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Pediatric Dentistry Supporting Your Practice

Conversations with CAPD: Hyperdontia in the Primary and Early Mixed Dentition

Dr. Jennifer MacLellan joins Drs. Raymond Lee and John O'Keefe in this clinical conversation about hyperdontia in the pediatric patient.

Hyperdontia, or supernumerary teeth, has been defined as "teeth in excess of the normal number."1 They may be single, multiple, unilateral, or bilateral in their distribution, occurring in the maxilla and/or the mandible, and present in both the primary and permanent dentitions, but with a predilection for the premaxilla.2

We hope you you find the  presentation informative. We always look forward to hearing your thoughts and receiving your questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team


  1. Supernumerary teeth are about five times more common in the permanent dentition than the primary dentition.
  2. In about a third of the cases, a supernumerary primary tooth will have a supernumerary permanent successor.
  3. 80 to 90% of these will occur in the maxilla and about half of those are going to occur in the area of the incisors.
  4. The most common permanent supernumerary tooth is a single midline or unilateral supernumerary known as a mesiodens.
  5. Supernumerary teeth are in many cases an incidental finding in pediatric dentistry. A dentist may be taking a periapical or occlusal film for another reason, and they'll notice that there's a mesiodens in place. If it's not diagnosed early on, there may be a delayed exfoliation of primary teeth, or a non symmetrical exfoliation, or delayed eruption of permanent teeth, or displacement of permanent teeth.

Read/download the transcript of the conversation (PDF) 


  1. Shafer, WG; Hine MK; Kevy BM. A Textbook of Oral pathology. 4th Ed. Philadelphia, Pa: WB Saunders; 1983: 308-11
  2. Omer, Rashied S. M.; Anthonappa, Robert P.; King, Nigel M. Determination of the Optimum Time for Surgical Removal of Unerupted Anterior Supernumerary Teeth. Pediatric Dentistry, Volume 32, Number 1, January / February 2010, pp. 14-20(7)

Oasis Moment/Preview (0.56")

Full Conversation (15.40")

Dr. Lee is from Waterloo, Ontario.  He received a Bachelor of Mathematics (BMath, 1988) from the University of Waterloo, earned his Doctor of Dental Surgery (DDS, 1991) from the University of Western Ontario, and then completed an internship/residency at the Hospital for Sick Children in Toronto (1991).  His paediatric specialty training included a Diploma in Paediatric Dentistry (DipPaed, 1995) from the University of Toronto, a Masters in Science (MSc, 1996) completed at the Hospital for Sick Children through the University of Toronto, and a Fellowship in Paediatric Dentistry (FRCD(C), 2003) from the Royal College of Dentists of Canada.

Dr. Lee has maintained a private practice and has been Adjunct Professor at the Schulich School of Medicine and Dentistry, Western University, since returning to London in 1995.   He has been the Staff Paediatric Dentist at Children’s Hospital, London Health Sciences Centre since 1997 and became Site Chief, Paediatric Dentistry at Victoria Hospital in 2008.  At the University of Toronto, Dr. Lee has been an Associate-In-Dentistry since 2002 and was Assistant Professor from 2012 to 2016.  He continues to be involved in undergraduate and post-graduate training in Paediatric Dentistry at Western University and the Program for Persons with Disabilities at Mount Sinai Hospital (Toronto).

Dr. Jennifer MacLellan received her DDS degree from Dalhousie University in 1994 and practised general dentistry in Truro for eight years prior to completing her MSc and certificate in the specialty of pediatric dentistry at the University of Michigan. Since 2005, she has been a staff paediatric dentist at the IWK Health Centre and associate professor at Dalhousie University. Dr. MacLellan is an NSDA Governing Council member, vice-president of the Canadian Academy of Pediatric Dentistry, a fellow of the Royal College of Dentists of Canada, and she serves on the NDEB and American Board of Pediatric Dentistry written examination committees.

1 Comment

  1. REZA NOURI February 10, 2020

    an informative presentation. thank you.
    on your first case with the #52 supplemental/supernumerary, the permanent supernumerary is interfering with tooth #11, delaying its eruption compared to #21.
    wouldn’t you advise to have the permanent supernumerary extracted at this stage in order to establish balance and symmetry as early as possible?
    thank you.


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