May 10, 2009 –LOS ANGELES AND Santa Monica, CALIFORNIA – Orthodontics can correct a wide variety of tooth crowding, spacing and alignment issues in children and adults.

But what happens when some teeth are missing altogether? Orthodontics offers solutions for that, too, said Santa Monica Orthodontist Dr. Atoosa Nikaeen.

Orthodontists have a couple of options when it comes to addressing this issue, said Nikaeen, a Santa Monica, CA braces expert. First, let’s look at what causes this condition.

Congenitally missing teeth- also known as tooth agenesis- is a fairly common developmental problem occurring in children, according to www.dentalresource.org, a dental health Web site. ( http://dentalresource.org/topics13.htm )

The term that refers to the absence of six teeth or less is hypodontia. Oligodontia is the term used when six or more permanent teeth are missing and there is no associated systemic disorder involved. Common syndromes associated with oligodontia include Down syndrome, Ectodermal dysplasia and Rieger syndrome, according to an October 2008 article in the European Journal of Dentistry. (http://www.eurjdent.com/images/Volume_2/4-299-302.pdf )

Other causes of agenesis can be endocrine, local, environmental and hereditary, the EJD article stated.

Agenesis Treatment

Tooth agenesis is more than an aesthetic problem, Nikaeen said. It also can create functional issues and oral health problems, such as food impaction, bone loss in the area of the missing tooth and adjacent teeth, shifting and tipping of the adjacent teeth to the area, over-eruption of the opposing tooth into the edentulous area and interfering with the bite, to name a few examples.
Treatment of tooth agenesis varies according to the number of missing teeth and frequently involves a multi-pronged approach. The type and distribution of the missing teeth also plays a role in determining treatment options.

In some cases, it is important to have an early diagnosis, Nikaeen said. If the issue is not recognized early enough, the spaces where the missing tooth should be could be lost and the teeth around the missing tooth could shift into the space and tip severely.

In situations where a patient is missing their lateral incisors-upper front teeth- aesthetic issues must be addressed because these teeth- or the lack of- are noticeable when the patient smiles, she said.

“In these cases, we want to ensure that the space remains open so the patient eventually can get dental implants,” Nikaeen said. “We maintain the space so the implants can be placed once the patient stops growing at about age 18.”

There are multiple methods for space maintenance. They can be made of plastic or stainless steel and can be fixed or removable, according to the Colgate Web site. (http://www.colgate.com/app/Colgate/US/OC/Information/Popular-Topics/Orthodontics/Space-Maintainers-For-Premature-Tooth-Loss.cvsp)

“The possibility of congenitally missing teeth is just another reason why parents should take their children to an orthodontist for an evaluation by the time they are seven years old,” Nikaeen said. “When a condition such as this is detected early enough, there are many treatment options that will promotes aesthetics and possibly shorten the time a child spends in future orthodontic treatment.”