What is the link between tooth agenesis and the development of cancer?


Developmental tooth agenesis (TA) could affect 1–5 teeth (hypodontia), ⩾ 6 teeth (oligodontia) or all teeth (anodontia) (Dhanrajani, 2002, De Coster et al., 2009).

Prevalence of TA

The overall prevalence of TA, excluding third molars, is in the range of 3%–11% (Shimizu and Maeda, 2009, Khalaf et al., 2014).

Classification of TA

According to inheritance pattern, TA can be classified into syndromic and non-syndromic TA. The latter type is subclassified into sporadic and familial/ inherited TA (Dhanrajani, 2002).

Gene mutations in TA

The candidate gene mutations for non-syndromic TA including but not limited to MSX1, EDARRAD, EDA, WNT10A, 10q11.2.q21, LTBP3, PAX9 and AXIN2 (Vastardis et al., 1996, Lammi et al., 2004, Cobourne, 2007).

Problems associated with TA

In addition to the aesthetic and functional problems that are associated with non-syndromic TA, some of beforementioned genes have the same causation pathway in the development of tumours including breast cancer (BC), epithelial ovarian cancer (EOC), colorectal cancer (CRC) and lung cancer (LC) (Gerber et al., 2002; Lammi et al., 2004; Khalaf et al., 2014; Iavazzo et al., 2016).


The official Journal of the British Orthodontic Society (Journal of Orthodontics) published a paper in their January 2021 issue to investigated the association between TA and cancer.

The paper is titled “Are developmentally missing teeth a predictive risk marker of malignant diseases in non-syndromic individuals? A systematic review”. Authors: L. Almuzian, M. Almuzian, H. Mohammed, A. Ulhaq & A. J. Keightley

DOI: 10.1177/1465312520984166

The research was led by Dr. Libi Almuzian and I am a coauthor in this paper along with other colleagues from Scotland .


Taking in consideration the heterogeneity and the limited number of the included studies, the study concluded that:

  • Breast, epithelial ovarian, cervical uterine, colorectal, lung and prostate cancers are higher in patients with TA in comparison to those with no TA.

  • There is a positive correlation between the risk of developing cancer and the severity of TA. For instance, patients with oligodontia are at higher risk of developing cancer than those with single TA.

  • More robust and long-term prospective research is required,

  • Until the strength of association between TA and certain cancers is stronger and reported in higher quality studies, patients should not be burdened with this information.

  • It is also probably outside a dentist’s scope of practice to deliver such information without collaboration with the relevant oncology team.

What do you think?

Link to the paper: