Literature Review: Dental Agenesis

Literature review:
Dental agenesis or hypodontia which is congenitally missing teeth has a 6.34% prevalence in Africa (Rakhshan, 2015). African Blacks are the least likely to be affected as seen in a study by Nunn et al. in 2003, the same study also found that mandibular central incisors which are the teeth affected in this case are not commonly affected. Following maxillary lateral incisors they are affected 0.08 – 0.23% of the time.
Hypodontia is commonly associated with various systemic conditions such as ectodermal dysplasia, Down’s syndrome, Rieger syndrome, Book syndrome, Van Der Woude syndrome and cleft lip and palate. These conditions point to a genetic aetiology for hypodontia. When a systemic condition is not present hyopdontia

Other studies have tried to determine the relationship between the mandibular symphysis, some have seen that disturbances to its morphology and growth pattern can cause hypodontia while others show hypodontia can change the morphology of the mandibular symphysis. The aetiology of hypodontia can be multi-factorial with different factors playing a role.
The mechanism of how these factors act is still uncertain but ultimately they cause hypodontia due to either: 1.physical obstruction or disruption of the dental lamina 2.space limitation 3.functional abnormalities of the dental epithelium 4.failure of initiation of the underlying mesenchyme. (Nunn et al., 2003)
Hypodontia affecting teeth in the anterior region poses various physical and emotional problems. These include altered facial appearance, malocclusion, difficulty in mastication and speech (Nunn et al., 2003), delayed primary tooth exfoliation (Neville et al, 2013). A low self-esteem from the negative self-awareness can cause social

Majority of the responsibility lies with the parent. Caries in children needs to be prevented as it decreases their quality of life and causes problems while eating and sleeping. These events can the cause significant weight loss. It can also cause children and parents to miss school and work respectively. The child’s caries can also effect the parent’s sleeping pattern. (Acharya and Tandon, 2011). Paediatric patients with caries might also be subjected to teasing from family and friends due to the smell or colour of the carious teeth. Childhood dental caries play a major role in space loss. First molars can drift mesially and reduce the arch