Mesiodens as the most prevalent form of supernumerary teeth in permanent dentition is not a rare condition. Evidence regarding etiology of mesiodens indicates that genetic susceptibility together with environmental factors might increase the activity of dental lamina leading to formation of the extra tooth/teeth. Extraction of mesiodens in the early mixed dentition helps spontaneous alignment of the adjacent teeth; however, symptomless cases could be left untreated along with regular check up.