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Why Do Some People Have Small Teeth

by Annabel Caldwell
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Why Do Some People Have Small Teeth

Why Do Some People Have Small Teeth

Some individuals have teeth that are not only short but are also smaller in general and may look more like baby teeth than adult teeth. This is known as microdontia and is usually caused by a genetic condition. There are three different types of microdontia.

The human mouth contains 32 teeth — one central incisor, or eye tooth, two canines (front), two lateral incisors (side) and four premolars on each side. The first molar to erupt into the permanent dentition is called the “primary” second molar because it develops before all other permanent teeth. It is the primary molar which determines our dental arch length. If this molar does not develop correctly, we will end up with an underdeveloped dental arch, known as oligodontia. Oligodontia occurs when there are fewer than six teeth present between both upper and lower arches. These missing teeth are often replaced by supernumerary teeth or impacted wisdom teeth.
If you’re born without any teeth or if they fall out early in your life, then you might wonder why some people have small teeth. In fact, many people don’t think about their own teeth at all until someone points them out and makes them feel self-conscious. But for others, having small teeth isn’t something they even notice, especially since most adults have had their permanent teeth for years.
Sometimes, however, the lack of large teeth can make a person stand out among his or her peers. For example, if you were to attend a formal event where everyone was wearing white dress shirts, you would probably find yourself wondering what’s so special about yours. While some people are blessed with big chins, others seem to be cursed with undersized mouths.
This condition is known as microdontia and has been described as being either generalized or specific. Generalized means that the entire mouth appears smaller than normal, while specific means that just certain parts of the mouth are affected. According to the American Association of Orthodontists (AAO), approximately 1 percent of the population — or roughly 6 million people worldwide — suffers from microdontia. Microdontia affects males and females equally, although it tends to occur somewhat less frequently in men than women [sources: AAO; NIDCR].
Microdontia can affect several areas of the face including the jawbone, lips, nose, cheekbones and chin. Sometimes, the size difference between the top and bottom front teeth can be significant enough to cause speech problems. One type of microdontia, termed maxillofacial micrognathia, causes the lower lip to protrude forward over the upper lip, making speaking difficult. Another type, termed mandibular hypoplasia, results in a reduced jaw bone that can cause facial asymmetry and pain when chewing food.
Genetic disorders are responsible for 90 percent of cases of microdontia, and these conditions tend to run in families. However, environmental factors such as trauma during birth, infections, nutritional deficiencies and exposure to toxins can also lead to the disorder.
So how do you know whether you’ve got microdontia? Read on to learn how to determine if you do.
How Can You Tell If You Have Microdontia?
While few people are aware of it, microdontia is quite common. Even though it’s rarer than cleft palates, it’s estimated that 2 percent of the U.S. population suffer from microdontia. So how exactly can you tell if you have microdontia?
First, you need to understand the differences between your natural teeth and your artificial teeth. Artificial teeth, known as false teeth, are made out of porcelain or metal, depending on the material used. Since your real teeth aren’t visible, your dentist won’t be able to use x-rays to view the interior of your mouth. Instead, he or she must rely on physical examinations and impressions taken of your gums.
Your dentist will take measurements of your mouth using calipers to measure the distance between the roof of your nose and the floor of your mouth. He or she will compare those measurements with standard charts provided by the World Health Organization and the International Committee for Standards. Those measurement should come back within 10 percent of the accepted range.
To get a better idea about how much space is available inside your mouth, try sticking your tongue out as far as possible. Your tongue should form a straight line connecting your cheeks to the tip of your palate. A tongue that doesn’t extend past the midline of the face indicates microdontia.
Next, check your teeth. When looking down at your smile, hold a piece of paper horizontally above your head. Then place a pencil mark at the center of your upper lip. Where this line falls on the paper is the horizontal extent of your upper lip. Now look at your teeth. Is your lower lip covering part of your upper teeth? That’s good news — you likely have full sets of teeth. On the other hand, if your lower lip covers only part of your teeth, you may have microdontia.
Now you’ll want to visit your dentist, who will perform additional tests to help him or her determine what kind of microdontia you have. To see examples of how various degrees of microdontia manifest themselves, read on.
Degrees of Microdontia
There are three different types of microdontia. First, there’s true microdontia, which describes a total absence of teeth. Second, there’s conical mesiodens, which refers to teeth that appear larger than usual due to malformed roots. And third, there’s peg-shaped teeth, which are teeth that grow outward rather than downward. As you can imagine, these types of teeth can result in difficulty eating and speaking.
True microdontia is actually very rare. Only about 3 to 7 percent of patients diagnosed with microdontia have no permanent teeth at all. Most of these people do have temporary teeth, or deciduous teeth, which typically fall out once the patient reaches adulthood.
Conical mesiodens are another frequent type of microdontia. They mostly occur in the upper arch and rarely involve the lower arch. Conical mesiodenses often require root canal therapy to save them from extraction.
Peg-shaped teeth are the most severe form of microdontia. They are located along the upper and lower arches, and sometimes appear in pairs. Peg-shaped teeth are usually retained due to the presence of supplemental teeth, otherwise known as supernumeraries. Supernumeraries are teeth that develop outside the oral cavity, and can appear anywhere in the mouth, from underneath the gum line to behind the wisdom teeth.
Treatment options vary according to the severity of the case. Because of the potential complications associated with microdontia, early detection is critical. Once you know that you have microdontia, contact your health care provider immediately to schedule an appointment with a specialist who specializes in orthodontics. Treatment is required starting when children are young, and often includes braces and/or surgical procedures.
For more information about microdontia, its symptoms and treatment methods, explore the links on the following page.
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In addition to microdontia, there are other conditions that could mimic it. Although rare, a person could have a congenital abnormality that causes teeth to grow inward instead of outward. Also, enamel hypoplasia is a defect in the development of the outer layer of a tooth. Enamel hypoplasia can occur naturally or as a result of trauma or infection. Finally, a person who smokes cigarettes could experience a loss of teeth as a result of tobacco consumption.

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