So…What’s up with Dustin’s teeth?

In case you haven’t heard, Stranger Things is back! Season 3 – woot woot!! The hit Netflix show has finally returned to quench our collective thirst for throwback 80’s sci-fi. For those of you who don’t know about it, the show is like ET meets the Goonies, with a rad 80’s soundtrack and feel. For my ‘Stranger’ brethren, you have enjoyed the wild ride and dark adventures of the group of friends, and have without a doubt fallen in love with Dustin, the science and telecom prodigy and quick-witted brains of the gang. You’ve also likely wondered why his smile looks a little different. Dustin’s character is played by the young actor Gaten Matarazzo, a remarkable young man bringing a great deal of attention to a condition called Cleidocranial Dysplasia, or CCD. Let’s learn a bit about it.

Cleidocranial Dysplasia

When we break down the word, cleido means collarbone, cranial means head, and dysplasia means abnormal or irregular growth. CCD is characterized by the irregular development of the collar bones, the teeth and other areas of the head. The problem is related to a mutation in a gene called RUNX2 which is responsible for how bones develop. According to the National Craniofacial Association (FACES), two-thirds of cases are inherited from an affected parent, and the other one-third are spontaneous mutations during development of the fetus. The condition affects one per million people worldwide and likely goes under diagnosed because outward signs can be very mild.

People with Cleidocranial Dysplasia often have narrow, sloping shoulders and tend to be shorter compared to their siblings. There are also typical facial features like wide set eyes, a flat nose, and a prominent eyebrow area. Leg bowing, flat feet and scoliosis are also commonly seen. For affected women, the condition frequently causes complications with delivery, and C-section is often needed. It’s important to note that CCD does not impact any organ function, including the brain, meaning intelligence and cognitive development are completely unaffected.

CCD and dental problems

The most significant, and easily observable, complication associated with CCD, are the delays and difficulties with the development of the teeth and jaws. Adult teeth don’t develop normally and it results in baby teeth being kept for much longer, often combined with an underdeveloped upper jaw. Sometimes the adult teeth don’t come out at all or they develop poorly, but CCD most commonly leads to supernumerary, or extra teeth. There are ways to manage the dental complications but it usually takes extensive treatment, and a permanent solution like implants or bridges can’t be considered until patients reach developmental maturity where the upper and lower jaw have developed fully, usually around the age of 18. The show was filmed during Gaten’s early teens, making him too young for dental reconstruction at the time.

Big time kudos to Gaten Matarazzo, he’s an inspiration and a shining light for owning the condition and talking about it so openly, and a huge shout out to the Duffers brothers for writing it into the series in order to cast Gaten. A particular highlight was Dustin’s hilarious and endearing proclamation that his science camp love interest, Suzie, told him that ‘kissing is better without teeth’. Casting Gaten, was a great move – the show couldn’t have been the same without him.

Till next time!

-Dr. Alex

Purveyor of Smiles at Semidey Dental

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