Tooth Morphology Sept 2016

Tooth Morphology
(the study of the form of teeth)
1. Structure of teeth.
2. Supporting structures.
3. Deciduous tooth morphology.
4. Secondary tooth morphology
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Teeth
• General arrangement of teeth is called the dentition
• Primary dentition
– Contains the deciduous teeth
• Secondary dentition
– Contains the permanent teeth
• Mixed dentition
– Contains some deciduous and some permanent teeth

Maxillary teeth
• Supported by the
maxillary bone
• Belong to the
maxillary arch
Figure courtesy Hu-Friedy

Mandibular teeth
• Supported by the
mandibular bone
• Belong to the
mandibular arch

Each arch is divided into a right and
left quadrant

Types of teeth
• Incisors Anterior teeth

• Canines
• Molars Posterior teeth

• Premolars

Incisors
• Designed to bite or cut
food
• The biting surface is called
the incisal edge.
• Central incisor larger than
lateral incisor.
• Flattened crown with one
root.
• Upper central incisor is
largest of all incisors.

Canines
• Designed to cut and tear

food
• Upper canines larger than
lowers.
• Large conical crown with
pointed incisal edge and
one long root.
• Upper canines have longest
of all roots.

Premolars
• Used for tearing and

chewing food
• All have two cusps, equal
size in uppers, smaller
lingual cusp in lowers.
• Upper first premolar has
two roots (buccal and
palatal), all others have
one root.

Molars
• All have large occlusal surface
for grinding and chewing food.
• All upper molars have three
roots (palatal, mesiobuccal and
distobuccal)
• All lower molars have two roots
(mesial and distal).
• Upper first molar has five
cusps, fifth one called ‘cusp of
carabelli’.
• Lower first molar has five
cusps, three buccal and two
lingual.
• All other molars have four
cusps.
• Roots in third molars vary in
Figure courtesy Hu-Friedy number, uppers are often fused
together.

Occlusion
• In a normal mouth all incisal edges and cusps
of upper and lower teeth interlock to give a
stable bite (occlusion).
• The upper arch is usually wider so that the
lower teeth bite into the middle of the upper
teeth, or onto the cingulum of the incisors and
canines.

Parts of the teeth
• Each tooth consists of a crown and root
• The crown is covered by enamel
• The root is covered by cementum
• The crown and root are joined at the
cementenamel junction
• The cervical line separates the crown and root

Enamel
• Hardest tissue in the

body
• Covers the crown
• Thickest over the tips
of the crown
• Thinnest where crown
meets the root
• Colour is determined
by thickness
Figure courtesy Hu-

Friedy
Enamel
• It is made up of 96% inorganic crystals arranged as prisms

• Main mineral crystals are hydroxyapatite.
• Junction where enamel meets dentine is called the
amelodentinal junction.
• Contains no nerves or blood vessels and therefore cannot
experience sensitivity.
• Non-living tissue which cannot grow or repair itself, but can
remineralise after acid attack.
• Can exchange minerals, especially fluoride, to form
fluorapatite crystal which make the enamel surface harder
still and more resistant to acid attack.

Dentine
• Forms the bulk of the

crown and root of the
teeth
• Covered by enamel in the
crown
• Covered by cementum in
the root
• Living tissue
• Receives nutrition from
dentinal tubules running
from the pulp
Figure courtesy Hu-Friedy • Tubules are involved with
toothache
Dentine
• It is up to 80% inorganic.
• It is composed of hollow tubules containing fibrils, which are
sensory endings from the cells forming the dentine.
• It is therefore a living tissue, and can transmit sensitivity.
• It is formed by ondontoblast cells, which lie at the edge of the
pulp chamber.
• It can repair itself by producing secondary dentine.
• Secondary dentine also forms as part of the natural ageing
process.
• Caries progresses rapidly through dentine because of its
hollow nature.

Cementum
• The cementum is the layer

covering dentine of the root.
• It normally lies beneath the
gingiva.
• It allows attachment of the
tooth to the supporting
structure of the periodontal
ligament.
• Calcium Hydroxyapatite
• Similar chemically to bone

Pulp Chamber Pulp Canals
• Pulp is the soft tissue

within the tooth
structure.
• Surrounded by dentine
• Consists of connective
tissue, blood vessels
and nerves
• Odontoblasts present
on the wall of the pulp
chamber
Pulp
• It allows the tooth to feel hot, cold, touch, pain by
stimulation of fibrils in dentine.
• Vessels enter the tooth through the apical foramen,
at the end of each root apex.
• These tissues are enclosed within the pulp chamber
of the tooth.
• Chamber is lined by ondontoblast cells.
• Gradual formation of secondary dentine with age
causes pulp chamber to decrease in size and become
narrower.

