When Permanent Teeth Don’t Grow 

Treatment Options for Congenitally Missing Lateral Incisors 

According to recent estimates, some 178 million Americans are missing at least one tooth—that’s around three quarters of U.S. adults over age 20. Some teeth are lost due to decay or accidents, while others may have been extracted to resolve dental issues such as crowding in the jaw or impacted wisdom teeth. And some individuals are missing teeth because one or more of their permanent teeth simply didn’t develop—in other words, they are congenitally (“con” – together with; “genitus” – born) missing. Having a missing tooth anywhere can create problems for your oral health. But when the gap is right up front, it’s hard to miss; it causes your smile to look much less appealing. Over time, missing teeth can also lead to bite problems, as well as difficulties with speech, nutrition and self-esteem. 

The maxillary lateral incisors are a pair of upper teeth located immediately to the left and right of the central incisors (the “two front teeth”). On the other side of them are the pointy canine teeth (also called eyeteeth). Because they are near the front of the mouth, these teeth are quite visible in the smile. They are also the third most likely (after certain molars and premolars) to be congenitally missing. This form of hypodontia (hypo – “below normal”; dont – “teeth”) affects about 2% of the population and usually results from genetic factors. 

Contemporary dentistry offers a number of effective methods for replacing missing teeth. But when maxillary lateral incisors don’t develop, filling their place in the smile involves some unique challenges. Because they are in a highly noticeable area, aesthetics is a major concern: Not only must the teeth themselves look natural, but the gum line that frames the smile should also be even and healthy in appearance. 

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