Congenitally Missing Teeth: Why It Happens and How to Treat It
Most people have thirty two permanent teeth that develop in their mouths. Failure of any these teeth to fully develop is called congenitally missing teeth or, in scientific terms, hypodontia.
In fact, about 20% of all adults are congenitally missing at least one tooth!
What Are the Most Common Congenitally Missing Teeth?
The most common permanent teeth to be congenitally missing are:
1 - Wisdom Teeth - The teeth all the way in the back of your mouth. Wisdom teeth account for so many congenitally missing teeth that when you take them out of the equation, the percentage of adults with missing teeth drops from 20% to around 5%.
2 - Second Premolars - The teeth right in front of your molars. If you only have one instead of two, you could either have a congenitally missing tooth or it's possible that one of your premolars was taken out when you had braces.
3 - Upper Lateral Incisors - These are the two teeth to the side of your two front teeth.
4 - Lower Central Incisors - These are the two front teeth in the lower jaw. I've seen several adults in their 40's who still have their lower front baby teeth because the permanent ones were congenitally missing!
Congenitally missing teeth are much more common in permanent teeth. Only about 0.5 to 0.9% of kids have a congenitally missing baby tooth. If a child has a congenitally missing baby tooth, it is likely that there isn't a permanent tooth developing under the gums of the congenitally missing tooth.
When people are missing a tooth, it is most common to only see one or two teeth missing rather than many teeth. Neville and Damm's oral pathology textbook states, "In whites with missing teeth, approximately 80% will demonstrate loss of only one or two teeth."
Why Would a Tooth Be Congenitally Missing?
Forming a tooth is a complex process. There are a lot of genetic signals that must be processed for everything to go correctly. Most cases of hypodontia result from a lack of a little band of tissue, known as the dental lamina, underneath the gums to form. Since the tooth forms from this band of tissue, the tooth will not form if the dental lamina does not form.
That band of tissue doesn't form due to a variety of different genetic factors. Scientists have pinpointed three main genes that play a big role in tooth development (AXIN2, PAX9, and MSX1.) If there is a mutation on any one of these three genes, it could mean that a tooth will not form.
Congenitally missing teeth are often associated with various syndromes, one of which is Down's syndrome. Congenitally missing teeth can also be genetic.
Some dental experts believe that we are currently in the intermediate stage of an evolutionary change in the number of teeth that humans have and that future members of the human race will only have somewhere around 20 teeth instead of 32.
Treatments for Congenitally Missing Teeth
If you are congenitally missing your wisdom teeth, then no treatment is really necessary since most people have their wisdom teeth extracted.
If you are missing your lateral incisors, your second premolars, or any other teeth, then there are a few treatment options.
Getting an implant to replace your missing tooth is probably the treatment of choice. An implant has a root that integrates with your jaw bone and a crown to make it look like your natural tooth.
The next best option would be to get a bridge. A bridge is like three crowns connected together. The two teeth adjacent to the missing tooth are cut for dental crowns. The bridge is then placed onto those two adjacent teeth. The bridge has a fake tooth that connects to two crowned teeth and fills in the empty space from the congenitally missing tooth.
Another option for replacing a congenitally missing tooth would be to get a removable partial denture. This is an appliance that you can put in and take out of your mouth. It rests on your natural teeth and your gums and has teeth on it that replace the congenitally missing teeth.
Congenitally missing teeth is not as rare as you may have guessed. The causes of this phenomenon vary and there are also multiple treatments available if you are missing one or more of your teeth.
Do you have any questions about congenitally missing teeth? Did you have congenitally missing teeth? If so, did you do anything to fill in the empty space? I'd love to hear your questions, comments, and stories in the comments section below.
Thanks for reading!
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