Normal dental development and oral pathology
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Normal Dental Development and Oral Pathology. Rebecca L. Slayton, DDS, PhD Department of Pediatric Dentistry Amanda Keerbs, MD Department of Family Medicine. PRIMARY DENTITION. Eruption Schedule. Eruption Schedule. Distal surface – towards the back of the mouth. Midline.

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Normal Dental Development and Oral Pathology

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Normal dental development and oral pathology

Normal Dental Development and Oral Pathology

Rebecca L. Slayton, DDS, PhD

Department of Pediatric Dentistry

Amanda Keerbs, MD

Department of Family Medicine


Normal dental development and oral pathology

PRIMARY DENTITION


Eruption schedule

Eruption Schedule


Eruption schedule1

Eruption Schedule


Normal dental development and oral pathology

Distal surface – towards the back of the mouth

Midline

Mesial surface – towards the front of the mouth


Normal dental development and oral pathology

Upper (Maxillary) Arch

Incisal Surface

Labial/Buccal

Surface

Palatal

Surface

Occlusal Surface


Normal dental development and oral pathology

Lower (Mandibular) Arch

Occlusal

Surface

Labial/Buccal

Surface

Lingual

Surface

Incisal

Surface


Ectopic eruption

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


Syndromes with dental manifestations

Syndromes with Dental Manifestations

  • Dentinogenesis Imperfecta

  • Amelogenesis Imperfecta

  • Cleidocranial Dysostosis

  • Ectodermal Dysplasia


Common causes of malocclusion

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


Common oral lesions in the primary care office

Common Oral Lesions in the Primary Care Office

  • Lip lesions

    • Angioedema

    • Herpes Labialis

    • Mucocele

    • Angular cheilitis

  • Lingual Lesions

    • Hairy Tongue

    • Geographic Tongue


Common oral lesions in the primary care office1

Common Oral Lesions in the Primary Care Office

  • Oral conditions of infants and children

    • Natal teeth

    • Epstein’s pearls

    • Eruption cysts

    • Thrush

  • Tooth Conditions

    • Tooth Staining

    • Erosions


Common oral lesions in the primary care office2

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


Common oral lesions in the primary care office3

Common Oral Lesions in the Primary Care Office

  • Ulcers

    • Aphthous Ulcers

    • Behcet’s Syndrome


Caries

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.


Dental caries process

Dental Caries Process

MUTAN

STREPTOCOCCI

LACTOBACILLI

TEETH

Host

Bacteria

DENTAL

CARIES

Substrate

FRUCTOSE

SUCROSE


Dental caries stages

Dental Caries Stages

The acid created by the caries bacteria’s metabolism of sugar leads to demineralization. Demineralization is the loss of calcium, phosphate and carbonate from the enamel


Dental caries stages1

Dental Caries Stages

Lesion is progressing laterally and towards the pulp

Lesion has reached the dentinoenamel junction (DEJ)

Incipient Lesion

(caries not more than halfway into enamel)

Lesion extended into the pulp

If demineralization is allowed to continue, the tooth will eventually be eroded enough for a cavity to form.


Oral screening examination

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


Important landmarks of the oral cavity

Important Landmarks of the Oral Cavity

  • Lips

  • Labial and Buccal Mucosa

  • Floor of mouth

  • Hard and soft palate

  • Parotid papilla

  • Oropharynx and tonsilar pillars


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