Periodontal tissues
Support and attach the teeth to their

bony sockets

Attachment tissues
Periodontal
ligament Cementum
Alveolar bone
Diagram courtesy Oral-B

Periodontal Ligament
• This is a specialised fibrous tissue which attaches the

teeth to the alveolar bone and surrounding tissues.
• Fibres are made up of protein called collagen.
• Acts as a shock absorber when tooth undergoes
normal chewing movements, so that the tooth can
bounce a little in its socket and not fracture.
• Destruction of periodontal ligament occurs during
periodontal disease.

Alveolar bone
• The bony extensions of the maxilla and mandible,

where the teeth are formed and from where they
erupt into the mouth.
• Special bone found only in the jaws.
• Sole purpose is to support the teeth during their
lifetime.
• When teeth are extracted, alveolar bone gradually
resorbs away.
• Outer layer is hard compact bone, with the surface
being called the lamina dura.
• Inner layer is cancellous bone, sponge like in
appearance to allow blood vessels and nerves to run
through.
• Destruction of the alveolar bone can occur during
periodontal disease.
Cementum
• The cementum is the layer covering dentine of

the root.
• It normally lies beneath the gingivae.
• It allows attachment of the tooth to the
supporting structure of the periodontal
ligament.

Gingivae
• This is the correct term for the gums.
• In health they are light pink in colour with a stippled
(orange peel) surface.
• Form a 2mm crevice (gingival crevice) around the
necks of each tooth, above periodontal ligament.
• Gingivitis occurs when this area becomes inflamed.
• Inflamed gingivae are red and shiny, with a swollen
appearance.

EXERCISE

Eruption

Eruption
• Two sets of teeth develop in a person’s
lifetime
• The deciduous dentition contains 20 teeth
• The permanent dentition contains 32 teeth
• And for a period of time a child will have a
mixed dentition
– Containing some deciduous teeth and some
permanent teeth

Deciduous dentition
• The first teeth to appear are the deciduous

incisor teeth at about 6 months
• The last teeth to appear are the deciduous
second molars at 2 ½ years

Deciduous dentition

Deciduous dentition eruption ages
Tooth Eruption age

Central incisors 6 to 8 months
Lateral incisors 7 to 9 months
First molars 12 to 16 months
Canines 16 to 21 months
Second molars 21 to 30 months

Deciduous Teeth
• Deciduous teeth in general resemble their
corresponding permanent teeth but there are some
important differences.
• Deciduous teeth are much smaller.
• There is adequate space so crowding is uncommon.
• Deciduous crowns are whiter.
• Pulp chambers of deciduous teeth are relatively
larger, their enamel is much thinner.

Deciduous Teeth
• Deciduous incisors and canines are smaller
versions of their permanent successors.
• Deciduous molars have the same number of

roots as permanent molars but differ in other
respects.

Deciduous Teeth
• The crowns of deciduous molars are more
bulbous.
• To provide space for the developing premolar,
the roots of deciduous molars are more
divergent than those of permanent molars.
• Deciduous 2nd molars resemble miniature 1st
permanent molars; but the shape of
deciduous 1st molars is much less typical,
having a pronounced mesio-buccal bulge.

Permanent dentition
• The permanent teeth replace the deciduous
teeth
• The first permanent teeth to appear are the
mandibular first molars
– These teeth erupt behind the deciduous second
molars
• The next permanent teeth to erupt are the
central and lateral incisors

Permanent dentition

Permanent dentition eruption ages
Tooth Eruption age
First molars 6 to 7 years
Central incisors 6 to 8 years
Lateral incisors 7- 9 years
Canines 9 to 11 years
First premolars 10 to 12 years
Second premolars 10 to 12 years
Second molars 12 to 13 years
Third molars 17 to 22 years

Exercise

What Is the
Approximate Age
of These
Patients?
CHARTING

Tooth surfaces-posterior teeth
• Mesial – nearest the
midline
• Distal – furthest from the
midline
• Lingual - facing the
tongue
• Buccal – facing the cheek
• Occlusal – chewing
surface

