Why grandma, what big teeth you have! There’s no escaping from the fact that teeth, generally, make a big impression. Whether it is a deep time hangover from when we were prey for larger beasties or just a predilection for dental enamel – the visual impact of teeth stick out. In this regard, for the wearer of the teeth that don’t fit, macrodontia may feel like big teeth syndrome: Can it be treated? Yes, there is not necessarily a fix for every thing and every ailment, but there are possible solutions in macrodontia’s case.

Also known as megadontia or megalodontia, this condition refers to the congenital abnormal enlargement of teeth. We are used to seeing big teeth on carnivorous predators but not so in the mouths of human beings. Not since the days of our primate ancestors, anyway.

“Macrodontia is a term used when teeth that are physically larger than what is considered normal is present. It is thought to affect between 0.03% to 1.9% of people worldwide . A tooth, or teeth that is greater that two standard deviations larger than the average for their age and gender is considered to be macrodontic. True generalized macrodontia is rare and seen infrequently in conditions such as pituitary gigantism. The localized phenotype involving just one or a few teeth is even more rare. Macrodontia is far less common than microdontia and occasionally the term “megadontia” may be used for this condition.”
– Chetty M, Beshtawi K, Roomaney I, Kabbashi S. Macrodontia: A brief overview (et al)

The Varieties Of Macrodontia

There are several distinct types of macrodontia and dentists may come across all three. However, dental practitioners often encounter the prevalence of one of these varieties in younger patients.

True Generalised Macrodontia

This particular version of the condition involves all of the subject’s teeth growing larger than normal. This is most commonly linked to a disorder titled pituitary gigantism. Considered to be reasonably rare it is the result of the pituitary gland producing excessive growth hormone. This form of megadontia is frequently identified in childhood and can include additional indicators like enlarged hands, feet, and facial features.

“Macrodontia is associated with endocrine abnormalities. Acromegaly and pituitary gigantism are two rare conditions resulting from excessive secretion of growth hormone (GH), usually as a result of pituitary adenoma formation. Pituitary gigantism occurs when there is excessive GH secretion and/or high levels of its mediator, Insulin-like growth factor-1 which overlaps with the period of rapid linear growth during childhood and adolescence.”
– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026913/

Solated Macrodontia

This form of the condition features an isolated enlarged tooth. This version of macrodontia is rare but slightly more prevalent in men than women. Causes for it have been identified as genetic and environmental. Insulin resistant diabetes, pituitary gigantism, otodental syndrome, pineal hyperplasia and unilateral facial hypoplasia have all been linked to the condition.

Relative Generalised Macrodontia

This variety involves an undersized jaw with normal or slightly oversized teeth. Thus the teeth appear to be much larger due to the underwhelming size of the patient’s jaw. Dentists refer to this as the illusion of excessively large teeth.

What Can Be Done About Macrodontia?

Sensitivities about appearance are highly prevalent especially in the young. Indeed, all of us want to feel as if we belong. We share a strong desire to look as much like the finest exemplars from within the dominant cohort as is humanly possible. Cosmetic dentistry has come to the fore on the back of this wave of wanting to appear as “normal” as we can. Normal being defined as handsome and winsome as we can be according to our social parameters. Unsightly big teeth and small jaws, especially in the male category, are not the thing. Bucking great teeth for girls that are all out of proportion are definitely not a desirable characteristic according to the sad, superficial dictates of the beauty myth. So, what can be done about macrodontia?

Orthodontics Can Help In Some Cases

Orthodontics is the management and correction of misaligned teeth. Generally, it deals with the bite, the overbite, the misaligned bite, and the jaw. Dentofacial orthopaedics, which is the modification of facial growth, may be utilised in some instances as well. Braces and Invisalign are popular techniques employed to retrain and reshape facial characteristics. Misaligned teeth can be realigned to get back into line.

Tooth Shaving & Tooth Extraction

Shaving or recontouring the affected teeth is one such approach utilised by dentists in the treatment of macrodontia. The cosmetic dentist will seek to improve the look and feel of the teeth via this process. Similar to a sanding device this sands down the size of the tooth and reshapes it to the desired appearance. Obviously, this approach only works with patients that have strong and healthy teeth. Weak teeth will suffer from increased sensitivity and the possibility of decay if sanded via this process.

Removing the enlarged tooth or teeth is an option in this regard. Tooth extraction can create more room for neighbouring teeth and reduce crowding in the oral space. Alternatively, the removed tooth or teeth can be replaced with dentures or false teeth. Often, the enlarged teeth have been causing pain and problems in a too small jaw or space. Extraction can be a release from such pain and pressure- thus being a great relief.

Macrodontia, like many cosmetic dental problems, is no longer a life sentence. These abnormalities can be addressed by skilful dentists and oral surgeons. Young and older patients can have their bites and facial appearance transformed via modern dentistry. They can, then, bite into the best of both worlds. The look and feel, the form and the function, coming together in a symmetry of aesthetically pleasing “perfection”.

A smile is an interesting thing. It is the baring of teeth in a pleasing countenance. Today, we all want beautiful white teeth to display via our smiles. However, not too big a smile and not too big teeth. You can have too much of a good thing, it seems, when it comes to canines. We don’t want mega or macro teeth, rather, we desire proportionality. Therefore, it is good to know that you can have your teeth trimmed and shaped. If you are worried about the size of your teeth, We recommend a visit to your local dentist for an informed chat with someone who knows what they’re talking about.

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