Tooth agenesis or congenital tooth absence is the absence of development of at least one permanent tooth and a common dental anomaly in man. Hypodontia may occur either as part of a syndrome or as a non-syndrome developed by MSX 1 and PAX 9 are causative genes coexpressed in dental mesenchymal resulting in early developmental arrest of the developing tooth. As compared with permanent dentition, the prevalence of hypodontia in primary dentition is found to be very small. Most commonly missing tooth is a third molar. Most commonly missing tooth is a third molar. It is evident from the literature that the etiology of hypodontia is varied, and genetic, epigenetic, and environmental factors that contribute. Research has suggested that clinical hypodontia management requires careful planning across multidisciplinaires.