This blog was created for students to interact over the material in the Predoctoral course in Pediatric Dentistry, DS443b.

Monday, January 29, 2007

Lecture 3 - Development of the Dentition and Occlusion

Submit your "most important thing" recorded immediately after lecture.

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You must post by Sunday, Feb 4, at 11:59 PM for credit.

90 comments:

Anonymous said...

1-I learned that you don't need BWX when there are no contacts b/w the teeth.
2- That there is increased risk of caries when your child feed at night and it's not a feeding issue but a paranting issue.
3- Also, the mand incisors are at the lowest risk for caries b/c of the adjacent salivary glands, however the mand molars and max incisors at at a higher risk for caries.

Anonymous said...

last message posted by Sanaz Hamzehpour 132

Anonymous said...

by the age of 12 months, the child shouldn't be feed frequently at night time. Otherwise it is a parenting issue and this habit will highly increase the risk of baby caries.
Xiang Li #146

Anonymous said...

the transition of the dentition from primary, mixed to permanent and the different implications related with caries development,OH, Rx and ortho.
Heidi Gonzalez 526

Unknown said...

The Most important things I learned in this lecture are:
The eruption sequence of primary dentition is: A, B, D, C, E.
Primary teeth eruption has +/- 6 month variation.
Teeth start to have proximal contacts around age 4.

Naomi Nguyen, #158.

Anonymous said...

It is interesting to find that incisor liability and that there is an inconsistent discepancy and unpredicability between a child's incisors and their adult incisors. One cannot correlate the size of the child's incisors to the size of the adult incisors with certainty.

Neil Patel #165

Anonymous said...

The caries risk changes in the different dentition stages and it is important to educate pediatric patients and parents in how to improve the oral hygiene in this stages. During the eruption of the primary dentition the use of bottle should be avoided at night. As the child grows, and the spaces between the teeth close, the use of dental floss is indicated.
Claudia Rodriguez #531

Anonymous said...

you don’t need to floss until you get to perm dentition phase.

Catherine Do #122

Anonymous said...

The four dimensions you should look at during a child's development are AP, transverse, vertical, and alignment. The 2 that has the most significant changes are alignment and AP.

Stacy Yu #193

Unknown said...

This magic moment...
I thought the most interesting thing that I learned today is that the permenant incisors are more flared out than the primary incisors. This means that some of the crowding that is initially present might be alleviated, but it is still important to keep ortho possibilities in mind if the crowding persists.
Sincerly,
Paul Field #127

Anonymous said...

1. From primary -> mixed-> permanant dentition, there're different considerations in terms of caries risk, Oral hygienge, and Radiography.
2.Primary dentition has mesial. distal and flush plane which can be used to predict future ortho needs.

Tiffany Hsu #529

Anonymous said...

1. There were 24 teeth in a mixed dentition.
2. What Incisor Liability is.
3.That the Maxilla grows earlier than the Mandible.
4. In ant-Post alignment the incisor angulation is more in permanent than primary incisors.

Dilshad Abtin #524

Unknown said...

Natalie Nguyen #159:

Since primary teeth start calcification in utero, anything that occurs during the 2nd trimester can affect the teeth. Also, the caries risk, oral hygiene, and radiographic and orthodontic implications vary for each dentition stage and thus, each patient must be evaluated accordingly.

Eric Cheung said...

Eruption sequence ABDCE.
6 month variation is normal.
More leeway space in the mandible.
During primary or mixed dentition, don’t take a radiograph unless we will do something about that tooth/area
Eric Cheung 110

Anonymous said...

I hadn't really thought about children not needing BWX if they don't have contacts. Hopefully that bit of common sense will stop me from prescribing x-rays for children with large spaces between their teeth. I will also pay closer attention to when my patients finally do have contacts so I can instruct on flossing.

Anonymous said...

K. Pham #167
When dealing w/ pedo pts, knowledge of dentition development is important to address the concerns of parents as well in treatment of pts.

dangerous d said...

