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PERMANENT TEETH / PERMANENT DENTITION

The Permanent Dentition is comprised of 32 teeth.

There are 16 teeth in the maxilla and 16 in the mandible.
There are two central incisors, two lateral incisors, two canines, four
premolars, and six molars in each arch.

Table 1. Eruptions of Permanent Dentition

Tooth Eruption Tooth Eruption
Maxillary Mandibular
Central Incisor 7-8 Years Central Incisor 7-8 Years
Lateral Incisor 8-9 Years Lateral Incisor 8-9 Years
Canine 11-12 Years Canine 9-10 Years
1 Premolar
st 10-11 Years 1 Premolar
st 10-12 Years
2nd Premolar 10-12 Years 2nd Premolar 11-12 Years
1 Molar
st 6-7 Years 1 Molar
st 6-7 Years
2 Molar
nd 11-13 Years 2 Molar
nd 11-13 Years
3rd Molar 17-21 Years 3rd Molar 17-21 Years

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PRIMARY TEETH / PRIMARY DENTITION

Deciduous teeth is the official term for baby teeth, milk teeth, or primary
teeth.
These are the first teeth to erupt into the oral cavity in which comprised of
20 teeth and also known as deciduous teeth.

Table 2. Eruptions and Exfoliations of Permanent Dentition

Tooth Eruption Exfoliations
Maxillary
Central Incisor 8-12 Months 6-7 Years
Lateral Incisor 9-13 Months 7-8 Years
Canine 16-22 Months 10-12 Years
1 Molar
st 13-19 Months 9-11 Years
2nd Molar 25-33 Months 10-12 Years
Mandibular
Central Incisor 6-10 Months 6-7 Years
Lateral Incisor 10-16 Months 7-8 Years
Canine 17-23 Months 9-12 Years
1st Molar 14-18 Months 9-11 Years
2 Molar
nd 22-31 Months 10-12 Years

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INCISORS

Your eight incisor teeth are located in the front part of

your mouth. You have four of them in your upper jaw
and four in your lower jaw.
Incisors are shaped like small chisels. They have sharp
edges that help you bite into food. Whenever you sink
your teeth into something, such as an apple, you use
your incisor teeth.
Incisors are usually the first set of teeth to erupt,
appearing at about 6 months old. The adult set grows
in between the ages of 6 and 8.

CUSPIDS TEETH

Also known as canine teeth or "fangs" or "eye

teeth" if referring to the upper teeth.
A person will typically have four cuspids: two
uppers and two lower. It is used for the gripping
and tearing food, cuspids are larger and
stronger than the incisors with roots that sink
deeply into the bones of the jaw.
Cuspids are usually the last of the front teeth to
erupt. Their length paired with their single,
anchored roots are central to the alignment of
the bite.

PREMOLARS OR BICUSPID TEETH

There are 8 premolars used for chewing of the food,

which are placed lateral to and behind the Cuspids
teeth.
These teeth will have at least two cusps, or
elevations in the crown in the top surface portion of
the tooth. The first premolar will have two cusps. The
second premolar may have two lingual cusps, or
smaller cusps that are unequal in size.

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MOLARS TEETH

A molar tooth is located in the posterior (back)

section of the mouth. It is found in most mammals
that use their posterior teeth to grind food. Twelve
molars are usually present in an adult human, in
groups of three. These teeth are typically larger than
the premolars and have a larger surface area to in
order to chew and grind food into easily digestible
bits.

MAXILLARY

The maxillary teeth, which comprise the

upper set along the maxillary jawbone,
include your top incisors, canines,
premolars and molars.
Most of your maxillary teeth serve a
specific function in eating and
digestion.

MANDIBULAR

The mandibular teeth, which comprise

the upper set along the mandibular
jawbone, include your top incisors,
canines, premolars and molars.
The mandibular dental arcade is
smaller than the maxillary dental
arcade so that -in normal conditions-
the teeth of the maxillae slightly
overlap those of the mandible both in
front and on the sides.

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ANATOMY OF THE TEETH

CROWN
Part of the tooth that is above the gum

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ROOT

Part of the tooth which is below the gum and

cannot be seen

ENAMEL

The hardest substance in the human body.

The clear outer layer of the tooth above the gum line
Largest amount of minerals in enamel accounts not
only for its strength but also for its brittleness.
Its colour caries from light yellow to grayish white and
about 0.16 cm thick.
Protects the inner layers of the teeth from harmful
bacteria and changes in temperature
Does not contain collagen but does contain two
unique classes of protein which are amelogenins and
enamelins.

