Hypodontia: Symptoms, Causes, Treatment and Risk Factors

Are you missing teeth? While this may be fine for some, for some, it can have significant effects.

Hypodontia, the medical term for missing teeth, affects about 2% of adults, with women being slightly more prone to the condition than men (according to the NCBI). But hypodontia is not just about a gap in your smile; it can impact your oral health, your ability to eat comfortably, and even your self-esteem.

Whether the missing teeth are due to genetic issues like developmental anomalies or other reasons, modern treatments are available to restore your smile’s function and appearance. In this article, we’ll explore the causes behind hypodontia and provide insight into the latest advancements in treatment options.

Let’s begin by discussing what hypodontia is and what treatments are available.

WHAT IS HYPODONTIA?

Hypodontia refers to the congenital absence of one or more teeth. It is a form of dental agenesis, a term healthcare professionals use to describe teeth missing from birth. Specifically, those with hypodontia are missing up to six teeth (excluding wisdom teeth). The condition affects between 2% and 8% of the population and is usually present from birth.

Hypodontia can affect various teeth in the mouth. The most commonly missing teeth in those with the condition are:

Upper lateral incisors (the smaller teeth beside your two front teeth).
Lower second premolars (the teeth just before your molars on the bottom).

HOW DOES HYPODONTIA AFFECT YOUR ORAL HEALTH?

Missing teeth can impair your ability to chew and speak clearly. Hypodontia can also result in gum damage and inadequate jawbone growth. Insufficient bone development may weaken the jaw and cause noticeable differences in facial structure.

4 TYPES OF HYPODONTIA:

Hypodontia can vary in severity, from missing just one tooth to missing nearly all teeth. There are four types of hypodontia:

Congenitally Missing Teeth (CMT): The most common form refers to teeth absent at birth.
Tooth Agenesis: A broader term for the absence of one or more teeth.
Oligodontia: Missing more than six teeth (excluding wisdom teeth). It represents a more severe form of tooth asymmetry.
Anodontia: Complete absence of all teeth.

SYMPTOMS AND CAUSES:

IS HYPODONTIA A BIRTH DEFECT?

Yes, hypodontia is a congenital condition, meaning children can inherit it from their parents. In some cases, children may develop hypodontia if they experience infections, illnesses, or treatments (such as radiation or chemotherapy) during critical stages of tooth development.

WHAT ARE THE SYMPTOMS?

The most common symptom of hypodontia is the absence of one to six teeth (excluding wisdom teeth). The missing teeth can be located anywhere in the mouth. Hypodontia can also affect baby teeth, and individuals with the condition may have teeth that are peg-shaped or smaller than usual. Gaps or spaces between teeth are also common.

Hypodontia can be a sign of other genetic conditions. For example, those with hypodontia may also show symptoms of ectodermal dysplasias, which can affect hair, nails, and even sweat glands. Symptoms can include:

Nail anomalies
Thin hair
Hearing or vision problems
Poor development of sweat glands

CAUSES OF HYPODONTIA:

Hypodontia often occurs due to problems with the dental lamina, the tissue beneath the gums that helps form teeth. Genetics is a common cause, but other factors can also contribute.

HYPODONTIA AND ASSOCIATED CONDITIONS:

Hypodontia can be linked to other disorders or treatments, including:

Cleft lip or cleft palate.
Low birth weight.
Genetic syndromes like Down syndrome or ectodermal dysplasia.
Infections such as rubella.
Chemotherapy or radiation therapy.

OTHER CAUSES OF HYPODONTIA?

There are a variety of genes responsible for the condition, which include:

WNT10B
EDA
EDAR
EDARADD

Inheritance can occur in different ways depending on the specific gene. As with most genetic conditions, medical professionals can identify them by studying the state of two versions of the gene: one copy from the biological mother and one from the biological father.

Individuals with hypodontia may develop the condition through four inheritance patterns:

AUTOSOMAL RECESSIVE:

Two copies of an abnormal gene (one from each biological parent) are required to develop hypodontia.

AUTOSOMAL DOMINANT:

A single copy of an abnormal gene, inherited from either of the biological parents, is required for the hypodontia condition to develop.

X-LINKED DOMINANT:

One dominant abnormal gene is located on the X chromosome. This means that a male (AMAB, assigned male at birth) with X-linked hypodontia will transmit the abnormal gene to all of his daughters.

X-LINKED RECESSIVE:

There are one or two recessive abnormal genes located on the X chromosomes. This implies that a female (AFAB, assigned female at birth) with X-linked hypodontia has:

There is a 25% chance of having a daughter with the abnormal gene.
A 25% chance of having a daughter without the abnormal gene.
There is a 25% chance of having a son who suffers from hypodontia.
A 25% chance of having a son who is not affected by hypodontia.

DOES HYPODONTIA HAVE A STRONG GENETIC INFLUENCE?

Yes, genetics play a significant role. If a member of your family tree has it, it may be present in future branches as well!

