A guide to hypodontia

Missing teeth might sound unusual, but it’s actually more common than you think – especially when adult teeth simply never develop. This condition is called hypodontia, and at Ewell Orthodontics, we help patients of all ages manage it with personalised treatment plans designed around their needs and goals.

Whether you’re a parent wondering why your child’s adult teeth haven’t appeared, or an adult who’s lived with gaps for years, we’re here to guide you through the options available.

What is hypodontia?

Hypodontia is the medical term for congenitally missing teeth, which means one or more adult teeth never develop. It can affect both the baby and permanent teeth, but most often, it’s the adult teeth that are missing.

The most commonly missing teeth include:

• Second premolars (towards the back of the mouth)
• Upper lateral incisors (next to your front teeth)
• Wisdom teeth (although this is very common and usually less concerning)

What causes hypodontia?

Hypodontia is often inherited, so it tends to run in families. If a parent or sibling has missing teeth, there’s a higher chance you or your child may also have them. Occasionally, it can be linked to developmental conditions, but in most cases, it’s simply down to genetics.

How is hypodontia diagnosed?

Hypodontia is typically diagnosed during a routine dental or orthodontic assessment. If adult teeth don’t come through when expected, your dentist may take an X-ray to check whether they are developing underneath the gums.

At Ewell Orthodontics, we often spot hypodontia during early consultations with children. That’s why we recommend booking a free consultation from around age 9 – early diagnosis gives us more time and flexibility to plan the right treatment.

Treatment options for missing teeth

If you or your child has hypodontia, there are a number of ways we can manage it.

Treatment will depend on:

• How many teeth are missing
• Which teeth are affected
• The size of the gaps
• Your bite and overall oral health
• Whether the baby teeth are still present and healthy

We’ll work closely with you and your dentist to explore all the possibilities and find a solution that’s right for you.

1. No treatment

Sometimes, the best option is to do nothing – especially if:

• You’re not bothered by the gaps
• The baby teeth are still there and working well
• Treatment wouldn’t make a big difference to appearance or function

However, it’s important to understand the possible consequences:

• Baby teeth may become loose or wear down over time
• Adjacent or opposing teeth may shift, affecting your bite
• Delaying treatment may limit future options

If you choose to wait, we’ll monitor things closely and review the situation as needed.

2. Managing baby teeth

If baby teeth are still present and healthy, we may recommend keeping them for as long as possible. In the absence of adult teeth, baby teeth can act as useful placeholders and may last well into adulthood with proper care.

In some cases, we may plan to remove baby teeth to create space for orthodontic treatment, but this will always be considered carefully as part of your treatment plan.

3. Orthodontic treatment

Fixed braces or clear aligners can play a key role in managing hypodontia. Depending on your specific needs, orthodontic treatment may be used to:

• Close gaps where teeth are missing
• Open or adjust spaces for future tooth replacement
• Improve bite and alignment for better function and appearance

For younger patients, we can support jaw development and early tooth movement using Angel Aligner KiD – a gentle, discreet option designed specifically for growing smiles.

4. Restorative treatment

Once orthodontic treatment is complete – or in some cases instead of it – we may recommend restorative options to replace missing teeth. This might include:

• Dental implants – long-lasting and natural-looking replacements
• Bridges – false teeth anchored to adjacent teeth
• Dentures – removable options, often used for multiple missing teeth
• Composite bonding – to adjust the shape or size of existing teeth to close small gaps

Often, orthodontics is used first to position the teeth correctly, making the replacements look and function more naturally.

We’ll work closely with your own dentist or with our in-house dentist, Dr Neva Patel, to ensure the best possible outcome for your smile.

5. Wearing retainers

Whatever treatment path you choose, wearing retainers afterwards is essential. They keep your teeth in their new position and prevent unwanted movement while waiting for further treatment like implants or bridges.

We’ll provide custom retainers and full instructions on how to wear and care for them – and we’ll be here to replace them if they’re lost or damaged.

Helping you make the right decision

Choosing the right treatment for hypodontia isn’t always straightforward. You may want to avoid certain types of treatment or take things step-by-step. That’s completely fine – our role is to support you with honest, expert advice.

The earlier we can assess things, the better. That’s why we offer free orthodontic consultations from age 9. Whether you’re a parent looking out for your child’s future smile or considering treatment for yourself, we’re here to help.

Book online or call our friendly team to arrange your no-obligation appointment with a specialist orthodontist in Ewell, Surrey.

You can also find lots of useful information at mymissingteeth.co.uk.