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December 30, 2009 | dentalproductsreport.com Teens without teeth A genetic condition prevents permanent teeth from forming. Hear from one woman living with the condition and what you can do to help.  Mackensey Carter Both mother and daughter suffer from the same symptoms. Their upper right and left laterals never grew in after their baby teeth fell out. “We’ve been told that this is a genetic condition,” said Mackensey Carter, a Georgetown student who learned of her condition at an early age. “I discovered that I had this condition when I was very young because right when I lost all my baby teeth and my permanent teeth were coming in, I noticed that nothing was growing in the spots by my two front teeth," she said. "I was already planning on having orthodontic work done and x-rays confirmed my condition.” Studying the gene pool The researchers’ efforts revealed that a mutation in the PAX9 gene was responsible for a rare form of oligodontia, missing molars, in a Houston family. Finding more genes responsible for congenitally missing teeth may unravel the genetic code for all teeth, and it may potentially provide for genetic screening and new forms of treatment for individuals with this condition1. Treatment options “The options he gave me for the future were either implants or a complete upper bridge,” Carter said. “ He explained that implants were the better option because they are more permanent and more cosmetically attractive.” Carter’s orthodontist also recommended she wear braces to fix her bite and straighten her teeth before processes were put in place to repair the gaps and missing teeth in her bite. “He recommended that I look into implants around the age of 18 because by that time my teeth would not be shifting as much,” she said. Because Carter did not have any bone to support an implant structure for her upper right and left laterals, her orthodontist started by moving the two teeth on the other side of the missing teeth over so bone could grow in the gap where implants would eventually be placed. After a few months, the teeth were moved back to their normal position and two prosthetic teeth were constructed and fastened onto her braces so the gaps would not be noticeable. After the braces were removed, the doctor constructed a retainer with prosthetic teeth to create the illusion that she was not missing any teeth. Unfortunately for Carter, the orthodontic work that had been done to form bone for implant placement had not created bone with enough depth to withstand a fixed implant. “This meant I would have to have bone grafting done, which is what my orthodontist was hoping to avoid,” Carter said. “So last summer I had bone grafting done so I will hopefully be able to get implants in the beginning of the upcoming summer.” Advice for others “Also make sure you speak to your dentist, oral surgeon or orthodontist about any worries or concerns you might have about your treatment plan so they can be addressed early,” she said. Flexibility also is important, Carter said. It’s uncertain how teeth will respond to treatment. Patients must be willing to accept successful treatment along with failed treatment and remember each body reacts differently. To dentists or other doctors who may be treating someone with this condition, Carter says to listen to that patient’s concerns about treatment. “For me, it was important that my oral surgeon was very understanding about my situation and how it could be embarrassing or uncomfortable,” Carter said. “For all dental professionals, care about your patients’ emotional and physical well-being because dental procedures can sometimes be uncomfortable and worrisome to patients.” Lauren Bryant is the associate web editor. Contact her at lbryant@advanstar.com.
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