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Missing Teeth? Extra Teeth?

Isn’t that just something I just see on BuzzFeed?

Nope! Researchers estimate that as many as 20% of all adults are born with at least one tooth missing. This condition is called “hypodontia” and it is one of the most common developmental oral health conditions.

What about extra teeth? That is a myth, right? Hyperdontia, the condition where someone is born with extra teeth, occurs in about 1% to 4% of the population. Most of the time it is only ONE extra tooth. BUT, there have been reported cases of dozens of supernumerary (extra) teeth in one person, but that is super rare!

Some typical examples we see in our practice:

Missing Premolars:

Missing premolar

This person was born without a lower left 2nd premolar. The patient was able to keep the baby tooth. The bone around the baby tooth and the adjacent teeth is adequate. We will recommend that the patient keeps that tooth clean and healthy with excellent brushing and flossing. The patient has the potential to keep this baby tooth for decades to come.

Treatment Plan:

  1. Keep baby tooth as long as possible

  2. When tooth is eventually lost, place an implant (oral surgeon/periodontist)

  3. Place a crown on implant (dentist)

Missing Incisor:

Missing Incisor

This adult woman was born without a lateral incisor. Multiple people in her extended family were missing the same tooth. Missing teeth can have a genetic component to it. She was unable to keep her baby tooth and she did not like to smile because she was missing a tooth in front. Dr. Cooke and her team are very sensitive to the fact that missing teeth in the front can be stressful and may be a source of insecurity for some. We make every attempt to get a "pontic" or "fake tooth" in place so the social impact of a missing front tooth is minimized as fast as possible.

Missing teeth in the front of the mouth can be more complicated than missing teeth in the back of the mouth. Factors that we need to keep in mind:

  • Age of patient - it is important to wait for implant placement until growth and development is complete

  • Patients bite affects the treatment decision, each treatment plan is unique

  • Lip line of patient (how patient smiles) plays into treatment decisions

Treatment Plan:

  1. Idealize the space (orthodontist), meaning make the space for the missing tooth the same size as the other side and make sure it is big enough to accept an implant.

  2. Place an implant (periodontist or oral surgeon) for the missing tooth

  3. Place a crown on the implant (dentist)

Supernumerary tooth:

Extra tooth

Even orthodontists's children have teeth problems! This is Dr. Cooke's son, Evan. He has an extra tooth that is nestled right behind his adult tooth. This area is a common area to find extra teeth. This is why Dr. Cooke takes an updated image annually for all of her patients. She is able to identify when people have extra teeth, missing teeth and teeth going in the wrong direction. She is also able to identify the exact right time to remove the extra tooth and when to fix the bite.

Treatment plan:

  1. Monitor the development of the extra "supernumerary" tooth

  2. When the adult tooth is fully formed, the oral surgeon extract the extra supernumerary tooth

Do I need Invisalign or Braces to treat missing or extra teeth?

Dr. Cooke uses both Invisalign and braces to treatment most bite arrangements!

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