Congenitally missing teeth (CMT) are of concern to many fields of dentistry. Only a few reviews have been published in this regard.

The aim was to analyze the literature on CMT in the permanent dentition, excluding the third molars, and to identify potential links with ethnicity, geographical regions, and time.

A total of 118 reports on CMT were collected by two authors by interrogating databases. Sample homogeneity, publication bias, publication year (in Caucasian and Mongoloid samples, and in general), ethnicities, and geography of CMT prevalence were statistically analyzed using a Q-test, Egger regression, linear regression, a Spearman coefficient, Kruskal-Wallis, a Dunn post-hoc (α=0.05), and a Mann-Whitney U test (α=0.0125, α=0.0071).

The mean CMT prevalence was 6.53%±3.33%. There were significant geographic differences in CMT rates (P=0.0001, Kruskal-Wallis) and between ethnicities (P=0.0002, Kruskal-Wallis). According to the Mann-Whitney U test (α=0.0071), eastern Asians (P=0.0008) and Europeans (marginally significant, P=0.0128) showed an elevated prevalence, while Western Asians (P=0.0001) and Americans (marginally significant, P=0.0292) had lower prevalence rates. Compared with other ethnicities, Mongoloids showed higher prevalence (P=0.0009) while Asian Caucasians showed lower rates (P=0.0005, Mann-Whitney U, α=0.0125). The year of publication was not significantly correlated with any of the subsamples studied (P>0.3, linear regression).

Clinicians should be vigilant in the assessment of CMT in Mongoloids. No increase of this condition was detected during the last century.