This paper is the first of a series on the comprehensive management of young people with hypodontia. The paper looks at the background to the condition, the possible aetiological factors, the prevalence of hypodontia and other related conditions. Lastly there is consideration of the role of the paediatric dentist in interdisciplinary management of the affected child and adolescent patient.

Clinical competency assessments are an important part of dental curricula-to satisfy national requirements, maintain professionalism and ensure graduates are prepared for independent clinical practice. It has been observed within Newcastle Dental School (UK) that students tend to undertake the majority of their competency assessments at a very late stage. A questionnaire was designed to investigate student perceptions of two different competency assessment processes (formative structured clinical operative tests vs. summative grading), assess why they chose to undertake competency exercises at a particular time, investigate how well prepared they felt, and finally to evaluate potential barriers that students perceived within the competency process. Data regarding the timing of competency assessments and grades achieved were analysed. Fifty-nine per cent of students reported preferring the summative grading system. Most students felt that they undertook their competency assessments at about the right time (54%: conservation department, 66%: paediatric department) and the majority felt adequately prepared to undertake each exercise (68-98%). The greatest barrier stated to undertaking competency assessments was a lack of suitable patients both on which to practise and to undertake the exercise. No correlation was found between when students took summative assessments and the grades achieved. Therefore, we must encourage students to undertake their competency assessments once they have accrued sufficient clinical experience and reassure them that timing has little effect on the grade achieved. We should assist them to locate suitable patients wherever possible.

The objective of this investigation was to examine the dentofacial features of a group of patients with hypodontia, in particular assessing whether cephalometric analysis confirmed the clinical assumption of a reduced lower face height, and to determine the relationship of these facial features with different numbers of missing teeth. It took the form of a cephalometric study, undertaken in a dedicated Dental Hospital clinic for patients with hypodontia. The study group comprised 59 patients seen on the Hypodontia Clinic: 32 females, 27 males, mean age 13.1+/-3.1 years (range 6-23 years). The average number of missing teeth was 7 (SD 5), ranging from 1 to 21. The mean SNA, SNB, and MMA angles were within normal limits, but there was a statistically significant reduction in the MMA when more than one tooth type was missing (P = 0.007) and the ANB angle decreased as the number of missing tooth types increased (P = 0.034). The mean values for the whole sample were within the normal range and did not demonstrate any feature specific to the group, but patients with more severe hypodontia showed tendencies to a Class III skeletal relationship and a reduced maxillary-mandibular planes angle.

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