Your teeth are like a flock of sheep just shorn,
coming up from the washing.
Each has its twin;
not one of them is alone.
Song of Solomon 4:2
Teeth come in pairs! Their presence and/or absence can mark our smile, giving it character. About a tenth of the general population are missing teeth due to natural causes. Many people don’t develop a number of teeth. The most common teeth to be missing in development are wisdom teeth, followed by our permanent second premolars. The front teeth that are most likely to be missing are our lateral incisors.
It is not unusual to be indifferent about missing posterior teeth. However, when front teeth are missing in development (typically lateral incisors), it is more noticeable, and therefore a cosmetic issue. The lateral incisor often presents different complexities by nature. Peg laterals are lateral incisors that form to a fraction of normal size. Missing teeth may be due to genetics. An individual may have family members that are missing the same tooth. Or relatives that also have peg laterals. The presentation of teeth can be a dominant or recessive trait.
Common causes include cleft lip, cleft palate, and ectodermal dysplasias (a group of about 150 syndromes that affect the hair, teeth, nails, and sweat glands). These syndromes are generally identified earlier in age. A dental exam and a visit to the physician can help in isolating and determining the primary cause of missing teeth.
But alas! There are multiple ways to provide and restore teeth that are missing in development. Orthodontic treatment can align and move other teeth to fill up the space. A dentist can reshape teeth that are moved to fit their position. A temporary solution is a retainer. An essix retainer can be made with a fabricated tooth to fit in the retainer, thereby appearing to be a regular clear retainer while replacing a missing tooth.
Most people prefer a long-lasting solution and a bridge is a viable fixed option for the long haul. A removable partial denture can be useful if there are multiple missing teeth. Given enough bone, implants can be placed in the gap. Bone grafts may be necessary in the absence of sufficient bone. No matter what the cause of missing teeth is, a person can work with their dentist and specialist(s) to come up with an affordable solution, while working towards a more permanent replacement.