When your child’s permanent incisors erupt, you may notice, on the top of the teeth, the incisal edges, has bumps. These bumps are called tooth mamelons.

Tooth mamelons vary from patient to patient.  Some patient’s mamelons are very prominent and some look like the tooth has an indentation.  The edges are rough and makes the teeth look uneven.  Mamelons are usually seen on the upper and lower, permanent central and lateral incisors.  

When the tooth forms under the gum tissue, three groups of cells with odontoblasts and ameloblasts start forming the incisal edge of the tooth.  As they develop the enamel and dentin, they move towards the apex of the tooth slowly forming the tooth.  When these cells come together as a group, they form three lobes of enamel.  We see these lobes on the edges of the tooth when they erupt into the mouth.

 

Some parents are concerned when they see the permanent teeth because they think the tooth is damaged.  Most adults do not have these mamelons because they slowly wear off.

During orthodontic treatment, the orthodontist will sometimes remove the mamelons.  It does not hurt when this procedure is performed and no local anesthetic is needed.  As the mamelons are removed, the vibrations may tickle your nose.  Some patient’s lower incisors are too sensitive for all the mamelons to be removed all at one time and has to be done over a series of appointments.  Removing the mamelons will not increase the chances of a cavity.

Why Remove the Mamelons?

We removed them for aesthetics and for alignment.  The reason an orthodontist wants to remove the mamelons is so that the teeth can be placed properly.  We know that the mamelons are going to wear off anyway, but this may be when the patient is no longer under the watchful eye of their orthodontist.  If the mamelons wear off asymmetrically, which is highly possible, the incisal edges may not be in one plane and make your teeth will look uneven.