In this work, the problem of segmenting teeth in panoramic dental images is addressed. The Random Forest Regression Voting Constrained Local Models (RFRV-CLM) are used to perform the segmentation in two steps. Firstly, a set of mandible and teeth keypoints are located, and then that points are used to initialise each individual tooth model. A method to detect missing teeth based on the quality of fit is presented. The system is evaluated using 346 manually annotated images containing adult-stage teeth. Encouraging results on detecting missing teeth are achieved. The system is able to locate the outline of the teeth to a median point-to-curve error of 0.2 mm.