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Healthy Mouth, Healthy Kids

Missing baby teeth, no adult teeth coming in



Several of my husband`s nephew`s baby teeth never grew in, and there are no adult teeth buds in his xrays. The bone in the lower jaw appears to be deteriating. I`m concerned that this beautiful boy who is 5, will never have a strong smile, and may start getting a deformed jawline. There has been talk of bone grafts, tooth implants and weak anchor teeth. Do you have any suggested reading? I have looked out on the internet and have found odontodysplasia, but in this case it sounds more severe. I`d like to do some research to help my sister-in-law. She is just worried sick.


Thank you for your question.  The most critical step is making sure that with the dental anomalies noted there are no systemic problems - many syndromes will have missing/extra teeth as a feature - and an evaluation by a pediatrician may be warranted. It is not unusual for some tooth buds to be barely visible at such a young age.

Secondly, an aggressive treatment plan such as some of what you have suggested should ideally be managed by a team approach; a pediatric dentist, oral and maxillofacial surgeon, orthodontist should be consulted prior to initiating potentially life-altering treatment.

In terms of getting information, while some oral pathology textbooks may be of use, if you are searching, I would use search terms such as 'hypodontia (fewer teeth than normal), anodontia (absent teeth), ectodermal dysplasias (a disorder with missing teeth as a classic feature). I would also inquire if anyone else on either side of family may have been missing teeth.

It would be helpful for you if you had some type of an actual diagnosis for why the teeth are missing.

I hope this helps and good luck.

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Response by:

Sarath  Thikkurissy, DDS, MS Sarath Thikkurissy, DDS, MS
Director, Residency Program, Division of Pediatric Dentistry and Orthodontics
College of Medicine
University of Cincinnati