Tooth surfaces-anterior teeth
• Labial – facing the lip
• Mesial – nearest the
midline
• Distal – furthest from the
midline
• Lingual - facing the tongue
• Incisal edge – biting
surface of anterior teeth

Tooth identification
There is a convention for naming the

teeth which must be followed

The tooth is identified by
• The dentition – permanent or deciduous
• The arch – maxillary or mandibular
• The quadrant – right or left side of the
mouth
• The tooth type – incisor, canine,
premolar or molar

EXERCISE

Palmer notation Permanent teeth

Examples of palmer notation
Palmer notation Tooth description
Permanent maxillary right second premolar
Permanent maxillary left third molar
Permanent mandibular left lateral incisor
Permanent mandibular right canine

Palmer notation system
Deciduous teeth
• Assigns a letter to the deciduous tooth
depending on its position relative to the
midline
• Central incisors are closest to the midline and
are given the letter A
• The second molars are furthest and are given
the letter E

Palmer notation Identification
Deciduous tooth
Deciduous tooth Symbol assigned

Central incisor A
Lateral incisor B
Canine C
First molar D
Second molar E

Palmer notation
Deciduous teeth

Palmer notation
Deciduous teeth
Palmer Notation Tooth description
Deciduous maxillary right second

molar
Deciduous maxillary left first molar
Deciduous mandibular left lateral

incisor
Deciduous mandibular right canine

EXERCISE

FDI notation system –
Permanent teeth
• Uses a two-digit number to identify each
tooth
• The first digit identifies the quadrant
– The permanent quadrants are numbered from 1
through to 4
• The second digit identifies the tooth
– The permanent teeth are numbered from 1
through to 8

FDI- Identification
Permanent tooth
Permanent tooth Number assigned
Central incisor 1
Lateral incisor 2
Canine 3
First premolar 4
Second premolar 5
First molar 6
Second molar 7
Third molar 8

FDI notation system
Permanent teeth

Examples of FDI notation
Notation Tooth description
11 Permanent maxillary right central incisor
16 Permanent maxillary right first molar
23 Permanent maxillary left canine
28 Permanent maxillary left third molar
34 Permanent mandibular left first premolar
37 Permanent mandibular left second molar
42 Permanent mandibular right lateral incisor
45 Permanent mandibular right second permolar

FDI notation system
Deciduous teeth
• Uses a two-digit number to identify each
tooth
• The first digit identifies the quadrant
– The deciduous quadrants are numbered from
5 through to 8
• The second digit identifies the tooth
– The deciduous teeth are numbered from
1 through to 5

FDI Identification
Deciduous tooth
Deciduous tooth Number Assigned
Central incisor 1
Lateral incisor 2
Canine 3
First molar 4
Second molar 5

FDI notation system
Deciduous teeth

Examples of FDI notation
Notation Tooth description
51 Deciduous maxillary right central incisor

54 Deciduous maxillary right first molar
63 Deciduous maxillary left canine
65 Deciduous maxillary left second molar
74 Deciduous mandibular left first molar
75 Deciduous mandibular left second molar
82 Deciduous mandibular right lateral incisor
81 Deciduous mandibular right central incisor

EXCERCISE


Tooth Morphology Sept 2016

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Tooth Morphology

(the study of the form of teeth)

Quality Education for a Healthier Scotland

Quality Education for a Healthier Scotland

Figure courtesy Hu-Friedy

Quality Education for a Healthier Scotland

Figure courtesy Hu-Friedy

Quality Education for a Healthier Scotland

Figure courtesy Hu-Friedy

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• Incisors Anterior teeth

• Molars Posterior teeth

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• Designed to cut and tear

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• Used for tearing and

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• Hardest tissue in the

Figure courtesy Hu-

• It is made up of 96% inorganic crystals arranged as prisms

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• Forms the bulk of the

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• The cementum is the layer

Figure courtesy Hu-Friedy

• Pulp is the soft tissue

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Support and attach the teeth to their

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Diagram courtesy Oral-B

Quality Education for a Healthier Scotland

• This is a specialised fibrous tissue which attaches the

Quality Education for a Healthier Scotland

• The bony extensions of the maxilla and mandible,

• The cementum is the layer covering dentine of

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• The first teeth to appear are the deciduous

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Figure courtesy Hu-Friedy

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Tooth Eruption age

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• Deciduous molars have the same number of

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Figure courtesy Hu-Friedy

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There is a convention for naming the

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