1. Normal Dental Development and Oral Pathology
Rebecca L. Slayton, DDS, PhD
Department of Pediatric Dentistry
Amanda Keerbs, MD
Department of Family Medicine

2. PRIMARY DENTITION

3. Eruption Schedule

4. Eruption Schedule

6. Distal surface – towards the back of the mouth
Midline
Mesial surface – towards the front of the mouth

7. Upper (Maxillary) Arch
Incisal Surface
Labial/Buccal
Surface
Palatal
Surface
Occlusal Surface

8. Lower (Mandibular) Arch
Occlusal
Surface
Labial/Buccal
Surface
Lingual
Surface
Incisal
Surface

9. 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

10. Syndromes with Dental Manifestations
Dentinogenesis Imperfecta
Amelogenesis Imperfecta
Cleidocranial Dysostosis
Ectodermal Dysplasia

11. 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

12. Common Oral Lesions in the Primary Care Office
Lip lesions
Angioedema
Herpes Labialis
Mucocele
Angular cheilitis
Lingual Lesions
Hairy Tongue
Geographic Tongue

13. 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

14. 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

15. Common Oral Lesions in the Primary Care Office
Ulcers
Aphthous Ulcers
Behcet’s Syndrome

16. 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.

17. Dental Caries Process Host Bacteria Substrate TEETH FRUCTOSE SUCROSE
MUTAN
STREPTOCOCCI
LACTOBACILLI
TEETH
Host
Bacteria
DENTAL
CARIES
Substrate
FRUCTOSE
SUCROSE

18. 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

19. Dental Caries Stages
Incipient Lesion
(caries not more than halfway into enamel)
Lesion has reached the dentinoenamel junction (DEJ)
Lesion is progressing laterally and towards the pulp
Lesion extended into the pulp
If demineralization is allowed to continue, the tooth will eventually be eroded enough for a cavity to form.

20. 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

21. Important Landmarks of the Oral Cavity
Lips
Labial and Buccal Mucosa
Floor of mouth
Hard and soft palate
Parotid papilla
Oropharynx and tonsilar pillars