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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 49-51

Assessing the knowledge of dental practitioners on development of occlusion and eruption patterns


1 MDS (Orthodontics and Dentofacial Orthopaedics), private practice, Saudi Arabia
2 MDS (Orthodontics), Private practice, Kochi, Kerala, India
3 MDS (Orthodotnics), Private practice, Dubai
4 Private practise, Calicut, Kerala, India

Date of Submission29-Apr-2021
Date of Acceptance30-Apr-2021
Date of Web Publication05-Jun-2021

Correspondence Address:
Dr. Jafer Salih Mohammed
MDS (Orthodontics and Dentofacial Orthopaedics), private practice.
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_17_21

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  Abstract 

Background: An ideal occlusion is the perfect interdigitation of the upper and lower teeth. The emergence of the primary dentition is a valuable time for the development of oral motor behavior and the acquisition of masticator skills. The clinician needs to be able to predict the influence that different treatment options will have on the occlusion and dentition when the child’s development is complete. Aim: The aim of this study is to assess the knowledge among dentists treating patients about the development of occlusion and eruption patterns in children, which is helpful in orthodontic referrals. Materials and Methods: A closed-ended questionnaire comprising 15 questions based on eruption sequence, pattern, and occlusion was given to 500 dental practitioners. Data were analyzed by computing the percentage response for each question. Results: The results show that 96% were aware of the Broadbent phenomenon/ugly duckling stage. About 72% knew about the sequence of eruption of primary teeth. Conclusion: This study concludes that most of the dental practitioners treating patients are aware of the development of occlusion and eruption patterns.

Keywords: Deciduous, emergence, eruption, occlusion, permanent, ugly duckling


How to cite this article:
Mohammed JS, Antony T, Hashim A, Salim N. Assessing the knowledge of dental practitioners on development of occlusion and eruption patterns. Int J Oral Care Res 2021;9:49-51

How to cite this URL:
Mohammed JS, Antony T, Hashim A, Salim N. Assessing the knowledge of dental practitioners on development of occlusion and eruption patterns. Int J Oral Care Res [serial online] 2021 [cited 2021 Aug 6];9:49-51. Available from: https://www.ijocr.org/text.asp?2021/9/2/49/317818




  Introduction Top


The specialty of orthodontics relates to facial and occlusal development and involves prevention, interception, and correction of occlusal and dentofacial anomalies that are known as malocclusion. Children form a major chunk of patients with orthodontics. Hence, the general dental practitioners’ referrals at the proper time can result in a huge difference in treatment results, even obviating the need for orthodontic treatment in a few cases. Tooth eruption is a long and complex physiological process involving from where it is formed until reaching the occlusal plane and starting its function.[1],[2],[3],[4] The process of teeth eruption and occlusion development lasts for approximately 13–15 years, during which period teeth erupt successively. Thus, our decision to explore the knowledge of dental practitioners pertaining to orthodontics was because the poor referral might not be unconnected with the poor knowledge of orthodontics and the low ability to recognize cases requiring orthodontic intervention. The purpose of this study was to determine the knowledge of dental practitioners regarding the development of occlusion and eruption patterns in Saudi Arabia.


  Materials and Methods Top


A questionnaire was designed for the dental practitioners regarding the development of occlusion and eruption patterns among patients. The survey sampled 500 general dental practitioners in Saudi Arabia. The survey consisted of 15 items in multiple-choice/answer format. The survey consisted of several questions related to gum pads, mesial shift, mesial step, distal step, ugly duckling stage, leeway space, secondary space, self-correcting anomalies, and eruption of primary and permanent teeth. The survey also asked the clinicians to provide demographic data, such as the name, age, sex, and year of study. All procedures performed in the study were conducted in accordance with the ethics standards given in 1964 Declaration of Helsinki, as revised in 2013. The study proposal was submitted for approval and clearance was obtained from the ethical committee, of our institution. A written informed consent was obtained from each participant. Data were analyzed by computing the percentage response for each question.