I thought that it was interesting to realize that development of the teeth occurs continually from ~5 mo in utero to age 18. Obviously I already knew that, but to conceptualize development as a continuum was a new way of looking at it. It will be a good perspective to use in pt education.

I also thought it was remarkable that variation between the left and right is possible by as much as 3 months. Good thing your kid is fine!

Dan Nelson #157

Anonymous said...

I learned that the treatment that you give your patients of all ages, especially children, is somewhat dictated by what is seen clinically and what is expected developmentally. This affects the types of radiographs that need to be taken, the type of oral hygiene you teach them, the type of orthodontics that needs to be considered, as well as the type of caries risk that is involved.

- Shelby Padua #166

Tina said...

my magic minute:
Mx teeth are more affected by kids bottle feeding at night than md teeth bc the salivary glands is protective for the md teeth.

Tina Duong #125

Anonymous said...

My most important thing is that primary dentition is based on mesial step, flush terminal plane, and distal step. This can predict what the permanent dention will be, depending on mandibular growth.
- Broc Mushet #156

Unknown said...

I learned 2 things:
1. The eruption sequence is: A B D C E
and,
2. Permanent incisors are more flared than their the primary counterparts.
Orly Hendizadeh #134

Anonymous said...

Keep in mind that growth of the mandible and movement into the leeway space may serve to change molar alignment and classification as the child grows, and so may change orthodontic needs. Thought it was interesting that when a parent asks when he should start worrying about their child's teeth, you can technically tell them 5 months into the pregnancy.
Diana Craft
115

Anonymous said...

At 1 yr of age, children should not be bottle feeding at night; risk is highest in max incisors and mand molars and lowest in mand incisors.
[Colby Smith #178]

Anonymous said...

I thought the most important thing from the lecture was the simple advice of how to tell if a tooth is permanent or deciduous. Look at the color, size and position in the mouth.

Ryan Plewe
#168

Anonymous said...

The treatment of children changes with increasing age. For example, by the age of 12 months children should not be fed at night. Then at the age of 4 proximal contacts become an issue and floss needs to be incorporated.

Josh Cardwell #108

Anonymous said...

The easiest way to distinguish between primary & permanent teeth is by the following criteria: size, color & position. Size, color, position. Size, color, position. Size, color, position. Got it? Simply counting the teeth will help you figure out which tooth you are dealing with.

Anonymous said...

I learned that the clinical exam may be as informative as the radiographs in diagosing interproximal caries when there is no contact between the teeth. The timeframe of primary, mixed, and permanent dentition was also refreshing. Sean Nguyen, #160.

Anonymous said...

One of the most significant changes that occurs from primary to permanent dentition in the A-P dimension is the increase in angulation of the incisors.
Sanam Soroudi #180

Anonymous said...

magic minute:The most important thing i learned was how to differentiate between primary and permanent teeth,eruption sequence and the parenting issue when parents are feeding the child at nightime and how to do clinical evaluation of primary teeth .
poonam rai#530

Unknown said...

I learned how important it is to educate parents about their child’s teeth development. This is so that the child can begin their dentate life with good oral health.
-Carol Kim (#138)

Anonymous said...

Around 5 years of age, the dentist should warn the parents that in around 6 months, their child's first molars will be erupting. This is important because they are easy to neglect since they are not replacing any primary teeth.
Joanne Kim #140

Anonymous said...

One interesting thing I learned is that as early as 5 months in-utero, primary teeth are beginning to develop and can be negatively affected by the mother's diet/nutrition, use of drugs and infections during the pregnancy
Amy Dixon #120

Anonymous said...

The four important dimensions in assessing a child's dentition are: Anterior-Posterior, Transverse, Vertical and Alignment. With respect to alignment, it is common to have spacing throughout the arches until 4 years of age.

Kevin Omoto #163

Anonymous said...

