← All explanationsDens evaginatus

What does an extra cusp on a tooth mean?

Dens evaginatus is a developmental variation with an additional cusp on the tooth crown. A fine extension of the dental pulp may lie within it. An unusual cusp therefore needs dental assessment before anyone considers reducing it.

For training & practice ↓

Teaching model of a single-rooted premolar with an additional tubercle on its chewing surface. — External teaching model of an additional tubercle. Dentine and any pulp extension are not visible here.

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An additional cusp

The shape formed during tooth development. It is not a deposit of tartar that grew afterwards.

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Consider the pulp

The cusp may contain enamel, dentine and a pulp extension. Wear or fracture can put the pulp at risk.

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Protect or treat

Depending on shape, contact and findings, monitoring, protection of grooves or treatment may be appropriate. Pain or a fractured cusp needs prompt assessment.

Read the full explanation

An additional cusp
The shape formed during tooth development. It is not a deposit of tartar that grew afterwards.
Consider the pulp
The cusp may contain enamel, dentine and a pulp extension. Wear or fracture can put the pulp at risk.
Protect or treat
Depending on shape, contact and findings, monitoring, protection of grooves or treatment may be appropriate. Pain or a fractured cusp needs prompt assessment.

Notes on the teaching images

External teaching model of an additional tubercle. Dentine and any pulp extension are not visible here.

For your visit: open the communication cards

Watch the short explanation ↓

At a glance

What is it?

An extra projection from the crown.

What matters?

Contact, fracture, pain and pulp condition.

Treat it yourself?

Do not file or break it off.

Knowledge in motion

Explained in 36 seconds.

Three steps. No audio.
Each scene can also be selected manually.

Silent educational film with German on-screen text and simplified teaching images. Not a patient case or a promised treatment outcome. The full English explanation is available as text.

Go to film text

Often confused

Cusp rather than an inward fold

Dens evaginatus projects outwards. Dens invaginatus involves an inward fold.

Quick answers

Can I file the cusp down?

No. This could expose the pulp.

Does every affected tooth need root canal treatment?

No. The pulp condition and examination findings determine treatment.

Is it an extra tooth?

No. It is an additional part of one tooth crown.

At the practice

For a personal discussion

Editorially suggested question to discuss with Dr Niusha Barahmand Pour:

Does this cusp need protection, and how close is the pulp?

An examination can assess an unusual cusp or broken tip. Contact a dental service promptly if it hurts.

Have the tooth shape assessedAppointment selection at Doctolib

Meet Dr. Niusha Barahmand Pour ↗

Learning layer for training & practiceUnderstand terminology and deepen knowledge

Accessory cusp: An additional part of the crown.
Pulp horn: An extension of the pulp towards a cusp.
Occlusal contact: Contact with the opposing tooth.

Make the distinction

Dens evaginatus projects outwards. Dens invaginatus involves an inward fold.

Knowledge questionWhy not grind it yourself?

For learning, not for assessing personal symptoms. Your answer is not stored or sent.

The cusp may contain a pulp extension.
Every cusp is tartar.
This makes the tooth grow back.

View answer

The cusp may contain a pulp extension.

The outer shape cannot reliably show how close the pulp is.

Sources and context

Editorial research: 2026-11-06. General information, not an individual diagnosis or treatment recommendation. Teaching illustrations are simplified and do not depict a patient case.