A child's radiant smile with missing teeth symbolized by twinkling stars in a gentle dental setting.

When Baby Teeth Don't Show: Understanding and Addressing Agenesis

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Kai Mendoza in Health & Wellness August 2025 • 4 min read.

"Navigating the complexities of missing primary teeth in children and exploring options for dental rehabilitation and long-term oral health."


Agenesis, the absence of one or more teeth, is a relatively rare occurrence in primary (baby) teeth. While it might seem concerning, understanding the condition and available interventions can help ensure your child's healthy dental development and overall well-being. Spotting missing teeth early is key.

In typical dental development, the reduction in the number of teeth often parallels a decrease in jaw size, reflecting human evolution. Hypodontia refers to the absence of a few teeth, oligodontia to the agenesis of numerous teeth (more than six), and anodontia to the complete absence of teeth. Hypodontia affects 0.1 to 0.9% of primary dentition and 2 to 10% of permanent teeth. Often, it involves the upper lateral incisors, lower central and lateral incisors; lower incisors being the common missing teeth in the Asian population.

Oligodontia, particularly in permanent teeth, is more common and is generally considered a variation of normal. However, it can also be linked to specific syndromes like ectodermal dysplasia or other systemic conditions. Recognizing the signs and seeking appropriate dental care are essential steps in managing agenesis and supporting your child’s dental health.

Understanding Agenesis: A Closer Look

A child's radiant smile with missing teeth symbolized by twinkling stars in a gentle dental setting.

A recent case study highlights the complexities of managing agenesis in primary teeth. A 6-year-old Asian girl was referred to a pediatric dentistry department because of several missing teeth. She was otherwise healthy, with no reported systemic diseases or significant family history. Clinical and radiographic evaluation revealed that she had only six primary teeth. This prompted the fabrication of maxillary and mandibular removable partial dentures for prosthodontic rehabilitation.

The girl’s oral examination revealed the presence of specific teeth: maxillary right and left primary second molars, mandibular right primary second molar, and mandibular left primary canine, first, and second molars. These teeth were normal in size, shape, and color. However, the alveolus (the bony socket for the teeth) was very thin. A panoramic radiograph confirmed the congenital absence of 14 primary teeth, including maxillary and mandibular incisors, canines, and first primary molars. The radiograph also showed the presence of all four first permanent molar tooth buds, lower left first and second premolar tooth buds, and lower right and left second permanent molar tooth buds. It also indicated the beginning of calcification of some premolars.

  • Genetic factors: Often, a dominant autosomal gene pattern with incomplete penetrance plays a significant role.
  • Environmental influences: Trauma, infection, radiation overdose, and certain systemic conditions can impact tooth development.
  • Syndromic associations: Oligodontia can sometimes be associated with ectodermal dysplasia or severe systemic abnormalities.
  • Evolutionary trends: Reduction in tooth number may be linked to the ongoing reduction in jaw size in human evolution.
The treatment plan focused on creating simple acrylic partial dentures and educating the child and her parents about oral health. Maxillary and mandibular removable partial dentures were fitted with minor occlusal adjustments. Instructions were provided on the proper insertion, removal, and maintenance of the dentures, along with guidance on maintaining adequate oral hygiene. Regular follow-up appointments were scheduled every three months to make necessary adjustments and monitor the patient’s compliance and oral hygiene.

The Bigger Picture: Addressing Oligodontia for Overall Well-being

The role of a pediatric dentist extends beyond addressing the immediate dental issues; it significantly contributes to the child's overall development and well-being. Early detection and rehabilitation of children with oligodontia play a vital role in helping them interact confidently and integrate seamlessly with their peers and society. Monitoring the long-term impacts on facial structure and permanent tooth development is also essential for comprehensive care and future planning.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5005/jp-journals-10005-1188, Alternate LINK

Title: Agenesis Of Multiple Primary Teeth And Its Rehabilitation: A Case Report

Subject: Periodontics

Journal: International Journal of Clinical Pediatric Dentistry

Publisher: Jaypee Brothers Medical Publishing

Authors: N Sivakumar, Md Akhil Quadar

Published: 2013-01-01

Everything You Need To Know

1

What is agenesis, and how does it relate to missing baby teeth in children?

Agenesis, specifically hypodontia, oligodontia, and anodontia, refers to the absence of one or more teeth. Hypodontia is the absence of a few teeth, oligodontia is the absence of many teeth (more than six), and anodontia is the complete absence of teeth. This condition can affect both primary (baby) teeth and permanent teeth. The absence of teeth is usually noticed during a dental exam or via radiographs.

2

What are the typical steps in treating oligodontia in a child who is missing multiple primary teeth?

The most common treatment for oligodontia in young children involves the use of maxillary and mandibular removable partial dentures. These dentures help with chewing, speech, and maintaining space for future permanent teeth. Regular dental check-ups are essential for adjustments and monitoring oral hygiene. Educating the child and parents about the importance of oral hygiene and proper denture care is also essential for successful treatment.

3

What are the primary causes or contributing factors that lead to agenesis in baby teeth?

Several factors can contribute to agenesis including: Genetic factors, often following an autosomal dominant pattern, Environmental influences like trauma, infection, or radiation, Syndromic associations such as ectodermal dysplasia, and Evolutionary trends related to the reduction in jaw size. The exact cause can vary, and in some cases, it may be a combination of these factors.

4

What are the broader implications of oligodontia for a child's overall development and well-being?

Agenesis, specifically oligodontia, can have a significant impact on a child's development and well-being. Early detection and intervention, often with maxillary and mandibular removable partial dentures, helps children interact confidently and integrate seamlessly with their peers. It also maintains proper spacing for the eruption of permanent teeth, which influences facial structure and overall dental health in the long term. Neglecting oligodontia can affect speech development, nutritional intake, and self-esteem.

5

Are maxillary and mandibular removable partial dentures the only available treatment for children with missing teeth (oligodontia)? What other options might be considered?

While the case study mentioned the successful use of maxillary and mandibular removable partial dentures in a young girl with oligodontia, other potential treatments exist depending on the specific situation. These can include: Space maintainers to preserve space for future teeth, Orthodontic treatment to align existing teeth and close gaps, and Dental implants or bridges as the child gets older and their jaw development is complete. The best course of action is determined by a pediatric dentist based on a comprehensive evaluation.

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