Hypodontia (Missing Teeth)

What is hypodontia?

“Hypodontia” is the medical term for being born without some of your teeth. It’s a form of dental agenesis — a term healthcare providers use to describe congenitally missing teeth. (“Congenitally” means you’re born with the condition.) Specifically, a person with hypodontia is missing one to six teeth (not counting wisdom teeth). Between 2% and 8% of the general population has hypodontia. Anyone can be born with it.

Hypodontia can occur in any area of your mouth. But the teeth most commonly missing in people with hypodontia include your:

• Upper lateral incisors (the smaller teeth on either side of your top two front teeth).
• Upper second premolars (the teeth just in front of your molars on the top).
• Lower second premolars (the teeth just in front of your molars on the bottom).

How does hypodontia affect my oral health?

Missing teeth can interfere with your ability to eat and speak. Hypodontia may also cause gum damage and inadequate jawbone growth. This lack of bone growth can lead to an underdevelopment of your jaw, making it appear smaller than it should be.

Is hypodontia a birth defect?

Hypodontia is a birth defect. Children can inherit hypodontia from their biological parents.

In some cases, infants and young children may develop hypodontia if they had certain illnesses, infections or treatments (like chemotherapy or radiation) during their tooth development phase.

What are the symptoms of hypodontia?

The most common symptom of hypodontia is being born missing one to six teeth. The missing teeth can occur anywhere in your mouth — except your wisdom teeth. Hypodontia can affect primary (baby) teeth or permanent (adult) teeth. People with hypodontia may also have existing teeth that are peg-shaped or smaller than average. They may also have gaps and spaces between their existing teeth.

Hypodontia can also be a symptom of other genetic disorders. Some people with hypodontia may also develop symptoms of ectodermal dysplasias. People with ectodermal dysplasia may have:

• Nail abnormalities.
• Thinning hair.
• Poor hearing.
• Poor vision.
• A lack of sweat glands.

What causes hypodontia?

People with hypodontia usually have an abnormality affecting the dental lamina — a band of tissue under your gums where your teeth form. In most cases, family history is the cause. But other factors can result in hypodontia, too.

Hypodontia associated syndromes

Hypodontia can occur alongside other conditions or treatments, such as:

• Cleft lip or cleft palate.
• Low birth weight.
• Genetic disorders, such as Down syndrome or ectodermal dysplasia.
• Infectious diseases, such as candida or rubella.
• Chemotherapy.
• Radiation therapy.

How is hypodontia inherited?

There are several genes responsible for hypodontia, including:

• WNT1OB.
• EDA.
• EDAR.
• EDARADD.

Depending on the specific gene, inheritance can follow different modes. Like most genetic disorders, healthcare providers determine them by looking at the status of the two copies of a gene: one from each biological parent.

People with hypodontia may inherit the condition in one of four ways:

Autosomal recessive

Two copies of an abnormal gene — one from each biological parent — are necessary for hypodontia to develop.

Autosomal dominant

Only one copy of an abnormal gene — from either biological parent — is necessary for hypodontia to develop.

X-linked dominant

There’s one dominant abnormal gene on the X chromosome. This means that a person assigned male at birth (AMAB) who has X-linked hypodontia will pass the abnormal gene to all of their daughters.

X-linked recessive

There are one to two recessive abnormal genes on the X chromosomes. This means that a person assigned female at birth (AFAB) who has X-linked hypodontia has a:

• 25% chance of having a daughter who carries the abnormal gene.
• 25% chance of having a daughter who doesn’t carry the gene.
• 25% chance of having a son who has hypodontia.
• 25% chance of having a son unaffected by hypodontia.

How is hypodontia diagnosed?

If your healthcare provider suspects hypodontia, dental X-rays can confirm the diagnosis. During an exam, a dentist will look for other signs of hypodontia, including small teeth, peg-shaped teeth and spacing between teeth.

How is hypodontia treated?

Hypodontia treatments may include:

• Braces or other types of orthodontics.
• Partial dentures.
• Dental bridges.
• Dental implants.

Children with hypodontia typically wear partial dentures until they’re old enough for other treatments.

Can I prevent hypodontia?

Because hypodontia is usually hereditary, there’s nothing you can do to keep it from happening. But remember, even if you have hypodontia, it doesn’t guarantee that you’ll pass it on to your children.

What can I expect if I have hypodontia?

Hypodontia isn’t dangerous or life-threatening. But left untreated, it can severely limit your quality of life. Fortunately, dentists, orthodontists and other dental providers can treat and manage the condition with personalized treatment.

If my child is missing teeth, when should I see a healthcare provider?

If your child’s primary teeth don’t erupt (emerge from their gums) by age 4 — or permanent teeth by age 14 — then a dentist should evaluate the issue. If you’re concerned about your child’s missing teeth, ask your dentist about it during a routine office visit.

What questions should I ask my healthcare provider?

If you or your child has hypodontia, here are some questions to consider asking your healthcare provider:

• How many teeth are missing?
• Is this condition interfering with my nutrition or digestion?
• What are my treatment options?
• How long will treatment take?
• Should my child or I have further testing to find out if I have other genetic disorders?

A note from Cleveland Clinic

Hypodontia is a congenital condition characterized by one to six missing teeth. The condition can make eating and speaking a challenge. But the good news is that it’s treatable. If you or your child has hypodontia, talk to your dentist about options that can restore your smile, confidence and quality of life.