Orthodontics
Congenitally missing teeth
Some people are born without one or more adult teeth ever forming.
Cause
Tooth never develops
Common in
Certain tooth types
Often
Runs in families
Plan
Close or replace gap
Overview
Sometimes an adult tooth never develops under the gum. This is fairly common with certain teeth, such as the upper side teeth or some premolars.
If a baby tooth is holding the space, it may last for years but can be smaller and may eventually be lost. Options include orthodontics to close or open the gap, or later replacing the tooth.
What to know
- An adult tooth never forms under the gum
- Often runs in families
- A baby tooth may hold the space for a while
- Gaps can be closed or kept open with braces
- Replacement options are planned over time
Common questions
How do you know a tooth is missing?
An x-ray shows whether an adult tooth is present under the gum.
Will my baby tooth last?
It may last many years, but can be smaller and wear over time.
What are the options for a gap?
Closing the space with braces, or keeping it for a future replacement.
Is this my fault?
No. It is usually inherited and not caused by anything you did.
When is treatment planned?
Often during the teenage years, working with growth and orthodontics.
Related topics
Why orthodontics?
Straightening teeth can improve how your bite works, looks and stays clean.
Dental implants
A titanium post that replaces a missing tooth root and holds a new tooth.
Dental bridge
A fixed way to replace one or more missing teeth using nearby teeth for support.
Space maintainers
A small device that holds space when a baby tooth is lost too early.
Dr Rick Iskandar · Reviewed June 2026