A complete set of baby teeth consists of 20 teeth, including incisors, canines and molars. It is fairly rare for a child to be missing a baby tooth, and it is actually more common to have an extra baby tooth. An extra baby tooth will most likely be located as a front tooth at the top of the mouth. Sometimes the additional tooth comes into the mouth, and sometimes it stays under the gums. In terms of adult teeth, it is far more common to be missing one or several, than it is to have extra. We call this condition “congenitally missing” or “hypodontia” if the tooth or teeth were naturally never there.
Which Adult Teeth Are Most Commonly Congenitally Missing?
This occurs most commonly with the wisdom teeth, called the 3rd molars, followed by the second premolars, followed by the upper lateral incisors. It is thought that upwards of 20% of people have this condition and are missing at least one adult tooth. That percentage falls drastically if you take 3rd molars out of the equation, only about 2-8% of the population.
What Causes a Congenitally Missing Tooth?
The process of tooth formation is exceptionally complex. Commonly, the dental lamina will be the cause for concern in terms of tooth development. The dental lamina is located underneath the gums and is where the tooth bud begins its formation. Several genetic factors can result in disruption to the dental lamina, which may also mean the corresponding tooth doesn’t form either.
Is There A Genetic Predisposition for Congenitally Missing Teeth?
Yes, there is. If either one or both parents has this condition and is missing at least one permanent tooth, there is a reasonably high chance that the child will inherit it. Around 25% of children missing a tooth/teeth have a parent who is missing a tooth/teeth. There is also a link with close relatives, such as a grandparent or aunt/uncle.
Treatment for Congenitally Missing Teeth
The treatment for congenitally missing teeth largely depends on which teeth are missing. If any or all of the wisdom teeth are missing, it’s actually beneficial because most of the time, the wisdom teeth don’t fit and lead to problems anyway. In terms of the 2nd premolars or the lateral incisors, they can either be left (depending on how strong and healthy they are) or extracted. Braces or dental implants can be used to close the spaces or a combination of both. It is not recommended to remove a baby tooth that doesn’t have a permanent tooth underneath and leave the area, because there will be problems with bone resorption and tooth shifting.
If you or your child has congenitally missing teeth, it is important to discuss treatment options with your dentist. We encourage you to call us today to book an appointment.

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