Introduction: Supernumerary teeth refer to an excessive number of teeth. A mesiodens is a supernumerary tooth in the midline of the maxilla. This study emphasizes multidisciplinary management and long-term follow-up. Aim: To investigate characteristics of mesiodens in children reported to a pediatric and preventive dentistry department in Tamil Nadu, India. Materials and Methods: 55 children under 14 years studied. Characteristics obtained from radiographs and clinical exam, confirmed surgically. Results: Males affected twice as frequently as females. Predominant shape conical (79.7%). 49.09% had multiple mesiodens. 45.45% required orthodontic correction. Conclusions: Mesiodens can cause complications. Routine radiographic examination is advised, and extraction should be early to prevent complications. © 2014 Elsevier B.V., All rights reserved.