A common dental condition, hyperdontia causes excess number of teeth to grow in your mouth. Also known as supernumerary teeth, these extra teeth can appear in any of the curved areas (called dental arches) where teeth attach to your jaw and can affect any dental organ. Generally, the standard number for permanent teeth in adults is 32 and primary teeth in children are 20. A person who develops more than 20 primary teeth or more than 32 permanent teeth has hyperdontia. Supernumerary teeth are associated with delayed eruption of permanent teeth, over retention of primary teeth, deflection of roots with unusual inclinations, displacement of teeth, diastemas, abnormal root resorption, and formation of follicular or dentigerous cysts. Supernumerary teeth appear twice as often in adult males as they do in adult females. The exact cause of this oral condition is unknown. However, a combination of hereditary conditions and birth defects can contribute to this condition. Several factors make the process of medical billing and coding for hyperdontia complex. Healthcare providers can rely on the services of a reliable dental billing company for accurate clinical documentation and appropriate reimbursement.

The prevalence of hyperdontia is between 1 percent and 4 percent of the US population and is twice common in men than they are in women. The majority of cases are limited to a single tooth. The extra teeth can appear in anyone but are more often associated with people who have Gardner’s syndrome (a rare genetic disorder), Down syndrome, Ehlers-Danlos syndrome, Cleidocranial dysplasia, Fabry disease and those born with a cleft lip and palate.

Types of Hyperdontia and Symptoms

Normally, supernumerary teeth can appear anywhere in the mouth and are mostly found among the permanent teeth. However, they also occur among baby teeth, but tend to be harder to identify, as they often erupt normally, are shaped like other teeth, and are in correct alignment.

Supernumerary teeth can be classified in two different ways – by way of shape and by way of location. When classified by shape, these extra teeth include four different categories such as –

  • Supplemental – A common type found among the baby teeth, supplemental supernumerary teeth appears near the lateral incisors. They usually erupt.
  • Tuberculate – Located on the palatal aspect of the central incisors, tuberculate supernumeraries have abnormal roots and seldom erupt. The tooth has a tube or barrel-like shape.
  • Conical – Conical is peg-shaped teeth that is generally at the base and narrows out near the top.
  • Molariform – These have a complete root and resemble the shape of premolars. They tend to appear next to the molars.
  • Compound odontoma – The tooth is made up of several small, tooth-like growths near each other.
  • Complex odontoma – Rather than a single tooth, an area of tooth-like tissue grows in a disordered group.

When classified by location, supernumerary teeth comprise of three categories –

  • Paramolar – This is an extra tooth at the back of the mouth, next to a molar.
  • Distomolar – An extra tooth grows in line with your other molars, rather than around them.
  • Mesiodens – This is the most common type of extra tooth in people with hyperdontia which grows around your incisors, the four flat teeth at the front of your mouth used for biting.

The sudden growth of extra teeth (directly behind or close to your usual) primary or permanent teeth is one of the primary symptoms associated with the condition. If left untreated, it can lead to a variety of dental problems that can directly interfere with normal oral functions and generate several health and cosmetic issues. Some of the common dental problems hyperdontia can cause include – tooth impaction, crowding, displacement, and misalignment of normal permanent teeth, premature closure of spaces in between the teeth, formation of oral cysts or tumors, eruption of teeth into the nasal cavity, problems with bone grafting essential for dental implants, fusion of permanent teeth and issues with proper chewing.

How Is Hyperdontia Diagnosed and Treated?

Diagnosis of hyperdontia is quite easy if the extra teeth have already grown in. On the other hand, if the teeth have not grown completely it is difficult to detect the same. Imaging tests like dental X-ray and CT scan may be done to get a more detailed look at your mouth, jaw, and teeth.

While some cases of hyperdontia do not require any specific treatment, others require removing the extra teeth. If the extra teeth start to affect your dental hygiene or other teeth (like delaying the eruption of permanent teeth) it is always best to remove them as soon as possible. This in turn will help avoid any lasting effects, such as gum disease or crooked teeth. Generally, dentists or orthodontists treating patients with this dental disorder will recommend removal of the extra teeth if it causes – chewing problems, pain or discomfort due to overcrowding, problems with brushing teeth or flossing due to the extra teeth or if the patient is uncomfortable with the overall look of the teeth.

Treatment for hyperdontia depends on the type and position of the supernumerary tooth and how it affects the adjacent teeth. If the extra teeth only causes mild discomfort, the dentist may recommend non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) for pain. Other treatment modalities consist of removal of the teeth when possible, which is normally done under local or general anesthesia. In some cases, supernumerary teeth may need to be cut and then removed in pieces. On the other hand, supernumerary teeth fused with permanent teeth may involve endodontic treatment (also known as a root canal) to treat the tooth pulp as well as surrounding tissue.

As part of the hyperdontia treatment, the modalities and other screening tests performed by dentists, orthodontists or other dental specialists must be carefully documented using the correct medical codes. Medical billing and coding outsourcing services provided by established medical billing companies help physicians use the correct codes for their billing purposes.

ICD-10 Codes for Diagnosing Hyperdontia include –

  • K00 – Disorders of tooth development and eruption
  • K00.0 – Anodontia
  • K00.1 – Supernumerary teeth
  • K00.2 – Abnormalities of size and form of teeth
  • K00.3 – Mottled teeth
  • K00.4 – Disturbances in tooth formation
  • K00.5 – Hereditary disturbances in tooth structure, not elsewhere classified
  • K00.6 – Disturbances in tooth eruption
  • K00.7 – Teething syndrome
  • K00.8 – Other disorders of tooth development
  • K00.9 – Disorder of tooth development, unspecified

Many people with hyperdontia do not require any treatment. Others may need to have some or all of their extra teeth removed to avoid any other problems. However, it is generally not necessary to remove natal teeth unless the supernumerary teeth are loose and present a risk for aspiration due to passage into the lung.

Dental billing services provided by AAPC-certified coders can help physicians in this specialty optimize reimbursement for the services they offer. Make sure that the coders are well-versed with the codes relating to the diagnosis and treatment of supernumerary teeth and its related complications.