  Results Top


Most of the clinicians (82%) responded correctly that gum pads are divided into 10 segments. About 72% of the practitioners responded that the eruptive forces of the first permanent molars that close the space distal to primary canines constitute the early mesial shift. About 80% of the respondents answered that when the distal surface of the maxillary deciduous second molar and mandibular deciduous second molar is in the same vertical plane, it is called flush terminal plane. Only 42% of the clinicians responded correctly that when the distal surface of the mandibular deciduous second molar is mesial to the maxillary deciduous second molar, it is called mesial step, whereas 53% called it a distal step. When questioned about the effect of the distal step, 53% answered that it may develop into Class 2 occlusion or an end–end relation. About 96% were aware of the Broadbent phenomenon/ ugly duckling stage. About 74% responded that the sum of the mesiodistal width of primary canine and primary first and second molars is larger than the sum of their succedaneous teeth, which is known as the leeway space of Nance. About 72% of clinicians responded that the sequence of primary teeth was ABDCE [Figure 1]. The sequence of an eruption of permanent teeth in the maxilla is 6/1, 2, 4, 5, 3,7 by 52% of the participants. About 67% answered that the first primary tooth to erupt is the mandibular central incisor [Figure 2]. About 43% answered that the permanent maxillary canine erupts at 11–12 years. About 67% said that the permanent mandibular molar erupts by six to seven years, 17% said by five to six years, 7% said by seven to eight years, and 9% said by eight to nine years.
Figure 1: Responses on the effect of the distal step

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Figure 2: Responses on the first primary tooth to erupt

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  Discussion Top


The results showed that 82% of the practitioners answered that gum pads are divided into 10 segments. The primary dentition is complete with the eruption of the second primary molars, which means that the location for eruption of the permanent teeth in the future has already been determined at this stage. According to the results, 80% were aware of the flush terminal plane but a majority of them seemed to be doubtful about mesial and distal steps. This terminal plane relationship is used to forecast the future interocclusal relationship of the erupting first permanent molars.[5],[6],[7],[8] The ugly duckling stage refers to the appearance of the diastema at the midline of the maxilla with flared incisors during the eruption of permanent incisors and canines. It occurs due to the pressure exerted by the crowns of the erupting canines over the roots of the incisors. As the crowns of the canines erupt, they exert a mesial component of force, which will tend to straighten the incisors and close the diastema. Hence, this is a self-correcting anomaly and no treatment is required.[9],[10] The results show that 96% of clinicians are aware of this phenomenon. Thorough knowledge of the development of occlusion and eruption patterns is essential for the clinician to be able to identify any disturbance or deviation from the normal in occlusion or eruption patterns, which will assist in improving the orthodontic patient’s oral health and development.


  Conclusion Top


The findings of this study demonstrate that a majority of the dental practitioners treating patients are aware of the development of occlusion and eruption patterns in patients with orthodontics. This study also provides vital information about the sequence of occlusion and eruption patterns and self-correcting anomalies. A more thorough and detailed knowledge of these will ensure early management and, hence, a successful outcome of the treatment provided.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Nainar SM, Straffon LH. Targeting of the year one dental visit for United States children. Int J Paediatr Dent 2003;13:258-63.  Back to cited text no. 1
    
2.
Rayner JA. The first dental visit: A UK viewpoint. Int J Paediatr Dent 2003;13:269.  Back to cited text no. 2
    
3.
Yang CW. Pediatric Dental Basics. Case Based Pediatrics for Medical Students and Residents. Ch. 1.12. Honolulu: Department of Pediatrics; 2003.  Back to cited text no. 3
    
4.
Peltomaki T. Development of the occlusion. In: English JD, editor. Mosbys Orthodontic Review. 2nd ed. St. Louis: Mosby Elsevier; 2014. p. 14-23.  Back to cited text no. 4
    
5.
Kanellis MJ. Orthodontic treatment in the primary dentition. In: Bishara SE, editor. Textbook of Orthodontics. Philadelphia, PA: WB Saunders Co.; 2001. p. 248-56.  Back to cited text no. 5
    
6.
Woodside DG. The significance of late developmental crowding to early treatment planning for incisor crowding. Am J Orthod Dentofacial Orthop 2000;117:559-61.  Back to cited text no. 6
    
7.
Sriram CH, Priya VK, Sivakumar N, Reddy KR, Babu PJ, Reddy P. Occlusion of primary dentition in preschool children of Chennai and Hyderabad: A comparative study. Contemp Clin Dent 2012;3:31-7.  Back to cited text no. 7
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8.
Suri L, Gagari E, Vastardis H. Delayed tooth eruption: Pathogenesis, diagnosis, and treatment. A literature review. Am J Orthod Dentofacial Orthop 2004;126:432-45.  Back to cited text no. 8
    
9.
Moslemi M. An epidemiological survey of the time and sequence of eruption of permanent teeth in 4-15-year-olds in Tehran, Iran. Int J Paediatr Dent 2004;14:432-8.  Back to cited text no. 9
    
10.
Nanci A. Ten Cate’s Oral Histology, Development, Structure and Function. 8th ed. St. Louis: Mosby; 2008. p. 233-52.  Back to cited text no. 10
    


    Figures

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  Introduction
   Materials and Me...
  Results
  Discussion
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