Supernumerary Teeth (Extra Teeth in Babies and Toddlers)
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAPD, AAO, NIH guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect supernumerary teeth (extra teeth in babies and toddlers), here is what the evidence says.
The short answer
Supernumerary teeth are extra teeth beyond the normal set (20 baby teeth or 32 permanent teeth). They occur in approximately 1-3% of children and are more common in boys. The most common type is a mesiodens, an extra tooth that appears between or behind the two upper front teeth. Supernumerary teeth may not cause any problems, but they can sometimes prevent normal teeth from erupting, cause crowding, or lead to cyst formation. Diagnosis is typically made by dental X-ray, and treatment depends on whether the extra tooth is causing or is likely to cause complications.
Key takeaways
- Supernumerary teeth are extra teeth beyond the normal set (20 baby teeth or 32 permanent teeth). They occur in approximately 1-3% of children and are more common in boys. The most common type is a mesiodens, an extra tooth that appears between or behind the two upper front teeth. Supernumerary teeth may not cause any problems, but they can sometimes prevent normal teeth from erupting, cause crowding, or lead to cyst formation. Diagnosis is typically made by dental X-ray, and treatment depends on whether the extra tooth is causing or is likely to cause complications.
- Usually normal when: Your child's teeth are coming in at the expected times and in the usual positions
- Call your doctor if: A natal tooth in a newborn is very loose and could pose a choking or aspiration risk
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to AAPD, AAO, NIH guidelines, supernumerary teeth are extra teeth beyond the normal set (20 baby teeth or 32 permanent teeth). They occur in approximately 1-3% of children and are more common in boys. The most common type is a mesiodens, an extra tooth that appears between or behind the two upper front teeth. Supernumerary teeth may not cause any problems, but they can sometimes prevent normal teeth from erupting, cause crowding, or lead to cyst formation. Diagnosis is typically made by dental X-ray, and treatment depends on whether the extra tooth is causing or is likely to cause complications. At 0-6 months, rarely, a baby may be born with one or more natal teeth (teeth present at birth). While natal teeth are most commonly normal baby teeth that erupted early, they can occasionally be supernumerary (extra) teeth. If your newborn has a natal tooth, your pediatrician or a pediatric dentist should evaluate it to determine whether it is a regular baby tooth or an extra one. Natal supernumerary teeth that are very loose or could pose a choking risk may need to be removed. It is generally considered normal when your child's teeth are coming in at the expected times and in the usual positions. However, you should contact your pediatrician promptly if a natal tooth in a newborn is very loose and could pose a choking or aspiration risk.
Normal vs. Concerning
By Age
What to expect by age
0-6 months
Rarely, a baby may be born with one or more natal teeth (teeth present at birth). While natal teeth are most commonly normal baby teeth that erupted early, they can occasionally be supernumerary (extra) teeth. If your newborn has a natal tooth, your pediatrician or a pediatric dentist should evaluate it to determine whether it is a regular baby tooth or an extra one. Natal supernumerary teeth that are very loose or could pose a choking risk may need to be removed.
6-12 months
As baby teeth begin erupting (typically starting around 6 months), supernumerary teeth may appear as unexpected or out-of-sequence teeth. You might notice what looks like a small extra tooth between the upper front teeth or an oddly positioned tooth. Most supernumerary teeth in the primary (baby) dentition do not cause significant problems and may be discovered incidentally. Your baby's first dental visit by age 1 is a good opportunity to have any unusual tooth development evaluated.
1-3 years
During this period, all 20 baby teeth typically erupt. If you notice what appears to be an extra tooth, a dental X-ray can confirm whether it is supernumerary. In the baby teeth stage, supernumerary teeth are often monitored rather than immediately removed, unless they are causing crowding, interfering with normal tooth eruption, or causing discomfort. Your pediatric dentist will track the development of the permanent teeth underneath and plan accordingly.
3+ years
Supernumerary teeth more commonly affect the permanent teeth, with mesiodens being the most frequent. These may be discovered on routine dental X-rays before the permanent front teeth erupt. If an extra tooth is blocking a permanent tooth from erupting, is causing spacing or alignment problems, or is associated with a cyst, extraction under local or general anesthesia is typically recommended. Early removal generally leads to spontaneous eruption and alignment of the blocked permanent tooth. If discovered and managed early, the long-term dental outcome is usually excellent.
What to Tell Your Pediatrician
- Describe when you first noticed supernumerary teeth (extra teeth in babies and toddlers) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you notice what appears to be an extra tooth in an unusual position in your child's mouth.
