What Are the Options for Replacing Missing Teeth?

Cases of congenitally missing teeth aren’t uncommon, but patients who are missing permanent teeth often are quite concerned that a beautiful smile is out of their reach. We are happy to report that this is not the case. There is a solution for patients who are missing some of their permanent teeth.

What are Congenitally Missing Teeth?

This is the term used to describe the condition in which people are born without one or more of their permanent teeth. Sometimes people are missing teeth due to decay or trauma, but congenitally missing teeth have to do with genetics. Other terms you might often hear include:

• Anodontia– Being born without one or several teeth.
• Oligodontia– Being born with six or fewer teeth.
• Hypodontia– The absence of more than six teeth.

Conditions that may cause congenitally missing teeth include cleft lip, cleft palate, ectodermal dysplasia, Down Syndrome, Rieger Syndrome and Book Syndrome.

The most common congenitally missing teeth are the third molars or wisdom teeth. Between 10 percent and 25 percent of Americans of European descent are missing at least one-third molar, according to Princeton University researcher Alan Mann. This also is the case for 11 percent of African Americans and 40 percent of Asian Americans. The Inuit who live in the Canadian, Green landian and Alaskan Arctic regions, have the fewest wisdom teeth, with approximately 45 percent lacking one or more third molars.

The good news about missing third molars is that you need not address the issue. Many of us who have third molars have them extracted because our jaws typically aren’t large enough to keep them.

The lower second premolars are the next most common congenitally missing teeth, followed by the upper lateral incisors. Epidemiological studies show that missing one or both of the maxillary lateral incisors occurs in approximately 2 percent of the population, according to Dentistry IQ.

Orthodontics Can Address Missing Teeth

Although missing lateral incisors is not very common, it is the most common case of congenitally missing teeth that we treat in our office, says Dr. Nima Hajibaik, an Alpharetta braces expert.

“It’s important to many parents that we provide a solution to their children’s missing lateral incisors because those teeth are highly visible when speaking and smiling,” Dr. Nima says. “There’s no way that people won’t notice that those teeth are missing.”

Addressing the issue requires a two-pronged approach: orthodontic treatment to create or hold a space where the missing teeth should be, and prosthodontic treatment to provide a realistic replacement for the teeth. Failure to maintain the space where the tooth should be could result in loss of dental arch integrity and length.

Another approach, depending on the bite, is to close the missing teeth space with orthodontics. This typically takes 50 percent more time than regular orthodontics but it could be a great option for those who qualify.

Most of our patients with congenitally missing upper lateral incisors are children, which means we often cannot provide a permanent solution even after orthodontic treatment is complete because the child is still growing. Instead, we may use a Maryland bridge. This is a restoration that uses a metal framework with a porcelain tooth baked onto the front of the framework. Metal “wings” on either side of the porcelain tooth are bonded to the back of the teeth adjacent to the missing tooth. This provides a natural-looking restoration. While not permanent, this is a fixed solution that cannot be removed by the patient.

The other popular option is a flipper. This is essentially a retainer with an artificial tooth that looks exactly like a natural tooth. This method can be used until the patient is ready for a permanent restoration.

Once the child reaches adulthood, a permanent solution such as dental implants can be considered.

Dental implants are a viable solution because they integrate themselves into the jawbone just like natural tooth roots. They also look, feel, and function like normal teeth.

Call our office to schedule a consultation if you would like to learn more about treating congenitally missing teeth.