DENTIN

It is the substance between enamel or cementum and

the pulp chamber.
Porous, yellow-hued material made of 70% inorganic
materials, 20% organic materials and 10% of water by
weight.
Dentin has a degree of permeability which can
increase the sensation and the rate of tooth decay.
Has microscopic channels called Dentinal Tubules which radiate outward
through the dentin from the pulp cavity to the cementum or enamel.

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CEMENTUM

Outer layer of the tooth that lies below the gum line.
A bonelike substance that anchors the tooth the jaw
bone and anchors the tooth by attaching it via the
periodontal ligaments
Specialized bony substance covering the root of the
tooth

PULP
Pulp forms the core of the tooth which contains blood
vessels which carry oxygen and nutrients to the tooth.
And also carries nerves which transmit pain and
temperature sensations to the brain.
Dental Pulp is the central part of the tooth filled with soft
connective tissues.
Along the border between the dentin and the pulp are
odontoblast which initiate the formation of dentin.
Other cells in the pulp include fibroblasts,
preodontoblasts, macrophages, and lymphocytes.

SURFACES OF THE TEETH

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MESIAL SURFACE

The mesial of the tooth is found on the “in between surface” of the tooth
next to it.
The surface that is closest to the midline of the face.
The mesial surface of a tooth is the direction towards the anterior midline
in a dental arch, as opposed to distal, which refers to the direction
towards the last tooth in each quadrant.

DISTAL SURFACE

The back side of the tooth.

Distal refers to the surface of the tooth that is towards the back of your
mouth.

LABIAL SURFACE

Labial surface is the vestibular surface of the incisors and canines, which
faces the lips.
It is the surface of the tooth that faces inward toward the tongue and oral
cavity.

INCISAL SURFACE

Incisal surface the cutting edges of the anterior teeth, the incisors and
canines, which come into contact with those of the opposite teeth during
protrusive occlusion.

OCCLUSAL SURFACE

"Occlusal" refers to the surface of the tooth that is used for chewing or
grinding.
The surface of the teeth that comes in contact with those of the opposite
jaw during occlusion; called also masticatory surface.

APEX

Apex is the tip or terminal end of the root of a tooth.

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ALVEOLUS

The dental alveoli hold the roots of the teeth in place, and in case of a
dental implant, the alveolar process holds implant hardware in place.
The tooth sockets; where the teeth articulate with the maxillae and the
mandible.

GINGIVA

The gingiva is the anatomical term for gums. These are found in the oral
cavity or mouth of a human being surrounding part of the teeth. They
consist of mucosal tissue that covers the alveolar processes of the maxilla
and mandible and finish at the neck of each tooth.
DENTURE

A denture is a removable replacement for missing teeth and surrounding

tissues.
There are 2 types of denture: Complete dentures which are used when all
the teeth are missing, and Partial dentures are used when some natural
teeth remain.

PROSTHESIS

A dental prosthesis is an intraoral (inside the mouth) prosthesis used to

restore (reconstruct) intraoral defects such as missing teeth, missing parts
of teeth, and missing soft or hard structures of the jaw and palate.
Prosthodontics is the dental specialty that focuses on dental prostheses.
Dental prostheses, artificially made devices resembling natural teeth, are
used to replace missing or damaged teeth. These devices include
inlays/onlays, crowns, bridges, dentures, partial dentures, and dental
implants.

TOOTH ABSCESS

A tooth abscess is a pocket of pus that's caused by a bacterial infection.

The abscess can occur at different regions of the tooth for different
reasons.
A periapical abscess occurs at the tip of the root, whereas a periodontal
abscess occurs in the gums at the side of a tooth root.
A periapical tooth abscess usually occurs as a result of an untreated
dental cavity, an injury or prior dental work.
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Dentists will treat a tooth abscess by draining it and getting rid of the
infection. They may be able to save your tooth with a root canal
treatment, but in some cases the tooth may need to be pulled.
Signs and symptoms of a tooth abscess include:
Severe, persistent, throbbing toothache that can radiate to the
jawbone, neck or ear
Sensitivity to hot and cold temperatures
Sensitivity to the pressure of chewing or biting
Fever
Swelling in your face or cheek
Tender, swollen lymph nodes under your jaw or in your neck
Sudden rush of foul-smelling and foul-tasting, salty fluid in your
mouth and pain relief, if the abscess ruptures
Difficulty breathing or swallowing

CARRIES

Tooth decay or dental caries is injury to a tooth that can happen when
decay-causing micro-organism in your mouth make acids that assault the
tooth’s surface, or enamel. This can lead to a small hole in a tooth,
referred to as a cavity. If teeth decay is now not treated, it can cause
pain, infection, and even enamel loss.
As tooth decay advances, it can motive a toothache or teeth sensitivity
to sweets, hot, or cold. If the tooth will become infected, an abscess, or
pocket of pus, can form that can purpose pain, facial swelling, and fever.
Dentists normally treat cavities by way of filling them. A dentist will put off
the decayed tooth tissue and then fix the tooth by using filling it with a
filling material.

