Double teeth affect both sexes equally and some studies report higher occurrence in Asian and Indigenous populations.

[4][2] If a double tooth is present, then there may be a higher chance of other dental anomalies (see Related Abnormalities section).

However, the degree of separation will depend on where & when the fusion occurred so the pulp chamber and/or root canal may be completely fused into one.

Environmental (e.g. trauma, thalidomide exposure, hypervitaminosis A of the mother, viral infections), systemic, and genetic factors can cause formation of double teeth.

[1][8][6] While the specific pathophysiology of double teeth is difficult to determine, many purport it is due to force that brings tooth germs close together during development with necrosis of the tissue separating them allowing for the enamel organ and dental papilla to unite.

Whatever the cause of the double tooth (fusion or gemination), management depends on the morphology of the crown, root, & endodontic system, the type of dentition (primary or permanent), and the orthodontic (e.g. crowding, malocclusion, ectopic eruption or impaction of adjacent teeth), periodontal, esthetic, & other functional concerns.

[1] If the double tooth will have little impact functionally or esthetically, then it can be monitored with an emphasis on oral hygiene and prevention (e.g. topical fluoride).