Prevalence and patterns of congenital tooth agenesis in children: a mixed-method study on parental awareness

Congenital tooth agenesis is one of the most common developmental dental anomalies in children and may lead to functional, esthetic, and psychosocial consequences if not diagnosed and managed early. While its prevalence has been widely investigated, data regarding parental awareness and communication following diagnosis remain limited. This mixed-method study included a retrospective radiographic evaluation and a prospective telephone survey. Panoramic radiographs of 3,550 children aged 7–15 years who attended a university pediatric dentistry clinic between 2020 and 2025 were retrospectively assessed to determine the prevalence and patterns of permanent tooth agenesis, excluding third molars. Children diagnosed with agenesis were subsequently included in a prospective telephone survey to evaluate parental awareness and prior clinical communication. Descriptive statistics and appropriate non-parametric tests were used for data analysis. Permanent tooth agenesis was identified in 155 children, resulting in an overall prevalence of 4.4%. Hypodontia accounted for 4.2% of cases, while oligodontia was observed in 0.2%. The mandibular second premolars were the most frequently missing teeth, followed by the maxillary lateral incisors. Agenesis was significantly more common in the mandible than in the maxilla ( p = 0.009). Although no significant sex difference was observed in overall agenesis prevalence, maxillary lateral incisor agenesis was significantly more frequent in females (unadjusted OR = 7.5; 95% CI: 3.61–15.57; p < 0.001). Among the 127 families who participated in the telephone survey, 63% reported having been previously informed about their child’s condition; however, many described the information as insufficient. After receiving additional explanation during the survey, 83.5% of families requested further clinical evaluation or follow-up. The prevalence and distribution patterns of tooth agenesis observed in this pediatric population are consistent with existing literature. However, parental awareness regarding the diagnosis remains suboptimal. These findings highlight the importance of not only accurate radiographic diagnosis but also structured and effective communication with families to facilitate early intervention and long-term management.