PLAQUE

Dental plaque is a sticky, colourless or pale yellow film that is constantly

forming on your teeth. When saliva, food and fluids combine, plaque -
which contains bacteria - forms between your teeth and along the gum
line.
If plaque is not regularly removed from your teeth by proper brushing and
flossing, it mineralizes into tartar, a hard, yellow or brown deposit that
tightly adheres to the teeth and can only be removed by a dental
professional. If tartar is not removed it can lead to more serious gum
disease.
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CARIOUS LESION

A lesion that appears dark brown and shiny suggests dental caries were
once present but the demineralization process has stopped, leaving a
stain.
Initial carious lesion: Non-cavitated carious lesion limited to visual
change in enamel colour and texture
Moderate carious lesion: Carious lesion limited to the outer third of
dentine and micro cavitated carious lesions
Severe carious lesion: Carious lesion extending beyond the outer
third of dentine and cavitated carious lesions
Active carious lesion: Carious lesion exhibiting net mineral loss over
a period of time indicating that the lesion is progressing
Inactive carious lesion: Carious lesion exhibiting no net mineral loss
over a period of time indicating that the lesion is not progressing
Reduce tissue removal treatment of carious lesions in both deciduous
teeth and permanent teeth in order to save tooth substance, prolong the
life of a tooth and reduce or avoid negative iatrogenic outcomes such as
pain, anxiety and adjacent tooth damage.

DENTAL PROPHYLAXIS

A dental prophylaxis is a cleaning procedure performed to thoroughly

clean the teeth. Prophylaxis is an important dental treatment for halting
the progression of periodontal disease and gingivitis.
Here are some of reasons for prophylaxis:
Tartar removal
Aesthetics
Fresher breath
Prophylaxis is generally performed in several stages:
Supragingival cleaning – The dentist will thoroughly clean the area
above the gum line with scaling tools to rid them of plaque and
calculus.
Subgingival cleaning – This is the most important step for patients
with periodontal disease because the dentist is able to remove
calculus from the gum pockets and beneath the gum line.
Root planing - This is the smoothing of the tooth root by the dentist
to eliminate any remaining bacteria. These bacteria are extremely
dangerous to periodontitis sufferers, so eliminating them is one of
the top priorities of the dentist.

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Medication - Following scaling and root planing, an antibiotic or

antimicrobial cream is often placed in the gum pockets. These
creams promote fast and healthy healing in the pockets and help
ease discomfort.
X-ray and examination – Routine X-rays can be extremely revealing
when it comes to periodontal disease. X-rays show the extent of
bone and gum recession, and also aid the dentist in identifying
areas which may need future attention.

EDENTULOUS

Edentulous simply refers to a lack of teeth; an edentulous space is an area

of the mouth that no longer has (or was always missing) teeth. An
edentulous patient may have only one or two missing teeth, either in one
spot or throughout the mouth.
Common causes include periodontitis, or gum disease, dental caries, or
tooth decay, and trauma to the mouth. Because routine access to dental
care is a key method of preventing tooth loss, the rate of edentulism
increases with lower socioeconomic status, lower income, and lower
education level.

EXTRACTION

Tooth extraction is performed by a dentist or oral surgeon and is a

relatively quick outpatient procedure with either local, general,
intravenous anesthesia, or a combination. Removing visible teeth is a
simple extraction. Teeth that are broken, below the surface, or impacted
require a more involved procedure.
Before you undergo extraction, tell your dentist about any of the following
conditions:
a congenital heart defect
diabetes
liver disease
thyroid disease
renal disease
hypertension
an artificial joint
damaged heart valves
adrenal disease
an impaired immune system
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a history of bacterial endocarditis

You might be prescribed antibiotics in the days leading up to the
procedure if:
your surgery is expected to be long
you have an infection or a weakened immune system
you have a specific medical condition
A Simple extraction is when you will acquire a local anesthetic, which
numbs the place around your tooth so you’ll feel only pressure, now not
pain, during the procedure. The dentist then makes use of an instrument
referred to as an elevator to loosen the enamel and forceps to do away
with it.
A Surgical extraction is when you will probable acquire both local
anesthesia and intravenous anesthesia, the latter of which makes you
calm and relaxed. You may also additionally obtain usual anesthesia,
depending on any clinical conditions. With familiar anesthesia, you will
stay unconscious at some point of the procedure.