Differentiate between primary and permenant dentition by considering size, color, presence of mamelons (permanent)and position in arch (count teeth)
-Jeanne Wong #195

Anonymous said...

Some important things from class:
If a mother is feeding her child several times at night, it can be a parenting issue not a 'hunger issue' with the child. The child likely does not need that much milk at night. Instead, the child can be seeking attention from his mother. The mother should avoid feeding the child so much at night, especially if the child has teeth, since the constant feeding will lead to tooth decay. Also the child will be much heavier than other children his age. It is difficult for parents to see the dentist's point of view, especially if they are into protecting the child's emotional development.
Raquel Ulma #188

Anonymous said...

As a child transitions from the primary dentition stage to the mixed dentition phase, the individual's alignment and AP dimension are most heavily affected. Additionally, I thought it interesting that multiple nighttime feedings were more indicative of parenting issues than of variance in child development.

C.Chung #112

Jake said...

My magical moment occured when I heard that if you don't have contacts, you don't need floss!
I know this well because my kid has overlapping E and F and needs work done to fix this potential carious area.
Also, eruption is ABCDE, except BCD come first in Maxillary arch.

Jake Cragun #117

Anonymous said...

I learned that bitewing xrays are not always indicated for children. Not only this, but that they don't become indicated at a certain age, but at a developmental stage. This means that bitewings may be needed at different ages for different patients. When posterior teeth begin to contact interproximally they are at risk for interproximal caries, and this is the reason for bitewings.



-Jonathan Miller #149

Anonymous said...

The most important things I learned were that teeth erupt within 6 months of the standard age and that children should not have to get up in the middle of the night to feed by the time they are a 1 year old.

Shannon Lazarian #133

Anonymous said...

Parents should help children concentrate on brushing thoroughly instead of messing with floss when spaces exist in their developing dentition.
Emmy Le
#142

Anonymous said...

The most important thing for me was that I shouldn't take BWx if there are spaces between the teeth! Common sense but sometimes I'm loosing it!
Cornel Crasnean #525

Austin said...

We should be prepared to answer common questions from parents:
A) eruption of baby & permanent teeth
B) exfoliation of baby & permanent teeth
D) is that a baby tooth
C) whether braces are needed
E) when orthodontic Tx should start.
Austin Tung 187

Anonymous said...

Parents with children should not be alarmed if they have "gaps" in their teeth because they are typically just primate spaces.

E. Lai #141

Anonymous said...

Kids with mixed dentition get two bitewings every year, but around age 10 or 11 as they progress out of the mixed stage, bitewings are not necessary until contacts with premolars are established.
Bozhena Fisher #128

Anonymous said...

You don't need 4 BWX until the second molar comes in due to no proximal contact on the Distal of first molar. Otherwise you take two BWX.
Regina Espinoza #126

Lori said...

The most important thing I learned from lecture was that young children with open posterior contacts do not require BWX or the use of floss, brushing should be their main concern.

Anonymous said...

Michelle Duong #123
I learned that a child should stop bottle feeding by 12months otherwise this will increase the risk for baby bottle caries, and becomes a parenting issue rather than a nutrition issue.

Anonymous said...

The most imortant thing to me from last lecture was a reminder that permanent teeth begin developing as soon as a child is born and that the quality and health of those teeth can be affected throughout a lifespan.

Marc David Thomas
182

Anonymous said...

The Mx primate space is located between the lateral incisor and canine but the Mn primate space is between the canine and first molar.
Hoang #135

Tanguero said...
This comment has been removed by the author.
Tanguero said...

Clinical examination is as informative as BW's when there are no contacts between the teeth. Also, if the brush can get in between the teeth (no contact) then you dont need to floss (it makes sense, but I didn't think of it before the lecture).

Varo Boyajyan #106

Anonymous said...

I have learned that you don't need to floss untill the contacts between teeth are established and that no bitewings are needed untill the contacts between teeth are present.
And or course a very nice eruption mnemonic : ABDCE

Alina Tiraspolskaya #183

Anonymous said...

