< 6 years old – primary dentition
Image adapted from CDC Gov.
There are usually no teeth present at birth, however occasionally there may be a ‘natal tooth’ or supernumerary. The mandibular primary incisors normally erupt first (within 6 months of age) and this is followed by the other incisors. The primary dentition is usually complete by 24 to 30 months.
Neither the maxillary or mandibular alveolar process are well developed at birth. Syndromic defects and clefting of the hard palate or soft tissues are normally diagnosed in-utero or investigated by the neonatal team.
Assessing a child below the age of 6 years can be complex as growth patterns may not be clear and any future crowding or spacing is difficult to predict at this age. The primary dentition should have primate spaces present and the absence of this may be a sign of severe future crowding. Mandibular growth normally lags behind maxillary growth during this age. There is usually also more leeway space in the mandible than the maxilla. As such, the occlusal relationship of primary molars may not always translate to a similar Angle Class molar relationship when the child develops their full permanent dentition.
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