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Maternal and Child Health Bureau logoA Health Professionals Guide to Pediatric Oral Health Management
HomeModuleModule 1: An Introduction to Infants' and Young Children's Oral HealthModule 2: Managing Infants' and Young Children's Oral HealthModule 3: Oral Conditions and AbnormalitiesModule 4: Prevention of Oral DiseaseModule 5: Non-Nutritive Sucking HabitsModule 6: Oral InjuryModule 7: Infants and Young Children with Special Health Care NeedsContentsGlossaryEvaluationHelp
Module 3: Oral Conditions and Abnormalities
Module Contents
3.1 Recognizing Healthy Teeth, Soft Tissues, and Facial Bones
3.2 Healthy Teeth
3.3 Healthy Soft Tissues
Lips, Tongue, and
Oral Mucosa
Frena & Gingiva
Major Salivary Glands
3.4 Healthy Facial Bones
3.5 Tooth Conditions and Abnormalities
Dental Caries
Untreated Tooth Decay
Hyperdontia (current page)
Hypodontia & Anodontia (current page)
Hypoplasia (current page)
Fluorosis (current page)
Amelogenesis Imperfecta
Dentinogenesis Imperfecta
Extrinsic and Intrinsic Enamel Coloration
3.6 Soft Tissue Conditions and Abnormalities
Epithelial Cysts
Congenital Epulis
Natal or Neonatal Teeth
Eruption Cysts
Fibroma & Papilloma
Key Points
Additional Resources

3.5 Tooth Conditions and Abnormalities, continued


Hyperdontia (excess teeth) may be present in a young child. The excess teeth are called supernumerary (extra) teeth. Hyperdontia is more common with permanent teeth but can also occur with primary teeth. Hyperdontia can usually be diagnosed after radiographic assessment. Delayed tooth loss or eruption may be a sign of hyperdontia.

Hypodontia and Anodontia

photo of hypoplasia
  Fig 9.
Ectodermal Dysplasia

Numerous hereditary syndromes include congenitally missing teeth as a characteristic. One or several teeth may be missing (hypodontia), or all the teeth may be missing (anodontia) (e.g., in individuals with ectodermal dysplasias). Ectodermal dysplasia involves defects in two or more tissues derived from the ectoderm — skin, hair, teeth, nails, and sweat glands. Dental management of hypodontia or anodontia often involves the use of fixed and removable prostheses to replace the missing teeth to enhance oral function and appearance.[5]


photo of hypoplasia
  Fig 10. Hypoplasia

A disruption during tooth development may affect the enamel. Generally such a disruption is referred to as hypoplasia (insufficient and/or irregular quantity of enamel). Tetracycline can cause enamel hypoplasia when taken during pregnancy or by an infant or young child during tooth development. Tetracycline should not be used during pregnancy or by children ages 8 and under.

In addition, Vitamin D deficiency during tooth development and calcification results in enamel and dentin hypoplasia. The enamel is poorly calcified and may fail to form at all in some areas. In the dentin, areas of uncalcified dentin may result.


Fluorosis (hypomineralization of the enamel) is a type of hypoplasia caused by ingesting excessive quantities of fluoride during tooth development. Mild fluorosis causes the teeth to have a white, spotted, or lacy appearance. Severe fluorosis results in the enamel being markedly hypomineralized; the enamel may be brown in color and has a propensity to break and excessively wear.[5]

photo of mild fluorosis photo of moderate fluorosis photo of severe fluorosis
Fig 11.
Mild Fluorosis
  Fig 12.
Moderate Fluorosis
  Fig 13.
Severe Fluorosis
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logo: U.S. Dept. of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau