AbstractObjective: To test the null hypothesis that American blacks do not have a higher frequency of extra permanent teeth than whites.Materials and Methods: Panoramic radiographs of adolescent orthodontic patients, either American whites (n = 1100) or American blacks (n = 600), were reviewed systematically.Results: The frequencies of supernumerary incisors, premolars, and molars were each significantly more common in blacks. While incisors are the most common extra teeth in whites (and extra molars are least common), just the opposite ranking occurs in blacks. Overall, the odds ratio was 8.8 (95% confidence limits = 3.9, 20.0), confirming that American blacks are significantly more likely (almost 9 times more likely) to possess extra permanent teeth than American whites.Conclusions: The hypothesis is rejected. Both the frequencies and the patterns of extra permanent teeth are significantly different in blacks and whites, suggesting different frequencies of the relevant (but unidentified) factors governing the developmental mechanisms that result in hyperdontia.