European Archives of Paediatric Dentistry

, Volume 15, Issue 6, pp 449–454 | Cite as

Management of a child with severe hypodontia in the mixed dentition stage of development

  • H. J. TongEmail author
  • J. F. Tahmassebi
Case Report



Severe hypodontia is a condition characterized by developmental absence of six or more teeth and affects 0.14–0.3% of the overall population. Hypodontia can have a marked psychosocial effect and functional implications for a growing child.

Case report

A 10-year-old girl with a medical history of hypothyroidism and repaired spinal bifida was referred to the Leeds Dental Institute as she was becoming increasingly concerned about her appearance. On clinical examination, the patient had severe wear of her over-retained maxillary primary central incisors, microdontia of mandibular anterior teeth (32, 34, 41, 42, 43), and loss of anterior vertical dimension. Radiographic examination revealed that the patient had 11 missing permanent teeth (14, 13, 12, 11, 21, 22, 23, 24, 31, 35, 44), an ectopic mandibular left canine and taurodontism of the permanent molars.


Management of the patient included an intensive preventive programme with placement of fissure sealants; scaling of calculus deposition on microdont teeth; composite resin reconstruction of microdont teeth; fabrication of removable partial overdentures tailored aesthetically to match the patient’s age; orthodontic consultation and monitoring for the eruption of ectopic canine and permanent dentition. The patient and her parents reported marked improvement in self-esteem following dental treatment.


After 2 years of follow-up, a new pair of dentures were made and designed to allow ease of eruption of the existing permanent dentition. All permanent teeth have erupted. The patient is ready for further assessment and planning for future orthodontic and restorative/implant treatment.


This case illustrates the essential role of the paediatric dentist in the management of hypodontia in the mixed dentition stage.


Hypodontia Tooth agenesis Mixed dentition 


  1. Al-Emran S. Prevalence of hypodontia and developmental malformation of permanent teeth in Saudi Arabian school children. Br J Orthod. 1990;17:115–8.PubMedGoogle Scholar
  2. Arte S, Nieminen P, Pirinen S, et al. Gene defect in hypodontia: exclusion of EGF, EGFR, and FGF-3 as candidate genes. J Dent Res. 1996;75:1346–52.PubMedCrossRefGoogle Scholar
  3. Arte S, Pirinen S (2004) Hypodontia [Online] INSERM Available:
  4. Brook AH. Dental anomalies of number, form and size: their prevalence in British school children. J Int Assoc Dent Child. 1974;5:37–53.PubMedGoogle Scholar
  5. Brook AH, Elcock C, Al-Sharood MH, et al. Further studies of a model for the etiology of anomalies of tooth number and size in humans. Connect Tissue Res. 2002;43:289–95.PubMedCrossRefGoogle Scholar
  6. Carter NE, Gillgrass TJ, Hobson RS, et al. The interdisciplinary management of hypodontia: orthodontics. Br Dent J. 2003;194:361–6.PubMedCrossRefGoogle Scholar
  7. Chen YH, Cheng NC, Wang YB, Yang CY. Prevalence of congenital dental anomalies in the primary dentition in Taiwan. Pediatr Dent. 2010;32:525–9.PubMedGoogle Scholar
  8. Cobourne MT. Familial human hypodontia––is it all in the genes? Br Dent J. 2007;203:203–8.PubMedCrossRefGoogle Scholar
  9. Durey K, Cook P, Chan M. The management of severe hypodontia. Part 1: considerations and conventional restorative options. Br Dent J. 2014;216:25–9.PubMedCrossRefGoogle Scholar
  10. Endo T, Ozoe R, Kubota M, et al. A survey of hypodontia in Japanese orthodontic patients. Am J Orthod Dentofacial Orthop. 2006;129:29–35.PubMedCrossRefGoogle Scholar
  11. Goodman J, Jones S, Hobkirk J, King P. Hypodontia: 1. Clinical features and the management of mild to moderate hypodontia. Dental Update. 1994;21:381–4.Google Scholar
  12. Grahnen H. Hypodontia in the permanent dentition. A clinical and genetical investigation. Odont Revy. 1956;7(Suppl3):1–100.Google Scholar
  13. Jepson NJ, Nohl FS, Carter NE, et al. The interdisciplinary management of hypodontia: restorative dentistry. Br Dent J. 2003;194:299–304.PubMedCrossRefGoogle Scholar
  14. Lai PY, Seow WK. A controlled study of the association of various dental anomalies with hypodontia of permanent teeth. Pediatr Dent. 1989;11:291–6.PubMedGoogle Scholar
  15. Lammi L, Halonen K, Pirinen S, et al. A missense mutation in PAX9 in a family with distinct phenotype of oligodontia. Eur J Hum Genet. 2003;11:866–71.PubMedCrossRefGoogle Scholar
  16. Nasman M, Forsberg CM, Dahllof G. Long-term dental development in children after treatment for malignant disease. Eur J Orthod. 1997;19:151–9.PubMedCrossRefGoogle Scholar
  17. Nunn JH, Carter NE, Gillgrass TJ, et al. The interdisciplinary management of hypodontia: background and role of paediatric dentistry. Br Dent J. 2003;194:245–51.PubMedCrossRefGoogle Scholar
  18. Polder BJ, Van’t Hof MA, Van Der Linden FP, Kuijpers-Jagtman AM. A meta-analysis of the prevalence of dental agenesis of permanent teeth. Community Dent Oral Epidemiol. 2004;32:217–26.PubMedCrossRefGoogle Scholar
  19. Rolling S, Poulsen S. Oligodontia in Danish schoolchildren. Acta Odontol Scand. 2001;59:111–2.PubMedCrossRefGoogle Scholar
  20. Rolling S, Poulsen S. Agenesis of permanent teeth in 8138 Danish schoolchildren: prevalence and intra-oral distribution according to gender. Int J Paediatr Dent. 2009;19:172–5.PubMedCrossRefGoogle Scholar
  21. Tannure PN, Oliveira CA, Maia LC, et al. Prevalence of dental anomalies in nonsyndromic individuals with cleft lip and palate: a systematic review and meta-analysis. Cleft Palate Craniofac J. 2012;49:194–200.PubMedCrossRefGoogle Scholar
  22. Van Den Boogaard MJ, Dorland M, Beemer FA, Van Amstel HK. MSX1 mutation is associated with orofacial clefting and tooth agenesis in humans. Nat Genet. 2000;24:342–3.PubMedCrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2014

Authors and Affiliations

  1. 1.Discipline of Orthodontics and Paediatric Dentistry, Faculty of DentistryNational University of SingaporeSingaporeRepublic of Singapore
  2. 2.Child Dental HealthLeeds Dental InstituteLeedsUK

Personalised recommendations