Upper tooth drift related to a palatal tooth bump-Dens in Dente

Teeth can develop in many ways and sometimes an abnormal formation can cause occlusal/visual problems.

Dens in dente is an extra cusp formation usually on the incisors, which can interfere with the bite or cause tooth drift. The Dens in dente or talon cusp can be made of enamel, dentine and even nerve tissue.

It looks like a bump and sometimes you can feel it with your tongue. Most people grow up with them and think of them as normal.

They rarely are a massive dental problem.

Dental anomalies are rare and usually of a genetic nature or a disruption during tooth development, such as chicken pox or measles.

The case above shows the forward drift of the UL1 as the lower teeth bite onto the talon cusp, this can also be called an increased overjet.

The patient had a close/deep bite with a narrow arch and prominent UR1 and UL1.

Sometimes the teeth drift due to clenching, which can cause muscle forces to compress the back teeth, moving the front teeth forward, this is called arch collapse.

We advised Invisalign aligners with some minor recontouring of the UL1 incisor.

The lady wore Invisalign trays for about 9 months to expand the dental arch and bring in the upper incisors. The aligners were changed every 2 weeks. The lower teeth were also moved downwards to create space (deep bite reduction).

Patient was happy with straightened front teeth and widened arch.

Tooth whitening was done and the patient received 6 Vivera retainers that so far have lasted 10 years.