Normal Dental Development and Oral Pathology

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Normal Dental Development and Oral Pathology

• Dr S.E.Jabbarifar
• Department of Isfahan Pediatric Dentistry

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PRIMARY DENTITION
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Eruption Schedule
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Eruption Schedule
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Distal surface towards the back of the mouth
Midline
Mesial surface towards the front of the mouth
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Upper (Maxillary) Arch
Incisal Surface
Labial/Buccal Surface
Palatal Surface
Occlusal Surface
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Lower (Mandibular) Arch
Occlusal Surface
Labial/Buccal Surface
Lingual Surface
Incisal Surface
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Ectopic Eruption

• Abnormal pattern of tooth eruption
• Teeth are delayed in eruption or erupt in the
  wrong location
• Most common for permanent lower incisors,
  permanent upper canines and permanent first molars

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Syndromes with Dental Manifestations

• Dentinogenesis Imperfecta
• Amelogenesis Imperfecta
• Cleidocranial Dysostosis
• Ectodermal Dysplasia

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Common Causes of Malocclusion

• Non-nutritive sucking behaviors
• May cause anterior open bites or crossbites in
  children who use pacifiers and digits
• Most children will stop oral behaviors by age 2.
  For older children, consider using rewards,
  gloves, replacement items
• Caries or trauma with premature loss of teeth and
  loss of space

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Common Oral Lesions in the Primary Care Office

• Lip lesions
• Angioedema
• Herpes Labialis
• Mucocele
• Angular cheilitis
• Lingual Lesions
• Hairy Tongue
• Geographic Tongue

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Common Oral Lesions in the Primary Care Office

• Oral conditions of infants and children
• Natal teeth
• Epsteins pearls
• Eruption cysts
• Thrush
• Tooth Conditions
• Tooth Staining
• Erosions

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Common Oral Lesions in the Primary Care Office

• White lesions
• Candida
• Oral Leukoplakia
• Morsicatio Buccarum
• Vesiculobullous Lesions
• Primary herpes gingivostomatitis
• Recurrent herpes
• Herpangina
• Hand-foot-and-Mouth Disease

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Common Oral Lesions in the Primary Care Office

• Ulcers
• Aphthous Ulcers
• Behcets Syndrome

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Caries
Caries
Caries are an infectious, communicable disease
resulting in the destruction of tooth structure
by the acid produced by the metabolism of sugar
by bacteria found in dental plaque Plaque is a
dense bacterial aggregate containing about 10
bacteria per milligram that accumulates on tooth
surfaces.
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Dental Caries Process
MUTAN STREPTOCOCCI LACTOBACILLI
TEETH
Host
Bacteria
DENTAL CARIES
Substrate
FRUCTOSE SUCROSE
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Dental Caries Stages
The acid created by the caries bacterias
metabolism of sugar leads to demineralization.
Demineralization is the loss of calcium,
phosphate and carbonate from the enamel
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Dental Caries Stages
Lesion is progressing laterally and towards the
pulp
Incipient Lesion (caries not more than halfway
into enamel)
Lesion has reached the dentinoenamel junction
(DEJ)
Lesion extended into the pulp
If demineralization is allowed to continue, the
tooth will eventually be eroded enough for a
cavity to form.
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Oral Screening Examination

• Tips from a practicing clinician
• Get in the habit of performing a brief oral
  examination in all patients presenting to your
  office for general wellness exams and use that
  time to discuss with patients their dental habits
  and risk factors for oral disease
• Perform more detailed evaluations in patients
  when indicated by history any review of systems
• In kids always lift the lip

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Important Landmarks of the Oral Cavity

• Lips
• Labial and Buccal Mucosa
• Floor of mouth
• Hard and soft palate
• Parotid papilla
• Oropharynx and tonsilar pillars