A mesiodens is a supernumerary tooth in the maxillary anterior incisor region. If the supernumerary tooth were found in the posterior region it would be termed a distomolar or distodens (4th molar). If the tooth happens to be found lingually or buccally, the term paramolar is used (see Figure 2). Developmental alterations can occur affecting the number of teeth, the size of teeth, the shape of teeth, and the structure of teeth.