I was leaving a family celebration last week and stopped to say “thank you” to the restaurant manager to whom I had only spoken on the phone. He smiled and we shook hands. I glanced at his teeth (an irresistible temptation to a dentist) and saw – to my surprise – an extra left canine tooth! This is very rare and something I have never seen before. Should I say something or not? Would that be insulting? But I couldn’t resist so I mentioned this anomaly to him as nicely as I could, all the while trying to hide my excitement. He laughed out loud, giving me a really good look at this supplemental tooth (we call it a supernumerary tooth). Yes, he said, he has known about it and has had conflicting opinions on whether or not to have it extracted. I weighed in my opinion – yes, have it extracted if possible because it looks funny sitting up there above the plane of occlusion. He let me take a photo and we parted, best friends.
Supernumeraries do occur – usually an extra central incisor, and one of my dental school classmates was famous for having an extra wisdom tooth. But it is more common for teeth to be congenitally missing. The lateral incisors are most commonly missing and lower bicuspid teeth. Today these missing teeth are replaced with implants.