- Mention if a permanent front tooth has not erupted when the other side has been in for several months.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your child's teeth are coming in at the expected times and in the usual positions
- A dental X-ray shows a supernumerary tooth that is not affecting the position or eruption of other teeth
- Your pediatric dentist has identified a small extra tooth and recommends monitoring
- Your child has the expected number of teeth for their age with no crowding or displacement
- You notice what appears to be an extra tooth in an unusual position in your child's mouth
- A permanent front tooth has not erupted when the other side has been in for several months
- Your child has significant crowding or a tooth that appears to be erupting in an abnormal position
- A natal tooth in a newborn is very loose and could pose a choking or aspiration risk
- Your child has significant pain, swelling, or signs of infection around an extra tooth or in the area where a tooth is being blocked from erupting
What You Can Do at Home
- Keep track of when you notice supernumerary teeth (extra teeth in babies and toddlers) — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your child's teeth are coming in at the expected times and in the usual positions — this is generally within the range of normal.
- At 0-6 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if a natal tooth in a newborn is very loose and could pose a choking or aspiration risk.
Related Conditions
Preventing Early Childhood Cavities (Caries)
Early childhood caries (ECC) is the most common chronic disease in young children, affecting about 23% of US children under age 5. Cavities in baby teeth matter because they can cause pain, infection, and affect the development of permanent teeth. Prevention starts from the first tooth: use a rice-grain-sized smear of fluoride toothpaste, avoid putting baby to bed with a bottle of milk or juice, limit sugary foods and drinks, and schedule the first dental visit by age 1 or within 6 months of the first tooth appearing.
Baby Tooth Turning Gray or Dark
A baby tooth turning gray or dark usually happens after a bump or fall that damages the blood supply inside the tooth. This can happen within days of the injury or weeks later. A darkened tooth does not always mean it is "dead" or infected - many gray teeth remain healthy and eventually fall out normally when the permanent tooth is ready. However, a darkened tooth should be evaluated by a dentist to check for signs of infection.
Related Resources
Frequently asked questions
Is supernumerary teeth (extra teeth in babies and toddlers) normal?
When should I call the doctor about supernumerary teeth (extra teeth in babies and toddlers)?
When is supernumerary teeth (extra teeth in babies and toddlers) normal?
What causes supernumerary teeth (extra teeth in babies and toddlers)?
What should I mention to my pediatrician about supernumerary teeth (extra teeth in babies and toddlers)?
Is supernumerary teeth (extra teeth in babies and toddlers) normal at 0-6 months?
Is supernumerary teeth (extra teeth in babies and toddlers) normal at 6-12 months?
Should I go to the ER for supernumerary teeth (extra teeth in babies and toddlers)?
Does supernumerary teeth (extra teeth in babies and toddlers) go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Supernumerary Teeth (Extra Teeth in Babies and Toddlers).
Things to mention
- Describe when you first noticed supernumerary teeth (extra teeth in babies and toddlers) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you notice what appears to be an extra tooth in an unusual position in your child's mouth.
- Mention if a permanent front tooth has not erupted when the other side has been in for several months.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- You notice what appears to be an extra tooth in an unusual position in your child's mouth
- A permanent front tooth has not erupted when the other side has been in for several months
- Your child has significant crowding or a tooth that appears to be erupting in an abnormal position
Urgent signs to report immediately
- A natal tooth in a newborn is very loose and could pose a choking or aspiration risk
- Your child has significant pain, swelling, or signs of infection around an extra tooth or in the area where a tooth is being blocked from erupting
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of supernumerary teeth (extra teeth in babies and toddlers) are normal. Talk to your pediatrician if a natal tooth in a newborn is very loose and could pose a choking or aspiration risk.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Medical Concerns
Preventing Early Childhood Cavities (Caries)
Early childhood caries (ECC) is the most common chronic disease in young children, affecting about 23% of US children under age 5. Cavities in baby teeth matter because they can cause pain, infection, and affect the development of permanent teeth. Prevention starts from the first tooth: use a rice-grain-sized smear of fluoride toothpaste, avoid putting baby to bed with a bottle of milk or juice, limit sugary foods and drinks, and schedule the first dental visit by age 1 or within 6 months of the first tooth appearing.
Baby Tooth Turning Gray or Dark
A baby tooth turning gray or dark usually happens after a bump or fall that damages the blood supply inside the tooth. This can happen within days of the injury or weeks later. A darkened tooth does not always mean it is "dead" or infected - many gray teeth remain healthy and eventually fall out normally when the permanent tooth is ready. However, a darkened tooth should be evaluated by a dentist to check for signs of infection.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.
Adrenoleukodystrophy (ALD) in Babies
X-linked adrenoleukodystrophy (X-ALD) is a genetic disorder affecting about 1 in 17,000 newborns, caused by mutations in the ABCD1 gene on the X chromosome. It primarily affects boys and impairs the breakdown of very long-chain fatty acids (VLCFAs), which accumulate and damage the myelin sheath in the brain and the adrenal glands. The most severe form, cerebral ALD, typically affects boys between ages 4-10 with rapid neurological decline. Newborn screening now enables early detection, and hematopoietic stem cell transplant or gene therapy performed before significant brain involvement can be life-saving.