Things to Know When Your
Child Needs Dentures
Many children with developmental anomalies
or congenital conditions like ectodermal dys-
plasia are missing some, most, or all of their
teeth. Complete or partial dentures are good
treatment options to replace the missing teeth.
There are a number of factors to consider
when deciding which option is best for your
child.
A child with ectodermal dysplasia
who is missing many teeth.
Function can be thought of in several ways.
• Tissue-supported dentures require no teeth
to support the denture. Typically, this is what
most people think of when they think about a
denture.
• Tooth-supported dentures can take two
forms. One, these can be partial dentures
that clasp to remaining teeth. Two, these can
be complete dentures that go over the top
of teeth that are maintained to support the
alveolar bone.
• Implant-supported dentures are relatively
newer as an option for children with
ectodermal dysplasia. There are very specific
indications and locations within the mouth
where this can be an option. A child’s growth
status is frequently the primary limitation.
• Perhaps the most important factor This is a tissue-supported denture.
to think about when your child needs
dentures is the child’s age and growth
status. While growing children are resilient
and adapt to change fairly well, dentures
made early in a child’s life will require
frequent adjustment. The size of the teeth
Available treatment options also depend on the
increases from baby teeth to adult teeth,
combination of missing and remaining teeth.
and this period of transition will likely
require a remake of the denture.
How many teeth are missing?
• Our jaws grow simultaneously in three
dimensions, but at different rates. The
• This will ultimately determine whether a
complete or partial denture is an option.
width of our skulls stops growing before
the length (i.e. front to back), which
stops before height. Clinicians consider
these three dimensions when generating
treatment options for children with
missing teeth.
• Where are these teeth with respect to other teeth and oral tissues/
structures?
• Certain teeth serve as better abutments (i.e. pillars) for partial dentures.
For example, molars or canines offer better support than incisors.
• Missing teeth in the maxilla (i.e. top jaw) are easier to replace than in
the mandible (i.e. lower jaw) because the palate can be used to offer
support and stability for the denture. In the mandible, the tongue is
mobile and can interfere with how well a denture fits.
What teeth remain and what is their overall status (e.g. cavities, bone loss, or
resorption)?
• Remaining teeth with cavities need to be restored before serving as
abutments for a denture. However, if the cavity is too large, extraction
may offer a better prognosis.
• Teeth with bone loss or resorption also need to be treated with
periodontal therapy or endodontic treatment before they can be
considered for abutments. However, these teeth are frequently mobile
and have a poorer prognosis for long-term survival. A five-year-old boy with
hypohidrotic ectodermal
dysplasia gets impressions
Once you’ve decided on the type of denture, you might have questions about for his first pair of dentures.
the fabrication process. The process is somewhat variable according to the
denture type, the dentist’s experience, and the child’s temperament.
• Traditional techniques involve a series of dental impressions where the dentist uses a tray and dental-
specific putty to make models of the child’s teeth.
• Following these impressions, the dentures are mocked up in wax, tried-in for fit, and verified for
esthetics. The dentist will have the child go through a series of speaking exercises to make sure the
denture (and its teeth) are in the correct location and are the appropriate thickness. The try-ins are
then sent to a dental laboratory for final processing.
• More modern techniques and protocols make use of advances in dental technology. There are now
systems where dentures can be made from digital scans of a child’s teeth and gums. The digital files can
then be sent to dental laboratories who have access to CAD/CAM machines that can 3D print (additive
techniques) or mill (subtractive techniques).
• When it comes time to finally give the denture to the patient, the dentist will see the patient and adjust
the denture to verify fit. This day represents a major milestone for many families, so it is nice to get final
photos to document the result. Frequently, the denture will need re-adjusted in the subsequent weeks as
the child wears it and gets used to life with a new denture.
It can be overwhelming to hear that your child needs dentures. Fortunately, there are clinicians who tailor
these techniques specifically to your child’s needs. The functional and esthetic results can be life changing!
- Beau D. Meyer, D.D.S., M.P.H. is a pediatric dentist
at The Ohio State University.
The content of this document is for informational purposes only. Questions regarding specific patient issues should be
directed to the appropriate professionals for resolution.
NATIONAL FOUNDATION FOR ECTODERMAL DYSPLASIAS
T 618-566-2020 E
[email protected] W WWW.NFED.ORG
