macrodontia

The teeth can erupt in different shapes and sizes. Often, in such situations, people become conscious of their smile. Some people feel they have big teeth when they smile. However, teeth cannot grow more significantly than the regular size. They may appear more prominent due to the small size of the jaw.

Typically, when a person has two or more teeth that may appear more prominent than the average for their age and gender, such a condition is known as macrodontia. Macrodontia is prevalent in about 1.9% of the population worldwide. Macrodontia can occur in various forms; sometimes, two teeth may grow together and form a massive tooth. In other cases, a single tooth may grow abnormally and appear to be big.

There are many genetic and hormonal factors involved in macrodontia. It is believed that people with macrodontia have a large pituitary gland. Treatment usually includes tooth modification by aesthetic dental procedures. Today’s article will highlight the features of macrodontia. Furthermore, we will discuss the causes and treatment of macrodontia.

What is macrodontia?

Macrodontia is considered as a type of localized gigantism in which the teeth appear more massive than the regular teeth in the jaw. Macrodontia is determined when the dimensions of the teeth are more than two standard deviations from the average. (1)

Macrodontia is a developmental dental anomaly, and it is often confused with taurodontism and fusion of the teeth. In most cases, macrodontia is seen due to the reduced size of the jaw. Typically, it affects around 0.3 – 1.9% of the population worldwide.

What causes macrodontia?

There is no definite cause of macrodontia. However, several factors may be associated with the formation of macrodontia. Some of them are listed below –

Genetic conditions

Genetic mutations often regulate the growth of the teeth. In most cases, it causes teeth to grow together. Some of the genetic diseases associated with macrodontia include –

  • Otodental syndrome
  • Hemifacial hyperplasia (2)
  • XXY syndrome
  • Rabson – Mendenhall syndrome
  • Insulin- resistant diabetes

Age, race, and gender

Often, the risk of macrodontia is linked with a younger generation around six years to 9 years. Researchers have observed that Asians, native Americans, and Alaskans are more likely to develop macrodontia. Moreover, macrodontia is prevalent among males. (3) Other factors such as diet, exposure to toxins, and many environmental factors playa role in developing macrodontia.

Hormonal involvement

Hormonal imbalance is one of the most common causes of macrodontia. Often, people with macrodontia are thought to have large pituitary glands.

What are the types of macrodontia?

Typically, macrodontia is categorized into three types –

Isolated macrodontia

In this situation, only one tooth grows larger than the other teeth. Isolated macrodontia occurs rarely and is mainly caused by genetic mutations or hormonal imbalance. It is slightly more common in males. (4)

True generalized macrodontia

This type of macrodontia is characterized by all the teeth growing larger than the average size. True generalized macrodontia is caused by pituitary gigantism wherein the pituitary gland produces an excessive amount of growth hormone. (5)

Relative generalized macrodontia

This type of macrodontia occurs in patients with a small jaw size. In this case, some teeth appear larger than average.

What is the treatment for macrodontia?

The diagnosis of macrodontia is often made by dental examination and x-ray studies. Usually, cosmetic dental procedures are the best choice of treatment for macrodontia. Some of the treatment options may include –

  • Orthodontics – palatal expanders are often used during childhood to expand the jaw and fit the teeth better. Braces and retainer therapy may help to straighten the crooked teeth.
  • Tooth recontouring – teeth shaving is a cosmetic dental treatment in which the tooth surface is reduced and shaped with a gentle sanding device. This makes the teeth to look slightly smaller. (6)

This process requires detailed x-ray evaluation to check the thickness of the enamel and dentin. In some cases, teeth shaving may cause tooth sensitivity or permanent damage to the tooth.

  • Tooth extraction – this is the last resort for any dentist. Tooth extraction may seem like a viable option when the dentist requires space to straighten the teeth using braces. In some cases, the excessively large tooth may be removed and replaced by a bridge or implant.

It is essential to know about all the treatment options thoroughly before you make a decision. Moreover, consider your dentist’s advice to make the right decision.

Take away message

Macrodontia is a developmental dental disorder that is defined when teeth grow more than two standard deviations as compared to healthy teeth. In this case, the teeth may appear to be more significant. Often, macrodontia is caused by genetic alterations. However, some environmental factors, age, gender, and hormonal imbalance may also play a crucial role. For instance, macrodontia is prevalent in males and occurs in childhood age.

Additionally, people with large pituitary glands are linked with macrodontia. This is because the large pituitary gland produces excess growth hormone. Typically, macrodontia is categorized into three types – isolated, true generalized, and relatively generalized macrodontia. The treatment of macrodontia depends on the kind of problem. Some of the treatment options may include tooth recontouring, orthodontic assistance, and tooth extraction.