Congenitally Missing Teeth

The impact on children/adolescents and the importance of proper team planning

There’s little argument that teenage years can be difficult. Homework. Acne. First love. Add to it a missing tooth and peer teasing can make this time even tougher. For many, this missing tooth could be no fault of their own. Instead, it can be the result of a condition known as “congenitally missing teeth”.

To give a little background … A normal adult has 32 teeth and for those born with congenitally missing teeth, one or more of the adult teeth do not form. In most cases the non-forming teeth are not of consequence – i.e. wisdom teeth. When the condition does impact teeth of consequence, it is most often a prominently visible front lateral incisor tooth or back 2nd premolar chewing tooth. This issue generally comes to light in elementary or middle school years when a tooth (or teeth) is noticeably missing either in dental x-rays by a general dentist, pediatric specialist and/or orthodontist. It is also something that can be simply noticed by the child or their parents.

Studies show congenitally missing teeth impact approximately 2-5% of the population, which equates to one (1) in an average classroom of 30 children. It appears this condition occurs more often in girls, but boys are not immune.
There are no symptoms and while hereditary, almost always the patient will learn that a parent or grandparent has/had the same issue after the diagnosis.

The good news is that congenitally missing teeth is a treatable condition. Whether a front lateral incisor or back 2nd premolar, the key is proper planning for tooth replacement during adolescence. This often involves a team of dental specialists working in tandem with the general dentist, pediatric specialist and/or orthodontist. It should begin by the age of 9-12 years old, specifically the orthodontic treatment required in preparation for future tooth replacement. The orthodontic plan should involve consultation with a periodontist in order to prepare one’s mouth for the most optimum result. This proper planning generally includes a temporary prosthetic (plastic) tooth, which is ultimately replaced by a permanent tooth by the time a now mature teen reaches 17-20 years old. Treatment varies by case but generally involves a dental implant.

While congenitally missing teeth is not life threatening, this condition comes at a time when the impact can be life altering. Adolescence is such a formative time for children and teens. The importance of appearance, including a full mouth of teeth, cannot (and should not) be overlooked. In addition to purely aesthetic reasons, major concerns include health issues caused when teeth tip and shift as well as concerns resulting from having teeth in the wrong spots.

So like with many medical conditions, it begins with awareness.