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A Smile With Birth-Related Missing Teeth Can Be Restored


Like clockwork, a child's primary teeth fall out and their new permanent teeth soon erupt. Except when they don't: up to one in four people are missing teeth that never developed.

Congenitally missing teeth is a common birth malformation among people. Usually the teeth missing are the third molars (wisdom teeth), which may not have that great an effect on appearance or function. But about 5% of the population are missing one or more second premolars (closer to the front of the face) or the upper lateral incisors, just to the outside of the central incisors front and center in the “smile zone.”

The latter circumstance can definitely affect a person's appearance. The missing lateral incisors can make the sharp-tipped canines (eye teeth) normally to the outside more prominent. The canines may also drift into the open space toward the central incisors, rounding out what can be a rather odd-looking smile.

This is a situation that should and can be corrected, for the sake of both the smile appearance and healthy dental function. The most common treatment is to orthodontically move any misaligned teeth (like the aforementioned canines) into their proper positions and replace the missing teeth with some form of restoration like dental implants.

The real issue is the timing of these treatments, especially for younger patients who are still in the midst of jaw development. Orthodontics can be undertaken at an early age, with the bite correction maintained through retainers or other appliances. But replacing missing teeth with dental implants should wait until jaw development has fully completed around early adulthood.

If we place an implant before this, there is a moderate to high probability the jaw line will “outgrow” the implants and cause them to look out of place with the rest of the teeth. In the meantime, we can provide temporary restorations for the missing teeth such as attaching an artificial tooth to the retainer appliance to fill in the tooth gap.

A patient who is missing teeth that never were can have them replaced and their bite corrected. With a little time and patience, we can transform this kind of “toothless” smile.

If you would like more information on using orthodontics to enhance a smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When Permanent Teeth Don't Grow.”

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