Most people only have isolated microdontia (small teeth). But in other rare cases, the underlying cause is a genetic syndrome.
Small teeth are often caused by both hereditary and environmental factors. Conditions associated with microdontia include:
Pituitary dwarfism: One of the numerous types of dwarfism, pituitary dwarfism can cause what experts call true generalized microdontia, as all teeth appear equally smaller than average.
Chemotherapy or radiation: In infancy or early childhood, chemotherapy or radiation before the age of 6 can affect the development of teeth, causing microdontia.
Cleft lip and palate: Babies can be born with a cleft lip or palate if their lips or mouth are not formed properly during pregnancy. A baby can have a cleft lip, cleft palate, or both. Tooth abnormalities are more common in the cleft area and microdontia may be seen on the cleft side.
Congenital deafness with aplasia of the labyrinth, microtia and microdontia (LAMM) syndrome : Congenital deafness affects the development of teeth and ears. People born with this condition may have very small, undeveloped outer and inner ear structures, as well as very small, widely spaced teeth .
Down Syndrome: Studies show that dental abnormalities are common in children with Down syndrome. Peg-shaped teeth are often seen in Down syndrome.
Ectodermal dysplasias: Ectodermal dysplasias are a group of genetic conditions that affect the formation of skin, hair, and nails and can also cause smaller teeth. The teeth are usually conical in shape and many may be missing.
Fanconi anemia: People with Fanconi anemia have bone marrow that does not produce enough blood cells, causing fatigue. They may also have physical abnormalities such as short stature, eye and ear abnormalities, misshapen thumbs, and malformations of the genitals.
Gorlin-Chaudhry-Moss syndrome: Gorlin-Chaudhry-Moss syndrome is a very rare condition characterized by premature closure of the bones in the skull. This causes abnormalities of the head and face, including a flat appearance and small eyes in the central part of the face. People with this syndrome often experience hypodontia or missing teeth.
Williams syndrome: Williams syndrome is a rare genetic condition that can affect the development of facial features. It can result in features such as widely spaced teeth and a wide mouth. This condition can also cause learning disabilities as well as other physical abnormalities such as heart and blood vessel problems.
Turner syndrome: Also known as Ullrich-Turner syndrome, Turner syndrome is a chromosomal disorder that affects women. Common features include short stature, webbed neck, heart defects, and premature ovarian failure. It can also cause shortening of the tooth width.
Rieger syndrome: Rieger syndrome is a rare genetic condition that causes eye abnormalities, underdeveloped or missing teeth, and other craniofacial malformations.
Hallermann-Streiff syndrome: Hallermann-Streiff syndrome, also called oculo mandibulo facial syndrome, causes skull and facial deformities. A person with this syndrome may have a short, broad head with an underdeveloped lower jaw, among other features.
Rothmund-Thomson syndrome: Rothmund-Thomson syndrome appears as a rash on the baby’s face and then spreads. It can cause slow growth, thinning of the skin, and sparse hair and eyelashes. It can also possibly cause skeletal abnormalities and abnormalities of teeth and nails.
Oral-Facial-Digital syndrome: Known as Type 3 or Sugarman syndrome, this subtype of genetic disorder can cause malformations in the mouth, including teeth.
Microdontia can also occur in other syndromes and is usually seen in hypodontia with fewer teeth than normal.
When should you see a dentist?
Small teeth that are abnormally small or have large spaces between them may not fit together properly.
You may be at risk for more wear and tear on your teeth, or food can easily get stuck between the teeth.
If you feel any pain in your jaw or teeth, or notice damage to your teeth, make an appointment with a dentist who can evaluate your teeth and determine if any treatment is needed. Most of the time, localized microdontia does not need to be corrected.
If your concern is aesthetics, i.e. you want to mask the appearance of your microdont and have an even smile, the dentist can offer you some possible options:
Dental veneers are thin veneers, usually made of porcelain or resin-composite material. The dentist adheres the veneer to the front of your tooth, giving it a smoother and flawless appearance.
Crowns are one step ahead of veneers. Rather than a thin shell, a crown is more of a cap for your tooth and covers your entire tooth front and back.
Sometimes dentists have to shave the tooth to prepare it for veneer, but depending on the size of your tooth this may not be necessary.
This process is sometimes called tooth bonding or composite bonding.
The dentist applies a composite resin material to the tooth surface, smoothing the surface of the affected tooth. The material hardens with the use of a light.
After hardening, it resembles a normal-sized tooth.
These restorations can also protect your teeth from the wear and tear sometimes caused by irregularly fitting teeth.
Testing for an underlying genetic cause
Many causes of generalized microdontia have a genetic component. In fact, research shows that generalized microdontia of all teeth is extremely rare in people without some type of syndrome.
If you have a family history of the aforementioned genetic disorders, or if anyone has undersized teeth, you may want to tell your child’s doctor.
However, if you have one or two teeth that appear smaller than normal, the teeth may have just developed without an underlying syndrome.
If you don’t have a family history, but you think some of your child’s facial features appear atypical or distorted, you can ask your child’s doctor to evaluate them.
The doctor may recommend a blood test and genetic testing to determine if your child has a condition that causes other health problems that may require diagnosis and treatment.
A small tooth may not cause any problems or pain for you. If you are concerned about the aesthetics of the teeth or how they fit together, you may want to see a dentist.
A dentist can discuss possible solutions, such as veneers or crowns, that can correct or treat the problem.
In some cases, microdontia may be a sign of a larger health issue that may need to be addressed. If you notice any other unusual signs or symptoms, discuss the problem with a doctor or your child’s pediatrician.