Missing Teeth
What is meant by missing teeth?
Some people have one or more teeth that never develop. This is known as hypodontia.
The most common teeth to be missing are the wisdom tooth. These teeth are missing so often that they are not considered when making a diagnosis of hypodontia.
How common is hypodontia?
The prevalence varies in different parts of the world based on studies that have been carried out. On average, 1 in 20 of us, or 5% have hypodontia of at least one adult tooth (ignoring the wisdom teeth). The prevalence is slightly higher in females compared to males.
Hypodontia can also affect the baby teeth but usually to a lesser extent.
What causes hypodontia?
Hypodontia has been linked to a number of genes so it is quite common to have a parent or sibling who is also affected. It also means that if you go on to have children, they may also have hypodontia. These genes express themselves in different ways which means you could have just one tooth missing or several.
Sometimes, hypodontia can occur without there being any family link. It can also occur as part of another condition or syndrome.
Which teeth are usually affected?
If we ignore the wisdom teeth, the lower premolars are the most commonly missing teeth. This is followed by upper lateral incisors. The lateral incisor is the second tooth along from the middle of your jaw. This is often more of a concern to patients because the missing tooth is right at the front of the mouth.
What does hypodontia look like?
Patients with hypodontia can exhibit many dental features. The most common is spacing between the teeth. Your other teeth can also look slimmer and you may have baby teeth which do not fall out. This is because the adult tooth that would push out the baby tooth is missing.
What are the treatment options?
One option is always to leave things as they are and monitor how things go. Most patients are not satisfied with this and instead seek some kind of treatment.
Treatment is usually carried out with braces and the space for the missing tooth is either opened or closed. A detailed analysis of your dental condition will be made and sometimes, a restorative dental specialist will also see you in order to make the most appropriate treatment plan. You may also be asked to discuss things with your regular dentist as they will look after your teeth once the brace work has finished.
I have been told space opening is best for me, what does this mean?
If the space is opened, you will have a space left for the missing tooth at the end of treatment. A false tooth will be put in your retainer at the end of your brace treatment. You will then be asked to see your regular dentist to have the space filled with something more permanent.
Your dentist will talk to you about resin retained bridges and dental implants.
If you still have a healthy baby tooth in the position where the adult tooth is missing, this can sometimes be left in place. It may need to be re-shaped by your regular dentist to give it a better appearance. These baby teeth can last from a few years to many decades.
I have been told space closure is best for me, what does this mean?
If the space is closed, you will have no gap left at the end of treatment where the tooth is missing. Because a tooth that would not normally be in that position now takes the place of the missing tooth, you may need to see your regular dentist to re-shape some of the teeth.