Why doesn't my child's baby teeth fall out?

Let's talk about dental agenesis

What is dental agenesis and what does it have to do with baby teeth?

Although the term dental agenesis may not mean much to you, if we clarify the fact that agenesis means 'without birth', you can probably guess what we are talking about. Dental agenesis is a congenital problem that usually affects the wisdom teeth but can actually affect any tooth, usually permanent. It can also occur with a temporary or baby tooth, but this is much rarer. In fact, most of the time, dental agenesis is diagnosed because parents notice that baby teeth last longer than they should.

And the fact is that, as there is no replacement that forces the temporary tooth to fall out, it remains beyond the age at which it usually falls out. This initial clue leads our paediatric dentistry team to carry out a x-ray confirming that there is no permanent tooth waiting for replacement and that it would be a case of agenesis.

Types of dental agenesis

Depending on the number of missing teeth, dental agenesis is referred to as hypodontia, oligodontia and anodontia.

It is called hypodontia The most common form of agenesis, in which between one and five teeth fail to erupt.

Renamed oligodontia when there are six or more, and anodontia when teeth are completely missing. The latter case is extremely rare and there are no statistics on its incidence, only a few cases have been reported in scientific reports and no clear pattern has been established, although the cause is believed to be genetic.

Consequences of dental agenesis

The consequences of dental agenesis vary depending on the number of missing teeth. While the most typical agenesis, that of wisdom teeth or third molars, does not normally affect the patient in any way, when other types of teeth are missing, it can lead to different malocclusions and other functional problems that affect chewing, salivation, pronunciation and a long etcetera.

On the other hand, with a certain number of teeth missing, the jawbone grows less robust and develops to a lesser extent. This is directly related to the issue that most worries those who suffer from agenesis: aesthetics. Depending on the missing tooth, this absence can cause greater or lesser psychological and self-esteem problems. While the lack of teeth in the internal area goes unnoticed, when this absence occurs in the front part of the mouth it can create complexes, leading to cases in which the person does not want to smile, which leads to the development of a more introverted personality than in normal circumstances of dentition at such important ages of change as adolescence, when personality is forged.

In more extreme cases, malformations can occur due to the forced use that our teeth have to endure in order to balance the lack of teeth.

Treatment of agenesis

There are various options for treating agenesis, but depending on the number of missing teeth and where they are located, as well as the condition of the remaining teeth and the age of the patient, we will choose one or the other. Let us review the various options:

Dental implants

The most recommended option in the event of an absence, due to its success rate, versatility and the numerous other advantages we have discussed in other occasions. In order for them to be a treatment to be considered in these cases, it must be ensured that the agenesis has not affected the quality of the bone, as correct bone growth is linked to the normal development of the dentition.


Orthodontic treatment is also an ideal solution for some cases, either to fix the spaces and the bone so that an implant can be made to fill the gaps or, in certain cases, to reduce the spaces that have been created by a specific gap, so that it is not necessary to replace it in order to achieve almost ideal functionality.


For more severe cases, the most practical way to solve the agenesis is through dental prostheses. Depending on the extent of the problem and the number of missing teeth, partial or complete dentures can be fitted. In the end, the aim is to give the patient the possibility to enjoy a normal life, in which neither chewing nor aesthetics are affected.

Space maintainers

Finally, space maintainers are also often used as a way of preventing other teeth from taking the place of the missing one, causing greater problems. This allows the jawbone to develop normally, so that later on an implant can be used to cover the gap.

If you recognise yourself in this case and want to explore your options, or if you think it may be your children's case, ask for a citation at the clinic, where we will be happy to help you.

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