By the age of 18, most people have a total of 32 permanent teeth. However, in some cases, individuals are born with fewer teeth. Congenitally missing teeth, also known as hypodontia, is a developmental abnormality where some permanent teeth fail to develop.¹
What is hypodontia?
Hypodontia or congenitally missing teeth (CMT) is one of the most common developmental oral health conditions. The condition is characterized by someone having six or fewer permanent teeth. Excluding third molars, the reported prevalence of hypodontia ranges from 1.6 to 6.9%, depending on the population studied, according to an article in _BioMed Research International², the most common congenitally missing teeth are:³
Upper lateral incisors
What causes hypodontia?
Hypodontia is believed to be an inherited oral condition. However, even with the strong link between genetics and hypodontia, it's still possible for someone to develop the condition with no family history of it.⁴
The influence of the dental lamina
Most cases of hypodontia point to a problem with one's dental lamina.⁵ In the complex process of fetal development, this band of epithelial tissue is supposed to form into two dental arches. Our enamel organs should then map out the future site of a tooth within these arches, but sometimes that doesn't happen. If a mutation occurs where the dental lamina is missing, then it's likely that the tooth at that site will not form either. While this could be a genetic mutation, it could also be an outside influence.⁶
Other potential hypodontia causes
The dental lamina is especially sensitive to external influences and damage before tooth formation could lead to hypodontia. Outside influences that may impact tooth development include:⁷
Severe intrauterine disturbances and,
Hypodontia treatment options
Treatment for hypodontia generally involves a combination of orthodontic interventions, such as braces to align teeth or correct spacing, as well as prosthetics, such as dental implants or bridges, to replace missing teeth.⁸
Braces - Braces can be a first step towards fixing hypodontia in both children and adults. The goal with this treatment option is to either fill in the gaps or move teeth to allow for other treatments. Children should wait until their baby teeth have come out and their jaw bone is fully developed before getting braces.
Dentures - Removable partial dentures can help fill in the gaps left by missing teeth. Not only will it improve your dental appearance, but it'll also help with chewing food and speaking.
Bridges - There are two main types of bridges: removable and traditional. A bridge is a prosthetic tooth that is bonded to adjacent teeth or dental implants.
Implants - Dental implants are an option for adults with healthy jawbones and gums. You cannot be fitted for implants until everything has stopped growing, which is why it's not a good option for children. With implants, a false tooth on a metal screw is put into the jaw bone. Over time, the implants will fuse to the bone and should essentially function like natural teeth.⁹
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https://www.gotoapro.org/missing-teeth (Last accessed February 2020)
https://www.britannica.com/science/tooth-germ#ref1074207 (Last accessed February 2020)
https://www.ucsfbenioffchildrens.org/conditions/hypodontia/ (Last accessed February 2020)
https://www.dentistjustforkids.com/you-child-is-missing-a-permanent-tooth (Last accessed February 2020)