Double Teeth: Causes, Effects, and Treatment

Many parents find themselves anxiously awaiting their child’s first tooth eruption. The fact that some children develop double teeth naturally concerns the parents. Double teeth share the same dentin or even pulp, and are caused by gemination or fusion. More common in the upper front teeth, gemination and fusion can also develop in the lower teeth. Double teeth cause concern, because they can lead to a number of problems, from overcrowding to cavities. This article will explain what tooth gemination and tooth fusion are, what causes double teeth, and what treatments are available for this condition.

Double Teeth Overview

Double teeth usually appear when a child still has its “baby” teeth, which typically grow between the ages of 4 and 8. They are temporary replacements for the permanent teeth bound to come in later on. The rows of double teeth form when the permanent teeth grow behind the baby teeth, instead of underneath them, as they should.

Double teeth usually appear when a child is about 6 years old, and their permanent lower teeth start to erupt. However, they can also appear when the child is up to 11 years old, because this is when the upper back molars start to erupt.

Double teeth are quite common. A relatively large number of children develop double teeth, especially in place of their lower teeth. The condition is not a serious one, but it is normal for parents to still be concerned. Below, we will talk more about the causes, effects, and treatment options for double teeth.

Double Teeth Causes

“Double teeth” is a term for two teeth that are stuck together by the dentin in the tooth, and sometimes even by the pulp. It is a rather rare genetic abnormality that can occur with tooth buds. The two main causes of double teeth are tooth gemination and tooth fusion.

What is Tooth Gemination?

Tooth gemination happens when one tooth bud attempts to come between two teeth. The tooth count is normal with gemination. The geminated tooth will possess one pulp canal to share, but two pulp chambers. While tooth gemination can happen to both primary “baby” teeth as well as permanent teeth, it is more common with the former, and it’s more present with incisors.

Keep in mind that if a patient sports fusion or gemination of primary teeth, it doesn’t necessarily mean that their permanent teeth will be double teeth.

What is Tooth Fusion?

Tooth fusion is the condition where two tooth buds have fused together. This causes:

  • the creation of one large and wide crown
  • two separate pulp chambers
  • teeth that have their own root canals
  • tooth fusion that begins toward the top of the crown, and travels, sometimes, even to the apex of the tooth

When a dentist counts the teeth, they will notice that there is a missing tooth when they are fused. Fusion can also occur where an extra tooth is present, resulting in an abnormal tooth count.

Double Teeth Effects from Fused Baby Teeth

Fusion and germination of fused “baby” teeth can indeed cause atypical spaces between the teeth, and crowding of the teeth. They can also delay the eruption of the permanent teeth. Due to this delay, when a dentist or parent finds double teeth, they should be monitored, and so should the permanent teeth, to make sure that the new teeth come in normally.

The dentist may have to remove the double tooth to let the permanent tooth come in. Sometimes, but rarely, there will be no permanent tooth underneath fused teeth. This is determined with an X-ray.

As the fused or geminated teeth tend to have deep grooves between the “two” teeth, it can become easy to develop cavities, since it is hard to get the toothbrush into the space for proper cleaning. Having your dentist apply a sealant may help stop the formation of cavities.

Double Teeth Treatment Options

If the affected tooth is a primary tooth, it may come out on its own. If not, the primary tooth will need to be extracted. Extraction of the geminated or fused tooth is typical of orthodontic treatments of this condition. If the width of the geminated or fused tooth is not too wide, the tooth can be kept.

In some instances, a geminated or fused tooth may be able to get its crown resized to an acceptable width. That said, it is possible that both a root canal and a crown are necessary to complete this procedure, so it is not always feasible.

Rarer still, a dentist is sometimes able to surgically divide the teeth. This will usually only work with fusion, as each joined tooth will have their own individual root systems and pulp chambers. When surgically dividing teeth, both need to have a root canal done. This can become costly.

For this reason, and because most children’s teeth will fall out and be replaced with permanent ones before the age of 10, many elect not to have any procedures done, as double teeth do not pose a direct risk to one’s health.

Double Teeth – Conclusion

Tooth fusion and gemination are the two main causes of double teeth. As this rare condition mostly affects the primary teeth of children which will fall out in due time, many choose not to treat it, since there is no real problem with it outside of aesthetics. The condition should not be mistaken for tooth mamelons. Did you have double teeth as a child, or are you a parent whose child has this condition? Let us know your experience in the comments section.


    • Hello, Victor!

      We recommend that you talk to your dentist about the best course of action. They will be able to suggest the right treatment for you, or they can redirect you to a specialist that can help.

      Best of luck,
      Have a nice day!

  • Of all my dental issues, I’m definitely happy this is not one I have had to deal with myself! This seems so unpleasant. Then again, I think even basic dental procedures are unpleasant since I have super sensitive gums and teeth!

    • Hello, Manhil!

      You should go see a dentist as soon as possible. They will asses the situation and suggest the right course of action. Good luck!

      Have a lovely day!

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