Paeds: Developing Mixed Dentition Flashcards
When do permanent teeth first come in?
Age 6
When have the primary teeth all erupted by?
Age 3
Key differences between primary and permanent teeth (7)
- Dentin is less mineralised in primary teeth.
- Lamina dura is thicker in primary teeth.
- Enamel is thinner in primary teeth
- Primary teeth are whiter (dentin isn’t mineralised)
- Bigger pulp cavities
- Roots more divergent in primary teeth
- More bulbous
Clinical implications: Child with a mixed dentition and the parent is concerned the adult teeth look yellow.
Reassuring the parent that it’s very normal for the permanent teeth to appear more yellow, this is a natural developmental feature.
Clinical implications: Primary teeth have a larger pulp to crown ratio than permanent teeth
Important to know this when placing restorations and preparing cavities. Also caries progress occurs much faster (especially in the molars).
Clinical implications: more bulbous - larger surface area of contact point.
- Aproximal caries
When would you see the first primary teeth in the mouth?
6 months
Which are the first teeth to appear in the mouth?
Lower central incisors (As)
When is the primary dentition complete?
2.5 years (30 months)
When is the mixed dentition first seen and which teeth is first seen?
6 years old —> lower central incisors (followed by the first molars)
What age range do the anterior teeth erupt (aswell as canines and first molars)?
6-8 years old
When do the canines and the premolars tend to erupt?
8-11years old
Age 9 specific feature in the upper arch to be aware of…
upper canines should be palpable
Molar incisor hypomineralisation
Mother systemically unwell or child becomes unwell soon after being born in 3rd trimester.
Affects - 1s, 2s and 6s
Primate spacing
Necessary as teeth are bigger and more teeth.
Spaces seen —>
Upper arch: between the B and C
Lower arch: between the C and D
Clinical implications: diastema/spacing in child’s teeth —> parent is concerned.
Reassure parent this spacing is normal and allows and maintains space for adult teeth.
What habits could cause a child’s face to develop in an abnormal way?
Dummies and thumb-sucking
Orofacial dyskinesia
Excessive facial/tongue/oral movements “tics” that mean the face is in a constant state of movement (seen in patients with learning disabilities - this repetitive movements can dictate how the face grows an predispose patients to e.g. overjets).
Clinical implications: early loss of primary teeth
Formation of fibrous tissue over the erupting tooth = delayed eruption.
Describe features of this DPT
Patient ~ 7yrs
Lower Es have stainless steel crowns on them
Patient aged nine comes into the clinic…
3s are they palpable in the labial sulcus
6s are they carious, what’s the prognosis (now would be the best time to extract them)
5s are they there (hypodontia)
Angle’s classification
Molar relationships
Class II incisor molar relationshop
Class I incisor relationship
Class III
