Q: My son has had bitewing and panoramic X-rays taken, and is missing seven primary and at least seven secondary (adult) teeth. He appears to be a normal, healthy 5-year-old boy. We are being treated by a good pediatric dentist and have been to a few others, but no one has seen a child like him. They have ruled out ectodermal dysplasia. What other developmental problems should we be looking for? Can dental implants be used to replace his missing teeth?
A: The cause of your son's missing teeth can either be hereditary, or associated with a disease process. Some disorders that are associated with missing teeth include: ectodermal dysplasia (which has been ruled out), Down's Syndrome, cleft lip and palate, clediocranial dysplasia, Treacher Collins Syndrome, incontinentia pigmenti and others. If these possibilities have been ruled out and your son is otherwise healthy, I would recommend getting him some type of removable dental appliance.
At age 5, a dental appliance can be made that looks like a retainer (used when dental braces are removed) that has teeth on it to replace the missing ones. When your child reaches 16 or 17 and most of his facial skeleton has developed, you can consider the possibility of dental implants or other permanent tooth replacements.
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