Hypodontia (Missing Teeth)

Hypodontia is a congenital disorder that happens when your permanent teeth don’t develop as they should, so you’re missing teeth. “Congenital” means the condition is present at birth.

People who have it may be missing up to six teeth. They may have gaps or spaces between their existing teeth. This disease is a form of tooth agenesis. This is a term healthcare providers use to describe congenitally missing teeth.

In hypodontia (pronounced “hi-po-DON-shee-uh”), your primary (baby) teeth come in on schedule, but some permanent teeth don’t. This is a common dental issue that affects between 2% and 8% of the general population.

Missing teeth isn’t a serious issue. But without treatment, it can affect your quality of life. Fortunately, dentists, orthodontists and other dental providers can treat and manage the disorder.

Symptoms of hypodontia

You may first notice symptoms when your child’s primary (baby) teeth fall out, but no permanent teeth arrive to fill in the empty spots in their jaw. In general, children lose their primary teeth starting at age 6. Their permanent (adult) teeth typically emerge between the ages of 6 and 14.

This condition can develop anywhere in your child’s mouth, except for their wisdom teeth. They may be missing the:

• Smaller teeth on either side of their two front teeth (upper lateral incisors)
• Teeth just in front of their molars in their upper jaw (upper second premolars)
• Teeth just in front of their molars in their lower jaw (lower second premolars)

Some children may have small or cone-shaped teeth. These can be symptoms of ectodermal dysplasia, a group of inherited disorders that affect your skin, teeth, nails or sweat glands. They can also be symptoms of other medical conditions, such as amelogenesis imperfecta, or a syndrome that affects the way your child’s face or skull develops.

Hypodontia causes

The most common cause is heredity, which means biological parents pass certain genetic changes to their children. Several genes manage how different permanent teeth form during fetal development. When something affects these genes, it affects the dental lamina. This is the band of tissue that anchors primary and permanent teeth.

Some medical issues may increase the risk of being born with hypodontia:

• Inherited disorders: Children with cleft palate, Down syndrome or ectodermal dysplasia may have this condition.
• Medical issues: Experiencing rubella or candida during pregnancy may lead to hypodontia. Low birth weight is another risk factor.

Complications of hypodontia

This disease can make it hard for your child to chew food. It can affect their speech. Without treatment, they may develop:

• Gum damage
• A smaller-than-usual jaw if the disorder keeps your child’s jawbone from developing as it should
• Misaligned teeth, which can lead to temporomandibular joint disorder

Older children with hypodontia may avoid spending time with others or meeting new people because they feel self-conscious about their oral health and appearance. Feeling anxious about connecting with others can lead to social isolation.

How doctors diagnose this condition

A dentist will examine your child’s teeth and mouth. They’ll do a dental X-ray to see if your child has permanent teeth that haven’t emerged. They may classify hypodontia as being mild, moderate or severe:

• Mild: Your child is missing one or two teeth.
• Moderate: Three to five teeth are missing.
• Severe: They’re missing six teeth.

How is it treated?

Treatment typically involves dental appliances to move teeth together or treatments to replace them. Your child may have:

• Braces
• Partial dentures
• Dental bridges
• Dental implants

Your child may have different treatments as their jaw continues to develop. For example, your child may wear a partial denture until they’re in their teens. After that, your child may have a dental implant or bridge.

When should I seek care?

Talk to your child’s dentist if some of your child’s permanent teeth don’t emerge soon after their baby teeth fall out.

What can I expect if my child has hypodontia?

Treatment often cures the condition. But your child may feel uncomfortable about smiling, talking or eating when they’re around others. Likewise, wearing braces or partial dentures may also make them feel anxious about doing things like eating around other people.

Ask your child’s dentist about support groups for children with hypodontia. Spending time with other kids with this disorder may help your child feel more comfortable making connections.

Having good oral hygiene is essential, especially if your child wears braces or dentures. Their dentist or orthodontist will explain how to take care of braces and dentures.

What’s the difference between hypodontia and oligodontia?

Like hypodontia, oligodontia is a congenital disorder where you have missing teeth. The difference is that oligodontia causes six or more missing teeth.