The most important message of the lecture was:
eruption sequence is A-B-D-C-E and +/- 6 month variation in eruption is normal.
Soheil Yashari #191

Anonymous said...

Jonathan Do #121


The eruption pattern of primary teeth occurs in the sequence ABDCE. Also,flossing as well as bitewings are not needed until there are proximal contacts between teeth.

Anonymous said...

Most important minutes: Learning to stop feeding babies at night around 12 months, and if you aren't sure what tooth you are looking at just look at size, color, and count the position back from the incisors.
Morris Poole
#169

Anonymous said...

Permanent incisors are more flared than the primary incisors... this is important to explain to parents when discussing ortho.
#154

Anonymous said...

It is difficult to differentiate between primary and permanent teeth. The main differences are that primary teeth are whiter, smaller, and have thinner enamel.

Shelton Chow #111

Anonymous said...

I learned the primary first molar is similar to the permanent premolar but it still has 3 roots, whereas, the primary second molar resembles the permanent first molar, but both primary molars have 3 roots.

-Matthew Moadel, Student #151

Unknown said...

Azi Ardakani student 101

I learned that the most important difference overall between the primary and permanent teeth is the difference in their shape and color and the best way of knowing if the teeth have erupted or not is just counting back and checking to see they are in their position. also the eruption sequence order is ABDCE

Unknown said...

It makes sense why we would not order Radiographs for teeth that have open contacts. We are taught to order BWX, but usually these are for posterior dentition with contacts and not anteriors, which we can view and probe directly. Because we also can clinically examine the interproximal spaces of these non contacting, primary teeth, it would make sense to not over-prescribe radiographs and cause them to glow like christmas when we can directly probe and view the surfaces of the Primary and mixed dentition. Also no contact = no floss as these areas can be accessible with brushing or rinsing.


Jeff Flores #129

Anonymous said...

Liz Miltner#150
I learned that sippy cups filled with juice can also cause caries and that as dentists we need to stay educted on the health recommendations for children.

Anonymous said...

The eruption sequence is ABDCE and with regards to the primate space it is different in the max vs the mand. For the maxilla the primate space is btw the lateral incisor and canine while in the mandible the primate space is between the canine and first molar.

Niki Zarabian #194

Anonymous said...

Although a distal step of the primary molars is least common(14%), this A-P position almost always leads to a Class II permanent occlusion and has orthodontic implications.
J.Oka #162

Anonymous said...

Caries implication:
Interproximal caries decrease as primary molars fall out due to the leeway space. The premolar spacing is closed when the fixed occlusion is reached. Then, the risk of caries increases again.

Paredes #164

Anonymous said...

Primate space in the maxilla is mesial to K9 and in the mandible it is distal to K9
In transition from mixed to permanent dentition AP dimension decreases while Transverse increases
The eruption sequence of primary teeth: ABDCE

Edvin A. #100

Anonymous said...

I learned that there can be six months of variation in eruption time for the primary teeth. rita 109

Anonymous said...

Alignment deals w/ spacing. In a typical primary dentition, there is spacing throughout until about age 4 when the molars begin to drift forward. It is thought that when the permanent first molars develop, they begin to push other teeth forward.

Richard Duong #124

Anonymous said...

I learned that in terms of prevention, it is as important, if not more important, to educate parents, since caries and orthodontic issues can arise from parents allowing their children to continue bad habits such as night feeding.

Robert Busan #107

Anonymous said...

Amandeep Iqbal
#527

The most important things I learnt is:
After 1 yr of age if a child continues feeding at night,it must be stopped.It is a parenting issue not a 'hunger'issue. Also this can lead to increased risk of caries . The max incisors and mand molars are at highest risk .Mand incisors are at least risk because of adjacent salivary glands.

Anonymous said...

