What is Anodontia

May 08, 2021

The development of teeth and the way they find their positions in the oral cavity is called dentition. Humans develop two types of dentition in their lifetime - primary and permanent. Primary teeth or milk teeth erupt between 6 to 8 months of age. A full set of primary teeth is complete by 3 years of age. The permanent teeth begin to erupt at 6 years of age and the dentition is completed by 12 to 14 years of age. The third molar may or may not erupt.

Problems arise when the teeth fail to erupt, be it in the primary or the permanent dentition. Such abnormalities are usually diagnosed through regular dental check-ups and radiographic (x-ray) examinations. Three conditions may arise when teeth fail to erupt: hypodontia, oligodontia or anodontia. Hypodontia is when one to six permanent teeth are absent. Oligodontia is when more than six permanent teeth are absent. Anodontia is when there is complete absence of teeth. In this article, we shall be focusing on anodontia.

Anodontia is a genetic condition. The exact number of genes involved are still unknown. However, the genes involved are related to bone formation around the teeth, muscle attachments to the jaws, positioning of the teeth, etc. Mutation of these genes result in the agenesis (failure to develop) of teeth. All organs in human body are derived from three layers present at birth. These are the ectoderm, mesoderm and endoderm. The teeth, hair, skin, nails, etc are derived from the ectoderm. When the development of ectoderm is hindered, it in turn leads to the abnormal formation of the structures derived from it. This is another genetic condition called ectodermal dysplasia. The presence of these condition is a strong factor for anodontia, hypodontia or oligodontia.

Parents need to be educated about the eruption patterns of primary and permanent teeth. When primary teeth do not erupt by the age of 2 to 2.5 years, or when the permanent teeth do not erupt till 10 years of age, anodontia can be suspected. Addressing anodontia during childhood is important as it can have an effect on the child's social and psychological defect. The lack of teeth can also affect the normal speech of the child who can find it difficult to pronounce sounds lik t, th, dh, r, l, etc. The most compromised factor is the child's diet. Inability to breakdown food can lead to poor absorption of dietary sources, hinder the gastrointestinal system and affect the normal growth of the child. Even though aesthetics is not a major concern at this age, a toothless smile can certainly draw negative impact among the patient's peers of the same age.

A toothless oral cavity can also result in fast depletion of the jaw bones. This can further lead to a decrease in the vertical growth of the face. In order to prevent this, and restore the functioning of the oral cavity, artificial prosthesis like dentures, bridges or implants are the treatment modalities. Dentures are cost effective and the most common choice for countering anodontia. They can be removable or fixed based on the patient's bone density and developmental stage. Bridges are usually selected for cases of hypodontia or oligodontia. Here, the artifical prosthesis replace the missing teeth and take the support of the adjacent natural teeth present. Dental Implants for anodontia can be a very expensive alternative. Moreover, these can be opted for only once the patient is over 15 years of age (for girls) or 17 years of age (for boys). This is because by this age the patient completes skeletal maturation is complete. Since implants are fixed within the bone, it is important that the clinician evaluates all the growth related factors before using implants to treat a patient with anodontia.

Anodontia can have a strong impact on the quality of life of an individual. Patients with anodontia need to be reassured by the dentist that the condition can be countered with suitable prosthesis. Maintenance of gums (gingiva) is of prime importance in patients of anodontia. The artificial prosthesis is likely to inflame the gingival tissues or cause irritation if not maintained properly. Following a dental prosthesis, a patient with anodontia can see a gradual change in his or her speech, aesthetics and development. The latter can be a result of the new and improved ability to break down foods. Parents need to keep an eye on their children's dental health, and ensure a regular 6-month visit to the dentist. This should be done in order to keep a check that such adverse underlying conditions do not hamper their child's development in the future.

Comments