It is around the sixth month of life that the first baby teeth begin to appear and the baby starts to show that mischievous childlike smile. At this stage, children still don’t need to chew, but the teeth are already getting ready to start working full steam ahead soon enough.

What is Childhood Dental Agenesis

Dentition is a very important topic and requires care from the very first months of life. One of the dental problems that can occur is the absence of one or more teeth in the child’s dental arch—this anomaly is called dental agenesis. Generally caused by a genetic deficiency, and although not widely known, it is a fairly common anomaly and should be diagnosed still in childhood to allow for proper treatment.

Is Dental Agenesis a Disease?

Dental agenesis is not considered a disease, but rather a dental anomaly caused by the absence of one or more teeth, which can be a baby tooth or its permanent successor. When it happens with baby teeth, the diagnosis can be late since children’s teeth do not all emerge at once; they appear one by one, making it harder to notice when one is missing.

Origin of Dental Agenesis

Its origin may be due to a failure in the proliferation of the dental lamina, which is the tissue that forms teeth, usually caused by a genetic deficiency. Agenesis corresponds to the absence of any tooth in the arch, but it is most commonly seen with the wisdom teeth (third molars), second premolars, and the upper lateral incisors. When agenesis occurs in the primary dentition (baby teeth) it mainly affects the upper incisor teeth. Although it can also occur with baby teeth, dental agenesis is more common in permanent teeth and affects girls more than boys, unlike the index of supernumerary teeth (extra teeth), which is more common in boys. In Brazil, agenesis is a problem that affects 2% to 5% of the population. Regardless of which tooth is missing, agenesis can be unilateral—on only one side of the arch—or bilateral, with bilateral cases being the most common.

Classifications of Childhood Dental Agenesis

There are three classifications of dental agenesis, named according to the number of missing teeth: Hypodontia: Absence of fewer than six permanent teeth Oligodontia: Absence of more than six permanent teeth Anodontia: Absence of all permanent teeth Dental agenesis is not just an aesthetic problem, especially if it affects the front teeth, which are more visible, but it is still a sign that there is a genetic issue that needs to be evaluated by a specialist so that, once diagnosed, treatment can begin as soon as possible.

Diagnosis

One of the signs that can be noticed by parents and may indicate that the child has dental agenesis is a delay in loosening and shedding (exfoliation) of baby teeth, which usually occurs between ages 5 and 7. If you notice that your child is past this age and hasn’t lost any baby teeth yet, it’s best to seek out a pediatric dentist for an evaluation. It is likely that the dentist will request an X-ray to examine the dental arch. Through this exam, it’s possible to identify the absence of the germ of the permanent tooth, thus confirming dental agenesis. If dental agenesis is diagnosed early, the treatment options are more varied and, consequently, the results are faster and more satisfactory. So, always pay close attention to your children’s oral hygiene and at the first sign of a problem, consult a specialist. Since the most common cause for this dental deficiency is genetic, if there are any cases in the family, pay extra attention during tooth replacement, and as a preventive measure, a dental X-ray is recommended around the age of five.

How to Treat Childhood Dental Agenesis

Well, there are a few treatment options to fill the gap left by the missing tooth; determining the most appropriate one depends on factors such as the number of missing teeth, their position in the arch, the patient’s age, and dental and even facial characteristics. The most recommended treatments are:

  • Orthodontic appliance: works on the dental arch to close the empty space
  • Composite resin: If the space is relatively small, the crowns of neighboring teeth can be enlarged with tooth-colored resin, filling the gap and solving aesthetic issues
  • Implant or prosthesis: Recommended for cases where closing the gap isn’t possible with orthodontic devices

Treatment with an orthodontic appliance or resin can even begin in childhood, but of course with evaluation from a pediatric dentist, since it will depend on whether the other permanent teeth are already in place. In cases where an implant or prosthesis is required, the empty space is maintained until adulthood. Remember to consult a specialist if you notice any sign that baby teeth are not falling out or permanent teeth are not coming in as expected. Only a dentist can assess if your child has dental agenesis and, if that diagnosis is confirmed, indicate the most suitable treatment. Although not directly related to this anomaly, regular and proper mouth hygiene is always extremely important for dental health. It never hurts for us to supervise and make sure the kids really brush their teeth thoroughly! See also: Oral Hygiene from Birth through Childhood Photo: Bigbear