FRENUM

In the mouth, a frenum or frenulum is a piece of soft tissue that runs in a

thin line between the lips and gums. It’s present on the top and bottom of
the mouth.
There’s also a frenum that stretches along the underside of the tongue
and connects to the bottom of the mouth behind the teeth. The frenum
can vary in thickness and length among different people.
The purpose of a frenum is to give the upper lip, lower lip, and tongue
more stability in the mouth. When a frenum grows abnormally, it can
cause cascading development issues within the mouth.
Some conditions a person may experience if there’s a problem with a
frenum include:
developmental abnormalities in the mouth
discomfort while swallowing
disruption of normal development of the upper two front teeth,
causing a gap
frenum tear
issues with nursing, due to tongue-tie or lip-tie in babies
snoring and mouth breathing, due to abnormalities in jaw
development caused by unusual frenum growth
speech issues if the tongue tight
trouble fully extending the tongue
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gap created between front teeth

pulling gum tissue away from the base of the teeth and exposing
the tooth root
A frenectomy is surgery to remove a frenum. It’s designed to reverse any
of the undesirable effects of a frenum that does not develop properly. This
usually means reducing a frenum that is very long or too tight.

SALIVA

Saliva is the watery and usually somewhat frothy substance produced in

the mouths of some animals, including humans. Produced in salivary
glands, saliva is 98% water, but it contains many important substances,
including electrolytes, mucus, antibacterial compounds and various
enzymes.
Saliva plays a significant role in maintaining oral health, helping to build,
and maintain the health of soft and hard tissues. When saliva flow is
reduced, oral health problems such as dental caries and oral infections
can develop.

TMJ

The Temporomandibular joints, called TMJ, are the joints and jaw muscle
tissue that make it feasible to open and close your mouth. Located on
each aspect of the head, your TMJ work together when you chew,
communicate or swallow and include muscle tissues and ligaments as
properly as the jaw bone. They also manipulate the lower jaw (mandible)
as it moves forward, backward, and side to side.
Each TMJ has a disc between the ball and the socket. The disc cushions
the load while enabling the jaw to open extensively and rotate or glide.
Any problem that prevents this complex device of muscles, ligaments,
discs, and bones from working appropriate may additionally result in a
painful TMJ disorder.
Possible causes of TMJ disorders include:
arthritis
dislocation
injury
tooth and jaw alignment
stress and teeth grinding
Diagnosis is an important step earlier than treatment. Part of the dental
examination includes checking the joints and muscle tissues for
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tenderness, clicking, popping or situation moving. Depending on the

diagnosis, the dentist may refer you to a health practitioner or any other
dentist.

References
https://www.dentalcare.com/en-us/professional-education/ce-courses/ce500/permanent-dentition

https://www.dentalcare.com/en-us/professional-education/ce-courses/ce500/primary-dentition

https://www.verywellhealth.com/cuspid-definition-of-cuspid-
1059419#:~:text=The%20cuspids%20are%20among%20the,mouth)%20and%20the%20premolar%20teeth.

https://www.healthline.com/human-body-maps/premolar-tooth#1

https://www.healthline.com/health/teeth-names

https://www.ballantyneendo.com/dental-tips/mesial-of-the-tooth-understanding-dental-
lingo/#:~:text=The%20mesial%20of%20the%20tooth%20is%20found%20on%20the%20%E2%80%9Cin
,referring%20to%20the%20front%20teeth.
https://medical-dictionary.thefreedictionary.com/incisal+surface
https://www.kenhub.com/en/library/anatomy/gingiva#:~:text=The%20gingiva%20is%20the%20anatomic
al,the%20neck%20of%20each%20tooth.
https://www.sciencedirect.com/topics/medicine-and-dentistry/dental-alveolus
https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/dental-
prostheses-0
https://www.nidcr.nih.gov/health-info/tooth-decay/more-
info#:~:text=Tooth%20decay%20(dental%20caries)%20is,infection%2C%20and%20even%20tooth%20l
oss.
https://www.dentalcare.com/en-us/patient-education/patient-materials/what-is-plaque
https://www.fdiworlddental.org/resources/policy-statements/carious-lesions-and-first-restorative-
treatment
http://www.nashuadentist.com/procedures/periodontics/prophylaxis-teeth-
cleaning/#:~:text=A%20dental%20prophylaxis%20is%20a,of%20periodontal%20disease%20and%20gin
givitis.
https://www.healthline.com/health/tooth-extraction#procedure
https://www.healthline.com/health/dental-and-oral-health/frenum#treatment
https://www.nature.com/articles/bdjteam2015123#:~:text=25%20September%202015-
,Saliva%20A%20review%20of%20its%20role%20in,health%20and%20preventing%20dental%20disease
&text=Saliva%20plays%20a%20significant%20role,and%20oral%20infections%20can%20develop.

https://www.mouthhealthy.org/en/az-topics/t/tmj#:~:text=Share,well%20as%20the%20jaw%20bone.

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