Congenitally missing teeth are teeth that fail to develop. This can be caused by genetic issues, or medical conditions such as Down syndrome and Crouzon syndrom. There are three common terms used to describe congenitally missing teeth:
- Hypodontia- a patient is missing up to five permanent teeth
- Oligodontia- the patient is missing six or more teeth
- Anodontia- the patient is missing all of his or her primary or permanent teeth
By far, the most common congenitally missing teeth I encounter in my practice are maxillary lateral incisors. These are the two upper teeth on either side of your two front teeth. Missing maxillary incisors account for 20 percent of all congenitally missing teeth, according to an Oxford Journal study. These missing teeth require the most attention because of their location and how they affect facial aesthetics. The maxillary lateral incisors are a part of your smile!
There are two methods of addressing missing teeth: closing the space or opening the space. Closing the space isn’t typically my preferred treatment because of its aesthetic shortcomings. If you choose to close the space, a dental professional must reshape the maxillary canines in an attempt to make them resemble the lateral incisors.
In my opinion, the better option is to combine orthodontics and implant therapy, which will give your child a beautiful and naturally functioning smile.
Dental implants open up new restorative methods for patients seeking to “fill in the gap,” so to speak. However, dental implants are not recommended until facial growth is complete, which typically happens at around age 16 for girls and 17 to 18 for boys.
As an orthodontist, I work closely with an oral surgeon in dental implant cases to determine the amount of space that must be maintained until it is time for implant placement. By doing so, we help ensure the final restoration looks as natural as possible. I like to use the concept of the “golden proportion,” which is based on a specific mathematical proportion acquired from mathematics and nature. We achieve this by measuring and examining your child’s smile. This ensures the appropriate space is found, and the future dental implant will fit snugly and look natural.
How does my child maintain the space until it’s time for an implant, you’re wondering? Glad you asked. If the period between orthodontic treatment and dental implant placement is extensive, then I often recommend a resin-bonded bridge. But if the time period between treatment and implant is short, a removable retainer with a prosthetic tooth might be used instead. Not only will this hold the tooth in position, but it will leave the space open until your child is ready for the dental implant.
The issue of congenitally missing teeth drives home a point I frequently make to parents: you need to have your child evaluated by an orthodontist by age 7. At this age, we can gather digital images that will show us whether there are missing teeth that will need to be addressed as your child develops. Knowing what we’re dealing with at this stage enables us to develop a treatment plan that will best address your child’s needs.