Supernumerary teeth can be found anywhere in the oral cavity, during deciduous or permanent dentition, in males and females. They are rare, owned to various genetic or environmental factors and usually impacted. This article first reports three cases of young adult patients coming to the office for other reasons than their maxillary distomolars and without any pathology caused by them. The decision of keeping or removing these teeth was made based on other associated factors. The fourth case is one of a 40-year-old partially edentulous male patient, also with a good general health and no other associated condition, having a unilateral maxillary fourth molar; it was small, only partially erupted, with a normal morphology with crown and root and an impacted perpendicular position on the distal face of the third molar. It was extracted because of the periodontal and carious complications that it caused to the third molar facing it. The last reported case is a 64-year-old partially edentulous female patient with a maxillary tooth very similar to a distomolar because of its form and position; it was extracted because it interfered with the new removable partial denture treatment plan. The differential diagnosis between a distomolar and an anatomical variant of a third molar was difficult to make even using panoramic X-ray, also because of a very small inferior third molar. In young patients, distomolars are rather accidentally discovered during radiographic examination; later in life, they can cause both pathological issues and difficulties in diagnosis and prosthetic treatment.