- Anomalies of tooth formation and eruption - P. J. M. Crawford and M.
J.Aldred
13.0 ACKNOWLEDGEMENT
At the outset, we would wish to record both our personal and professional gratitude to
the late Professor GB (Gerry) Winter. He always encouraged our work and was
generous in his comments and sharing of material. Above all, he was an enthusiast
and a champion of his patients. He is missed.
13.1 INTRODUCTION
Both the primary and permanent dentitions may be affected by variations in the
number, size, and form of the teeth, as well as the structure of the dental hard tissues.
These variations may be exclusively genetically determined, brought about by either
local or systemically acting environmental factors, or possibly from a combination of
both genetic and environmental factors acting together. The same interplay of
influences may affect the eruption and exfoliation of primary teeth, as well as the
eruption of permanent teeth. This chapter considers a range of conditions involving
abnormalities of the number, size, form, and structure of teeth and their eruption.
It is important to be aware of the psycho-social aspect when meeting children and
families affected by these conditions. We have too often heard stories of social
isolation of even very young children as a result of their missing or discoloured teeth.
In the case of discoloured teeth, parents have told us that they have been 'taken to task'
by other adults for 'not looking after' their child's teeth⎯when the discolouration was
intrinsic and unavoidable.
While investigating inherited conditions, it is important to enquire both sides of the
family tree equally. Not only does this ensure that the investigation is complete, but it
may also help to alleviate the sense of 'guilt' felt by an affected parent.
Wherever possible, we try to avoid the use of the word 'normal' in our clinical care
although the word will be used in this text. Clinically we would speak⎯when offering
restorative treatment for example ⎯ of making a smile 'ordinary', or 'boring'. The vast
majority of children with these conditions want to become 'one of the crowd'. We
have found this approach successful in our practices; our readers may choose this or
one of many other approaches in order to further the care of these children.
We have been questioned repeatedly about the possibility of genetic treatment for
some of these inherited conditions. We are not aware of any progress in this direction
at present, outside the laboratory.
13.2 MISSING TEETH
13.2.0 Introduction
Hypodontia is the term most often applied to a situation where a patient has missing