I learned that the need for bitewings depends on the presence of interproximal contacts. I also learned that the eruption of primary teeth can vary +/- six months.

Trish Barsanti #105

Anonymous said...

The eruption sequence of primary teeth is ABDCE. You can expect a
6 month variation. Children over 1 year old shouldn't feed at night.

#175

Anonymous said...

It is important to not blindly take BWX, but rather only expose the patient when there is a need for them such as the presence of contacts between the teeth.
#177 Farshid Siami

pedram said...

what I learned in class that was diffrent from what I had learned before what the fact that the freeway space in the maxilla is about 2 mm larger than the mandible. The question that arises for me is whether this discrepancy of space is going to be significant on the correct alignment of the perminant teeth during eruption.
pedram sooferi #179

Anonymous said...

Dental treatment for children within the 1st year of life is important to appropriately monitor dental development. In addition, eruption time of primary teeth has a cushion of + or - 6 months.
Amy Tran 184

Anonymous said...

For primary teeth the pattern of eruption is ABDCE. Another thing I learned was the fact that Bitewings are not necessary for primary teeth especially if there is space between the teeth.
-Dave Tajima #181

Claudia Thomas #534 said...

I learned that calcification starts between 5 to 7 months in utero and any changes in the pregnancy at that time can affect calcification.To determ if it is a baby tooth look for color, shape, form and position.

Anonymous said...

Eruption sequence is ABDCE and can vary by six months. So look at tooth shape color and position to differentiate between primary and permanent teeth.
-H. Virk #189

Anonymous said...

It is important to understand the changes that occur as a chld transitions from primary to permanent teeth in order to be able to inform the child and parents of what to expect and prevent future problems.

Rick Shamo #176

Anonymous said...

A very good lecture, refresh lots of important concepts- classic definition of mixed dentition, relationship of second primary molars, sequence of teeth eruption, etc. Hope we can learn more about topics like sequential extraction.
Lei Zeng, #535

Anonymous said...

its important to learn about the pt's age before tx.

parham saghizadeh #171

William said...

I learned that it's alright for the eruption of teeth on either side of the midline to differ a little. Only when there is a few months difference should we start to worry and think about finding out the reason for the discrepancy.

William Traynor #186

Unknown said...

It was interesting that BWs are not necessary in children when they don't have contacts between teeth.It was also interesting that at a later stage a panoramic can be taken to assess proper development of dentition.

Anonymous said...

Well, it was interesting to learn that changes in the AP can be attributed to leeway space which affects how the Md and Mx grow.
Also, I found it interesting that girls erupt sooner than boys.
Alex Molayem
#152

Anonymous said...

At around 12 months, the child should be weaned from the bottle and start drinking from a cup. If the parents report that their child is having to feed multiple times in the middle of the night, this increases their baby's caries risk. This is not a feeding issue, but rather a parenting issue.
Sujain Dissanayake #119

Unknown said...

A-P position
• Distal step = 14 % -> class 2 or end to end (In perm)
• FTP (flush terminal plane = 37 % -> end to end or class 1 (in perm)
• Mesial step = 49% -> class 3 (in perm)

Jeffrey Kim 139

Unknown said...

As children grow up, no BWX are required until there is proximal contact. As the teeth grow in and the maxilla and mandible grow, alignment and the AP dimensions are two of the most affected.

Nick Quach #170

Anonymous said...

Taking bitewing for monitoring mix dentition development is not indicated. Class I with super mandibular growth can become class III.
Jing Lee #144

Anonymous said...

It is important to have a cut off time for feeding because feeding in the evenings before bed can increase the risk of caries.
Hamid Shafizadeh #174

Unknown said...

The decision to take x-rays is dependant on the clinical situation. A good rule is: Consider whether or not you can actually DO anything with the information in the films.
Also, it was helpfult to review eruption sequence.

Chris Claus
113

Anonymous said...

Maxillary growth occurs prior to mandibular growth.
Sydon Arroyo #102