Hypodontia

Last revised by Henry Atkinson on 11 Oct 2023

Hypodontia refers to the developmental failure of one or more teeth, excluding the third molars.

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The phenomenon of non-development of teeth has been described using several terms including 'hypodontia', 'oligodontia' and 'adontia'. The descriptor 'congentially missing teeth' has also been used, but may be misleading as teeth development is completed following birth so identification is only possible in early childhood.

Hypodontia is common, affecting between 1.6 to 6.9% of the population with a recognized variations in ethnicities. There is a female preponderance with a M:F of 2:3 1,2.

Hypodontia is relatively rare in the primary dentition, mostly affecting the secondary dentition. The maxillary lateral incisors or mandibular pre-molars are most commonly missing, and in most individuals only one or two teeth are absent . Hypodontia is also associated with microdontia and delayed dental development 1,2.

Absence of one or more of the third molars affects around 20% of the population and is considered part of normal variation rather than hypodontia.

Hypodontia is known to occur with a large range of syndromes including cleft lip and palate, Down syndrome and ectodermal dysplasia, but is also common in non-syndromic patients 1.

Hypodontia is usually assessed using orthopantomography, although cone beam CT may be utilized for problem solving.

Care should be taken not to confuse late calcification of the developing tooth bud with its absence and some authors suggest avoiding the diagnosis of hypodontia in children younger than 9 or 10 years old 3.

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Cases and figures

  • Absent lateral incisors
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  • Ectodermal dysplasia with hypodontia
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