What is tooth bud or tooth germ?
Your baby is born without any teeth but with tooth buds underneath their gums. The tooth bud or tooth germ can be defined as a mass of cells that will ultimately form a tooth. Each single tooth bud is in charge of forming one tooth.
A double tooth can be due to gemination or fusion.

What is tooth gemination?
Double tooth or tooth gemination is a dental anomaly when a single tooth bud divides and forms two teeth. The seemingly separate teeth have one root but two joint crowns and are attached and develop together. The double tooth is more likely to happen in primary teeth than in permanent ones, and it mostly occurs in the upper teeth in the front incisors and canine teeth.
Gemination may happen in the permanent teeth too, but the condition is very rare.
Several genetic and environmental factors may cause double tooth or tooth gemination. The exact cause of double tooth, however, has not yet been determined.
Listed below are some possible reasons for tooth gemination:
● Hereditary disease
● Trauma
● Hormonal irregularities
● Vitamin deficiency
● Genetic predispositions
● An increased intake of medicines

Does a double tooth create any problems for the person?
While a double tooth is typically asymptomatic and does not pose problems, it may lead to some dental issues.
This unsuccessful attempt of the tooth bud to split during its development can cause problems like:
● spacing
● crowding
● esthetic impairment
● caries
● periodontal issues
● problems with the eruption of the nearby teeth
● misalignment problems
Geminated or fused teeth can increase the risk of cavities and periodontal disease because it may be difficult to clean the deep grooves between them. These spaces and grooves between geminated and fused teeth can create a good place for bacteria and plaque to accumulate, eventually leading to tooth cavities or gum disease.
Make sure you arrange regular dental checkups for your child so your Child's paediatric dentist in Brisbane can monitor the proper eruption of the permanent teeth and prevent any irregularities in the process.
Does a double tooth mean you have an extra tooth?
No! The double tooth is considered a single enlarged tooth with one root and canal, so the geminated tooth is counted as one.
What is tooth fusion?
Are double tooth and tooth fusion the same thing?
What is the difference between tooth fusion and tooth gemination?
Tooth fusion is another dental anomaly that results from the union of two or more adjacent teeth. Tooth fusion occurs if two neighbouring tooth buds grow separate from each other but unite during development. While there's one single root and canal in the double tooth, X-Ray images show separate roots and canals in the fused teeth.
Tooth fusion can happen in both primary and permanent teeth.
Tooth gemination and tooth fusion diagnosis
The diagnosis usually involves a visual inspection with the dentist counting the person's teeth.
The geminated tooth should be counted as one enlarged tooth, and there should be no difference in the tooth count. If the dentist counts the oversized tooth as two separate teeth, they will have one extra tooth in their mouth.
However, in tooth fusion, the person will miss a tooth if the dentist considers the fused tooth one, and the counting does not show a normal number of teeth.

Double Tooth Treatment
How do they fix gemination?
Will your child's geminated tooth need to be extracted?
Treatment for double tooth varies according to each individual's unique case.
- Double teeth may require orthodontic treatment if they have caused bite problems for the person in the adult dentition.
- In some cases, the dentist will have to have the double tooth extracted if it's too large and problematic.
- Sometimes, the dentist decides to shave down and smooth the tooth to make it look better. Shaving down and smoothing the double tooth is a viable option as long as the tooth pulp is not too close to the surface.
- The paediatric dentist may decide to put a fissure sealant on the tooth to stop bacteria from developing in the grooves.
- It is also possible to leave the double tooth alone and without any treatment. Some parents will decide to go for this option believing the double tooth will eventually fall out and be replaced with a normal permanent one.
The double tooth is not a common dental phenomenon, and it is common to have an associated missing permanent tooth in the region where the double tooth I present. Take your child to the dentist's office if you think their double tooth is causing them problems. After a thorough oral examination and taking dental X-Rays, your dentist will inform you about the best course of action according to your child's situation.
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