Objective. The aim of this cross-sectional study was to investigate the prevalence of dental anomalies that could be a cause of malocclusion in the western region of Saudi Arabia. Materials and Methods. A retrospective study of 878 digital orthopantomograms (OPGs) taken of patients, age ranging between 12 and 30 years, who presented to treatment at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia between 2002 and 2011. The OPGs and dental records were reviewed for congenitally missing teeth, supernumerary teeth, impactions, ectopic eruption, transposition, germination, fusion, dilacerations, taurodontism, dens in dent, and any other unusual conditions that can be assessed with OPG. Results. The prevalence of patient that exhibited at least one dental anomaly was 396 (45.1%) patients. The prevalence of congenitally missing teeth was 226 (25.7%), impacted teeth 186 (21.1%), dilacerated teeth 10 (1.1%), supernumerary teeth 3 (0.3%), odontoma 1 (0.1%), and taurodontism was also 1 case (0.1%) of the total radiographs reviewed. Conclusions. Congenitally missing teeth were found to be the most prevalent anomaly (25.7%), and the second frequent anomaly was impacted teeth (21.1%), whereas root dilacerations, supernumerary teeth, and taurodontism were the least frequent anomalies (1.1%, 0.3% and 0.1%, resp.). 1. Introduction Dental anomalies in tooth number, shape, and position usually result in problems in maxillary and mandibular arch length and occlusion, which may greatly influence orthodontic treatment planning. The etiology of these conditions is usually attributed to certain genes in addition to some etiological events in the prenatal and postnatal periods that may result in anomalies in tooth size, shape, position, number, and structure [1–5]. Congenitally missing teeth constitute the most common developmental anomaly of the human dentition, occurring in approximately 25% of the population, and the wisdom tooth represents the most affected tooth (20.7%) [6]. Excluding third molars, the prevalence of tooth agenesis is approximately 4.3 to 7.8%, and the mandibular second premolars are the most commonly missing teeth, followed by the maxillary lateral incisors and maxillary second premolars [7]. Ethnic background was found to have an effect on the prevalence of tooth agenesis. Epidemiological studies revealed a lower prevalence of agenesis in the Black race compared to the White race, while Asians showed increased tooth agenesis compared to Whites [7]. Sexual differences were also reported in the prevalence of tooth agenesis, where
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