Important Facts About Congenitally Missing Teeth

Dr Sukanya Goswami
Sukanya has done BDS. She is a dentist, a blogger, an extrovert, and a travel enthusiast. She is also a spiritual believer. When she is not working, you can find her reading books.

Congenitally missing teeth are one of the most prevalent dental anomalies. Usually, congenitally missing teeth occur due to a failure in the development of a tooth bud. Several contributing factors may lead to congenitally missing teeth.

However, genetics play a crucial role in the occurrence of this rare condition. A person can experience partial or complete course of congenitally missing teeth. Usually, the upper lateral incisors and second premolars are the most common congenitally missing teeth.

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People who experience this condition may be exposed to a variety of dental treatments suitable for their case. Some of these treatments include prosthodontic rehabilitation, orthodontic treatment, and implants. Today’s article will highlight the causes of congenitally missing teeth. Furthermore, we will discuss the impact and treatments of congenitally missing teeth.

What are congenitally missing teeth?

Congenitally missing teeth is a developmental absence of one, more or all of the teeth in the mouth. Usually, this dental condition rarely occurs in the primary dentition. In permanent dentition, it can occur as a significant developmental disorder or occur as a part of a syndrome that requires multidisciplinary treatment. (1) Typically, congenitally missing teeth can be categorized into three forms –

  • Hypodontia – involves one to six missing teeth in the mouth, excluding the third molars.
  • Oligodontia – involves six or more missing teeth in the mouth, excluding the third molars.
  • Anodontia – all teeth are missing the mouth

Ideally, the most common congenitally missing teeth include the lateral incisors of the upper jaw and the second premolars of both the upper and lower jaw.

What causes congenitally missing teeth?

The hereditary malformation is one of the most common causes of congenitally missing teeth. In other cases, congenitally missing teeth can occur as a part of a syndrome such as –

  • Down’s syndrome
  • Ectodermal dysplasia (2)
  • Cleft lip and palate
  • Cleidocranial dysplasia

Some clinical studies have shown a link between the developmental relationship of a nerve and hard tissue. Experts say that a brainstem anomaly such as the development of a local nerve may affect tooth agenesis. Additionally, environmental factors such as alcohol or drug abuse during pregnancy can also lead to congenitally missing teeth in the child. Some other environmental factors may include –

  • Chemotherapy
  • Excessive caffeine use
  • Maternal smoking
  • Hypoparathyroidism

What is the impact of congenitally missing teeth?

Some of the typical effects of congenitally missing teeth include –

Dental anomaly

One of the typical effects of congenitally missing teeth in the developing jaw is microdontia. Microdontia is characterized by the presence of smaller than regular teeth. This condition is prevalent in syndromes like ectodermal dysplasia and down’s syndrome. (3)

Usually, the absence of teeth can impact the development and eruption of the neighboring teeth due to a lack of guidance and space in the jaw. This can further lead to malocclusions and misaligned teeth. Some other effects of congenitally missing teeth include –

  • Difficulty in chewing
  • Poor gingival contours
  • Deeper bites
  • Improper functioning of the muscles of the mouth

Skeletal anomaly

Many clinical studies have revealed that congenitally missing anterior teeth accompany retrognathic maxilla leading to an underbite and a protruding lower jaw. Hypodontia is commonly responsible for reduces the anterior facial height. Additionally, it also leads to lip protrusion. Such dramatic changes lead to the development of a more acute mandibular angle and flat hin. (4)

Other features

Some of the common anomalies caused by congenitally missing teeth include –

  • Development of peg-shaped lateral incisors in the maxilla
  • Taurodontism – a condition characterized by large and bulbous tooth body with roots reduced in size
  • Retained primary teeth
  • Ectopic canine eruption

What are the treatments for congenitally missing teeth?

There is a wide range of treatments available to manage the congenital condition. Some of the commonly used treatment options include –

Orthodontic treatment

Usually, orthodontic treatment is used to correct malocclusions and misalignments of the teeth in the jaw. Moreover, it helps to provide a natural appearance to the smile. In some cases, orthodontic treatments are also incorporated to upright the teeth and allow space for tooth replacement, such as with an implant or a tooth-supported bridge. (5)

Dental implants

Dental implants are one of the most advanced and self-supporting treatment options for the replacement of missing teeth. It is most commonly used for replacement of later incisors of the upper jaw.

Typically, a dental implant consists of a small titanium screw that is integrated into the jaw bone. The screw acts as an abutment for an artificial dental crown made from zirconia or porcelain. Dental implants provide supreme aesthetics and give a natural smile appearance.

Tooth supported dental bridge or dentures.

Removable dentures or a tooth-supported dental bridge are another cosmetic dental option for the replacement of missing teeth. Usually, in both cases , the supporting replacement tooth rests on the gums. (6)

Tooth supported dental bridge consists of abutments on either side of the unit. Usually, the adjacent teeth are reduced in size to accommodate the dental crown’s thickness and fit. Whereas a removable particle denture typically uses a denture case made of acrylic that rests on the gums and jaws and consists of artificial teeth that fill the missing tooth space.

Take away message

Congenitally missing teeth are a nightmare for children and adolescents. It is caused by genetic malformation or contributing to environmental factors. In either case, it negatively impacts the oral health and natural appearance of the smile.

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Some of the effects of congenitally missing teeth in the mouth include malocclusions, deep bite, underbite, microdontia, underdevelopment of the maxilla, poor gum contours, difficulty in chewing, and unpleasant looking smile.

There is no way to bring the missing tooth back. However, dental treatments such as dental implants, orthodontic intervention, and use of removable partial dentures or a tooth-supported dental bridge are some of the excellent therapeutic options that can maintain the structure and function of your mouth. Moreover, these treatments help to improve the appearance of the smile, making it as natural as possible.

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