Hypodontia, the condition where one or more teeth just don’t develop, is uncommon, but it’s not rare. In fact, nearly 1 in 10 people has one or more teeth that just don’t develop–and that’s not counting wisdom teeth, which are the most likely to not develop. There is even some evidence that hypodontia may be increasing. And that may mean more demand for dental implants to fill these gaps.
What Causes Hypodontia?
People call hypodontia by many labels. In the past, it’s been called “dental agenesis,” which has a poetic ring as well as being highly descriptive. More recently, it’s been termed the awkward but acronymable congenitally missing teeth (CMT).
The changes in labels isn’t too surprising. It’s something that happens regularly with many conditions, but seems to happen more to conditions that are poorly understood. And hypodontia is certainly that. We don’t know why it happens. Current theories center say that a combination of environmental and genetic factors may be involved, which is almost certainly true, since it’s pretty much true of any developmental condition.
This isn’t very helpful in part because it’s not clear which genetic factors are involved, though some research points at factors related to cleft lip and ectodermal dysplasia. With similar lack of certainty, it’s been linked to environmental factors like drug use, trauma, and infection.
Which Teeth Are Missing Most Often?
Studies haven’t been able to track down the causes of hypodontia, but they have done a good job of tracking the teeth that are most often affected. In general, it seems to affect the rearmost tooth of each type. Wisdom teeth are by far the most common teeth not to develop. In some populations, as much as 37% of people don’t develop one or more wisdom teeth. Other missing teeth, affecting only about 8% of people in North America. The second premolar is the second most common tooth not to develop, followed closely by the upper lateral incisors.
Is Hypodontia Increasing?
The suspicion that hypodontia is increasing comes from dentists, who seem to be reporting it more often. But that might not be indicative of a true increase. It may just be that we’re noticing it more now that people tend to keep almost all their teeth into adulthood.
The closest thing we have to an answer is a large meta-analysis of 19 studies on the question. The results suggest that there is a trend toward increasing hypodontia. However, the data is not conclusive because the time frame of the studies was too short.
Treatment for Hypodontia Has Improved
Although we aren’t sure whether hypodontia is increasing, we do know that treatment options for hypodontia have increased and improved. In the past, people might have been offered a partial denture, which is reasonable, or orthodontics to move other teeth into the space where the tooth didn’t develop. This can work well if a premolar doesn’t develop. It closes the gap, the molar looks fine in the place, and it makes space for wisdom teeth to come in.
But lateral incisors don’t benefit as well from this. Canine teeth don’t pass as well for incisors, although reshaping can help.
Dental bridges work reasonably well to hold the space, but over the long term, they can develop cosmetic problems due to the loss of jawbone under the bridge.
Dental implants are a great alternative for replacing teeth that don’t develop. Their only limitation is that you have to wait until your jaw stops growing to get them.
Do You Want an Attractive Replacement Tooth?
Do you have a tooth that never developed? We can help you look at the replacement options and help you find the best one for you.