature and also patients managed at the Eastman Dental Hospital (EDH) and to develop a clinical protocol for the management of double teeth in children and adolescents.

Key Messages

  • It was not possible to determine the best management strategies because of the variable reporting in the literature. The authors have proposed a protocol for management and a data collection sheet for essential information needed when reporting on double teeth cases.
  • All cases would benefit from multidisciplinary care involving a paediatric dentist, orthodontist and restorative dentist, but unfortunately, because of the variable reporting of cases in the literature with differences in success criteria and follow-up periods, currently it is not possible to recommend any one treatment modality over another.
  • Better collection of data is required for patients who present with double teeth.
  • The treatment success should be monitored for a minimum of 12 months and a set list of minimal criteria used to measure the success depending on the management strategy used. This will enable the formation of a protocol for the best management of various presentations of double teeth.


  1. Ammari AB, Young RG, Welbury RR, Fung DE. A report of treatment of a fused central incisor and supplemental incisor. Dent Update 2008; 35: 636–641.


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