Tooth agenesis: what is it, the causes and treatments

Dental agenesis is a fascinating yet complex phenomenon within the field of dentistry. This phenomenon refers to when certain teeth do not form and are therefore missing. This anomaly can refer to both missing milk teeth and adult teeth and has various causes and problems affecting oral health. In this article, you will learn everything you need to know about tooth agenesis: what it is, what types exist, the causes and consequences and the different treatments to correct it.

What is tooth agenesis?

Tooth agenesis, also known as dental agenesis or congenitally missing teeth, is a craniofacial anomaly in which one or more permanent teeth fail to develop. This condition can cause missing milk teeth and adult teeth. Dental agenesis is a dental pathology that can have genetic causes or be influenced by environmental factors. It is one of the most common anomalies in dental development. Having no teeth or missing teeth can have aesthetic as well as functional consequences.

Missing teeth can affect chewing function, cause misalignment of the remaining teeth and increase the risk of temporomandibular joint problems. It can also affect speech development. It is therefore important to diagnose dental agenesis at an early stage and to initiate appropriate dental or orthodontic measures.

Types of dental agenesis: hypodontia, oligodontia and anodontia

There are different types of dental agenesis depending on the number of teeth missing:

Hypodontia

Hypodontia is the most common type of dental agenesis. The term hypodontia is used when one to six adult teeth, excluding wisdom teeth, have not developed and are missing. The teeth most often affected by hypodontia are the second premolars and upper lateral incisors.

Oligodontia

Oligodontia is a more severe form of dental agenesis in which more than six adult teeth are missing. Oligodontia can be associated with genetic disorders and this type of tooth agenesis often requires extensive dental treatment.

Anodontia

Anodontia is the rarest type of dental agenesis. In cases of anodontia all adult teeth are missing. This condition is usually part of a more complex issue and requires comprehensive interdisciplinary treatment.

These different types of tooth agenesis require an individualised approach to diagnosis and treatment to achieve optimal results in both aesthetic and function.

There are other conditions that can be confused with dental agenesis which are explained below.

False cases of dental agenesis

Many people can have missing teeth or no teeth due to non-genetic and external reasons which are often confused for tooth agenesis. Below we explore some of these reasons.

Tooth aplasia

Tooth aplasia occurs in cases where certain teeth do not touch each other, usually due to their placement in the jaw or unusual positions of the teeth. Tooth aplasia impairs chewing and biting, and can affect the overall appearance of the teeth.

Tooth loss

Tooth loss, such as knocked-out teeth, describes situations where teeth are missing due to trauma, disease or when milk teeth are removed too early, which affects the development of permanent teeth.

Causes of tooth agenesis

The causes of tooth agenesis can be varied. Missing teeth can be hereditary or congenital, but the causes are also often dependent on environmental factors. The causes of hereditary or congenitally missing teeth also vary depending on whether it occurs in milk teeth or permanent teeth.

Causes of tooth agenesis or missing milk teeth in children

In children, missing milk teeth may be due to hereditary causes. Patterns of tooth agenesis within families are common. In addition, genetic disorders and syndromes, such as ectodermal dysplasia, may play a role. Congenital factors, such as stress or nutritional deficiencies during pregnancy, may also increase the risk of agenesis of milk teeth, such as missing incisors, in children.

Missing permanent teeth: dental agenesis in adults

Cases where permanent teeth do not erupt and are congenitally missing are referred to as dental agenesis in adults. As with milk teeth in children, adults can have missing permanent teeth due to genetic factors.

There are some other causes of missing teeth in adults that should not be confused with true dental agenesis. For example, if milk teeth are extracted too early, this can interfere with the normal development and eruption of the underlying permanent teeth. In these cases, even if there is a gap, it is not caused by tooth agenesis, but rather by the external interference with normal tooth development.

Dental agenesis consequences: problems resulting from missing teeth

The consequences of dental agenesis are both aesthetic and functional. Aesthetically, missing teeth can lead to aesthetic problems with the smile, which can affect confidence. Missing teeth can also have functional consequences, such as problems with chewing and speaking, and can also lead to incorrect jaw movements. In the long term, this can lead to temporomandibular disorders and increased wear of the remaining teeth. Tooth agenesis can also increase the risk of malocclusion and orthodontic problems.

How is tooth agenesis diagnosed?

Tooth agenesis is usually diagnosed by having a combination of a medical examination and x-rays. First, the dentist will perform a visual inspection to determine if any teeth are missing or not erupting as expected. X-rays, especially panoramic x-rays, are an essential tool in confirming the diagnosis of dental agenesis, as they show whether or not teeth are present in the jaw. In some cases, additional genetic testing may be recommended, especially if missing teeth are suspected to be hereditary or there is a family history. Early diagnosis is crucial to ensure the appropriate dental or orthodontic measures are taken in time.

Treatment options for missing teeth due to tooth agenesis

Many patients who suffer from tooth agenesis seek treatment options to replace or disguise their missing teeth. The treatment of congenitally missing teeth depends on several factors, such as the age of the patient, the number and location of the missing teeth and the individual aesthetic and functional needs. Some common treatment options for replacing or disguising missing teeth are listed below:

• False teeth: These may include tooth replacements such as bridges or dentures. In adults, they are often a viable option to help improve dental function and aesthetics.
• Dental implants: For many patients with dental agenesis, dental implants are a permanent solution. They provide a natural look and can help preserve the jaw bone.
  
• Cosmetic dentistry: In some cases, veneers or dental bonding can be used to improve the appearance of adjacent teeth for a more proportional overall appearance.
  
• Preventive and supportive treatments: Regular dental check-ups and professional teeth cleaning are important to maintain the health of the remaining teeth and to detect any possible problems at an early stage.
  
• Interdisciplinary treatment: In more complex cases, especially when dental agenesis is part of a broader condition, interdisciplinary treatment involving experts from different medical fields may be necessary.
  
• Braces and other orthodontic treatment for missing teeth: For children and adolescents with missing teeth due to dental agenesis, braces or other orthodontic treatments, such as clear aligners, may be used to place the remaining teeth in an optimal position and to create space for future tooth replacements.
  

Straighten your teeth with Impress aligners

Impress aligners offer an innovative and discreet solution for patients with dental agenesis. Our clear aligners are customised and can correct the position of the teeth. This is especially important to ensure an even distribution in jaw movement and to improve dental aesthetics. Impress treatments are suitable for both adolescents and adults and can be adapted to the needs of patients with tooth agenesis to achieve their desired aesthetic and to improve the function of the teeth.

If you are interested in our removable orthodontic treatments with aligners, visit your nearest Impress clinic and you can meet the team of professionals who will supervise your treatment. You can also make an appointment online, by phone on +44 20 3808 1072, or via WhatsApp.