Tooth Gemination – Cause, Symptoms & Treatment

There is a wide range of developmental dental abnormalities that people experience in their life. One of them is tooth gemination. Tooth gemination is a condition characterized by an oversized and abnormally shaped tooth. Often tooth gemination is also referred to as double teeth as it seems to be comprised of two teeth.

Although there is no definite cause for the development of tooth gemination, there are several contributing factors that can lead to this oral condition. Some of them include hormonal imbalance, vitamin deficiency, medications, and genetic predisposition. People with tooth gemination usually develop an irregularity in the smile leading to the crooked appearance of the teeth. Therefore, tooth gemination is one of the common conditions treated by cosmetic dental procedures.


Some of the treatments of tooth gemination include tooth replacement with a dental crown or bridge, dental implants, and orthodontic correction of the smile. Let’s read the article to understand the process of tooth gemination. Furthermore, we will discuss the causes and treatments of tooth gemination.

What is tooth gemination?

Tooth gemination is a unique dental developmental anomaly that is characterized by the growth of two teeth from a single tooth bud. In this condition, the central tooth crown develops with an incisal cleft that gives an appearance of two teeth. However, in reality, it is a single tooth in the jaw. (1)

The presence of tooth gemination does not change the number of teeth in the mouth because the dental anomaly is still counted as a single tooth.

What causes tooth gemination?

Typically, there is no definitive cause for tooth gemination. However, several factors may contribute to tooth gemination. Some of these causes are listed below –

  • Hormonal irregularity
  • Vitamin deficiency
  • Side effects from certain medicines
  • Infection or inflammation of the areas near the developing tooth bud (2)
  • Genetic predisposition
  • Damage to developing tooth bud from radiotherapy

How does tooth gemination occur?

As mentioned above, tooth gemination arises when two teeth crowns develop from a single tooth bud. In such cases, the patient is thought to have an extra tooth in the mouth.

Unlike fusion (union of two normally separated teeth), the division of tooth buds in tooth gemination is often incomplete. As a result, the tooth crown appears to be significant with a single root and canal. tooth gemination is typically a painless condition and is diagnosed on the routine dental check-up. (3)

The prevalence of tooth gemination is quite low in permanent teeth and accounts for 0.1-0.2%. In the primary dentition, it is observed frequently in the central incisors.

What are the signs and symptoms of tooth gemination?

Typical signs and symptoms of tooth gemination include –

  • Deviation of the tooth from its path of the eruption which may affect the occlusal alignment of the teeth.
  • Malocclusions such as rotation of the tooth, crowding, and crooked smile
  • Difficulty in chewing
  • Damage to the adjacent structures (4)
  • Asymmetrical dental arch
  • Obstruction or delayed eruption of the adjacent tooth
  • Increased susceptibility of tooth decay and gum problems
  • Non-appealing smile

What is the treatment for tooth gemination?

Diagnosis is often made during routine dental examinations when the dentist identifies the abnormality. Dental radiographs of tooth gemination often show two crowns arising from single tooth root with one pulp chamber and pulp canal — moreover, radiographic study aids in differentiating the condition from the fusion of teeth.

Treatment may vary depending on the type of malocclusion and the patient’s concern. Often, patients are advised to maintain proper oral hygiene. other treatments of tooth gemination may include –

  • Restoration of tooth cavities and dental cavities with fissure sealants. Resin materials can also be used to restore deep grooves and fissures.
  • Orthodontic extraction of the tooth followed by braces treatment to correct the alignment of the teeth. (5)
  • In some cases, the tooth may be reshaped or restored with appropriate tooth-colored resin material.
  • Root canal treatment followed by a reduction of the width and size of the tooth. The tooth is later restored with a dental crown. In rare cases, the bulky tooth may be treated by root canal and separated to function as two individual teeth.
  • Tooth extraction followed by replacement of the missing space with a dental bridge, denture, or dental implant. (6)
  • Transplantation of the supernumerary tooth to replace the geminated tooth.

Take away message

Tooth gemination is a unique dental developmental anomaly in which a tooth bud incompletely divides to form two tooth crowns. Clinically it gives the appearance of two teeth in one socket. Often, for this reason, the geminated tooth is also referred to as double teeth.

Tooth germination can occur due to several causative factors such as hormonal imbalance, drug-induced, vitamin deficiency, infection, and inflammation of the surrounding areas. Tooth gemination is a painless condition. However, the patient may experience difficulty in chewing, increased incidence of tooth decay, gum disease, and malocclusion.


Typically, tooth gemination is identified on routine dental examination. Treatment depends on the type of malocclusion and dental concerns. Often, the tooth is extracted, followed by orthodontic treatment or replacement of the tooth with a dental bridge, denture, or implant. In other cases, the tooth may be treated with root canal therapy and restored with a dental crown.


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