Our parents can pass down the hypodontia gene to us via many routes:

Both parents share the autosomal recessive gene, though they do not show symptoms. Parents must be carriers of this gene for their children to develop hypodontia.
Autosomal dominant A single parent needs to be genetically dominant to pass on hypodontia to their children.
X-linked dominant and X-linked recessive X genes on chromosomes can affect aspects like hypodontia.

If we dig more deeply into the genes behind hypodontia, certain genes are frequently mentioned:
Common Genes Linked to Hypodontia

PAX9 (paired box gene 9)
MSX1 (muscle segment homeobox 1)
AXIN2 (axis inhibition protein 2)
EDA (ectodysplasin A)

These genes are often associated with non-syndromic hypodontia, meaning the condition exists without other symptoms. Mutations or changes in these genes can lead to missing teeth.

HOW HYPODONTIA AFFECTS ORAL HEALTH?

Missing teeth can have a psychological impact, reducing self-confidence, mainly when the gaps are visible. Beyond aesthetics, hypodontia can cause significant oral health concerns.

IS HYPODONTIA A BIRTH DEFECT?

Each tooth has a specific role, and missing teeth can affect the ability to chew or speak. For example, the absence of premolars makes grinding food more difficult, while missing incisors can limit the ability to bite and shred food. Speech problems, such as difficulty pronouncing “f” or “s” sounds, are common.

AESTHETIC ISSUES:

The appearance of your smile can affect how you feel. Many people with missing teeth experience anxiety or self-consciousness and may avoid smiling.

BONE GROWTH AND GUM HEALTH:

Severe hypodontia can hinder jawbone growth, leading to changes in facial structure. Additionally, missing teeth can create pockets where bacteria can collect, increasing the risk of gum diseases such as gingivitis and periodontitis. If you want to know more about periodontitis, then you can read our detailed blog on it.

DIAGNOSIS AND TESTS

HOW IS HYPODONTIA DIAGNOSED?

Dental digital X-rays can confirm the diagnosis of hypodontia. During a dental examination, your dentist will check for other indicators, such as small or peg-shaped teeth and gaps between teeth.

MANAGEMENT AND TREATMENT:

For those dealing with hypodontia, there are several orthodontic treatments to consider:

Braces: Braces help shift and align the teeth to close gaps or prepare for future procedures like bridges or implants.
Dental Bridges: A dental bridge fills the space left by a missing tooth, using the neighbouring teeth as support. The middle section mimics a natural tooth.
Dental Implants: Implants are a permanent solution, replacing missing teeth with artificial ones anchored into the jawbone.
Partial Dentures (Flippers): Removable appliances that act as temporary or permanent solutions for missing teeth.

IS HYPODONTIA PREVENTABLE?

A large proportion of cases of hypodontia is attributed to genetic diseases. If it’s written into your DNA that certain teeth may not be visible, it’s unlikely you can change it. It’s the same as trying to alter the color of your eyes without contact lenses. It’s built in!

There are steps you can take to minimize the chance of developing hypodontia from other influences, including health conditions, environmental influences, and even trauma. In the plan of things, when you have hypodontia on the horizon, it’s more about treating and managing it rather than completely preventing it.

HOW MUCH DOES HYPODONTIA TREATMENT COST?

Hypodontia treatments differ depending on where you live. Dental specialists in cities with larger populations are likely to charge higher charges due to the location of their clinic. Another important factor is the type of treatment you prefer. Are you looking for implants, bridges, or braces that move things around? Each choice comes with its own cost. For instance, dental implants can be more expensive since they’re similar to new teeth.

Certain insurance plans may assist with the cost of hypodontia, but others may not, particularly if you’re suffering from congenital missing teeth. Your dentist will give you an overview of your problem’s appropriate treatment and the cost. Many dental offices offer payment plans that allow you to spread costs over time.

LIVING WITH HYPODONTIA:

IF MY CHILD HAS MISSING TEETH, WHEN SHOULD I VISIT THE DOCTOR?

If your child’s baby teeth don’t emerge (come out of their gums) by age 4, or if permanent teeth are missing by age 14, it’s important to consult your dentist. If you’re concerned about your child’s missing teeth, ask your dentist for advice during a routine appointment.

WHAT QUESTIONS SHOULD I ASK MY DOCTOR?

If you suspect that your child may have hypodontia, here are a few questions you can ask your doctor:

How many teeth are missing?
Does this condition affect my child’s digestion or nutrition?
What are my options for treatment?
How long will the treatment take?
Should I or my child undergo further testing to determine if we have other genetic conditions?

SUMMARY:

Hypodontia, a relatively common yet often misunderstood condition, can impact both children and adults. From the absence of a few teeth to more severe cases, understanding the condition and exploring treatment options is essential for maintaining a healthy smile.

Today, dentists offer a wide range of solutions, from braces to implants, ensuring that those with hypodontia can restore both the appearance and functionality of their teeth. Book an appointment or consult a healthcare professional who can help determine the best course of action if you or a loved one is missing teeth.