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PubMed This is a summary of 8 peer-reviewed journal articles Updated
Prosthodontics

Lifelong Dental Care and Facial Growth in HED

At a Glance

Because missing teeth are a core feature of HED, lifelong dental care is essential. Early use of removable dentures helps support proper facial growth, speech, and nutrition in children. By adulthood, patients can transition to permanent solutions like dental implants to ensure lasting function.

Because Hypodontia (missing teeth) or Oligodontia (severe lack of teeth) is a central feature of Hypohidrotic Ectodermal Dysplasia (HED), dental care is not just about a smile—it is about nutrition, speech, and the structural health of the face [1]. Most patients with HED are missing many, if not all, of their primary and permanent teeth [2].

While this presents a significant challenge, modern prosthodontics (the dental specialty of replacing missing teeth) allows patients with HED to eat a normal diet, speak clearly, and feel confident in their appearance.

The Impact on Facial Structure

Teeth act as a critical “scaffolding” for the face. When teeth are missing, the jawbone (alveolar bone) does not develop fully, which can lead to a concave or sunken facial profile [3]. Without the vertical support of teeth, the lower face may appear shorter, and the chin may look more prominent [4].

By introducing dental prosthetics early in childhood, dentists can:

  • Support the Lips and Cheeks: This helps restore a more balanced facial profile and prevents the “collapsed” look associated with missing teeth [3].
  • Improve Speech: Many speech sounds (like “s,” “t,” and “f”) require the tongue to touch the teeth. Early dentures help children develop clear speech during critical learning years [4].
  • Facilitate Nutrition: Being able to chew a variety of textures is vital for health and quality of life at any age [2].

Timeline of Dental Interventions

Dental care for HED is a lifelong journey that progresses alongside jaw growth.

Stage Age (Typical) Goal and Intervention
Early Childhood 2–3 Years Removable Dentures: The first set of dentures is often introduced when the child is ready to start preschool. These are “removable” so they can be cleaned and regularly adjusted as the child grows [4][5].
School Age 6–12 Years Frequent Adjustments: As the jaw grows and any “peg-shaped” teeth emerge, dentures are modified or remade. Orthodontics may be used to align the few natural teeth that are present [3].
Early Teens 12–15 Years Evaluating Bone: The care team monitors jaw growth. In some specific cases, limited implants may be placed in the front of the lower jaw, but most permanent work remains on hold [6].
Young Adulthood 17–21+ Years Skeletal Maturity: Once growth is definitively complete, dental implants and fixed bridges are utilized to provide a permanent, stable solution that functions like natural teeth [7][8].

Transitioning to Dental Implants

Dental implants are small titanium posts surgically placed into the jaw to act as artificial tooth roots. While they are the “gold standard” for HED rehabilitation, timing is critical. If implants are placed while a patient is still growing, they can become “submerged” as the surrounding jawbone continues to grow and move around them [6].

For this reason, specialists typically wait until skeletal maturity—usually the late teens or early twenties—to perform major implant surgery [7]. In complex cases, adult care may also involve orthognathic surgery (jaw surgery) to perfectly align the upper and lower jaws before final permanent teeth are placed [8].

Your dental team will be lifelong partners in maintaining a functional, healthy, and beautiful smile. Careful intervention ensures that by adulthood, patients have the structural support and confidence needed to succeed.

Common questions in this guide

When should a child with HED get their first set of dentures?
Children with HED typically receive their first set of removable dentures around 2 to 3 years of age. Introducing dentures early helps support facial structure, improves speech development, and allows the child to eat a wider variety of foods.
Why can't children with HED get permanent dental implants right away?
If dental implants are placed while a child's jaw is still growing, the implants can become submerged as the surrounding bone moves. Specialists usually wait until skeletal maturity in the late teens or early twenties to safely place permanent implants.
How do missing teeth in HED affect facial structure?
Teeth act as an important scaffolding for the face. Without them, the jawbone does not develop fully, which can result in a shorter lower face and a sunken or concave facial profile.
Will my child's HED dentures need to be replaced as they grow?
Yes, removable dentures will need frequent adjustments and replacements throughout childhood. As your child's jaw grows and any natural teeth emerge, the dentures must be modified to ensure a proper and comfortable fit.
How do dentures for HED help improve speech?
Many common speech sounds require the tongue to press against the teeth. Providing early dental prosthetics gives children the physical structure they need to successfully learn and produce clear speech.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.At what age should we initiate the first set of removable dentures?
  2. 2.How often will the prosthetics need to be adjusted or replaced as the jaw grows?
  3. 3.Can you explain how dental prosthetics will help improve speech and support facial structure?
  4. 4.When is the appropriate time to evaluate for dental implants, and what criteria must be met?
  5. 5.How do we coordinate care between our pediatric/general dentist and an oral surgeon?

Questions For You

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References

References (8)
  1. 1

    A recurrent missense mutation in the EDAR gene causes severe autosomal recessive hypohidrotic ectodermal dysplasia in two consanguineous Kashmiri families.

    Sadia , Foo JN, Khor CC, et al.

    The journal of gene medicine 2019; (21(9)):e3113 doi:10.1002/jgm.3113.

    PMID: 31310406
  2. 2

    Masticatory function in growing individuals with hypohidrotic ectodermal dysplasia: A longitudinal study.

    Ding M, Kang Y, Qin M, Zhu J

    International journal of paediatric dentistry 2025; (35(3)):598-607 doi:10.1111/ipd.13271.

    PMID: 39279151
  3. 3

    [Research progress on the diagnosis of ectodermal dysplasia and early oral prosthodontic treatment].

    Lin L, Li P, Zhao W

    Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology 2025; (43(4)):478-485 doi:10.7518/hxkq.2025.2025173.

    PMID: 40899200
  4. 4

    Facial Morphological Changes Following Denture Treatment in Children with Hypohidrotic Ectodermal Dysplasia.

    Ding M, Fan Y, Qin M, et al.

    Pediatric dentistry 2020; (42(4)):315-320.

    PMID: 32847672
  5. 5

    Rehabilitation Considerations for Very Young Children with Severe Oligodontia due to Ectodermal Dysplasia: Report of Three Clinical Cases with a 2-Year Follow-Up.

    Seremidi K, Markouli A, Agouropoulos A, et al.

    Case reports in dentistry 2022; (2022()):9925475 doi:10.1155/2022/9925475.

    PMID: 35360383
  6. 6

    Rehabilitation with implant-supported overdentures in preteens patients with ectodermal dysplasia: A cohort study.

    Montanari M, Grande F, Lepidi L, et al.

    Clinical implant dentistry and related research 2023; (25(6)):1187-1196 doi:10.1111/cid.13258.

    PMID: 37608501
  7. 7

    Complete-arch implant rehabilitation and adjunctive orthognathic surgery of a patient with hypohidrotic ectodermal dysplasia utilizing a digital workflow: A clinical report.

    Gonzaga L, Lawand G, Blumberg S, et al.

    Journal of prosthodontics : official journal of the American College of Prosthodontists 2025; doi:10.1111/jopr.14060.

    PMID: 40235042
  8. 8

    Management of a patient with ectodermal dysplasia with implant-assisted and implant-supported restorations: Sixteen years of clinical care.

    Moustafa OH, Aldosari AM, Knobloch LA

    The Journal of prosthetic dentistry 2025; (134(6)):2035-2043 doi:10.1016/j.prosdent.2025.01.031.

    PMID: 39984407

This page provides educational information on dental care for Hypohidrotic Ectodermal Dysplasia. It is not a substitute for professional medical or dental advice. Always consult your specialized dental care team for individualized treatment planning.

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