Study Establishes New Guidelines for Assessing Tooth Development

Dentistry Today

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Children’s teeth don’t develop along the timeline once commonly used, according to researchers at the University of Missouri School of Medicine who believe their study could inform clinical decisions for a variety of fields including dentistry and pathology.

“Our paper sets new standards, or reference values, for dental development. It provides information on the normal timing of dental stages for the permanent dentition as well as comprehensive characterization of the variation that can be expected,” said Richard Sherwood, PhD, vice chair of research at the school and principal investigator of the study.

“For example, we found that development of molar crowns tend to occur earlier than we previously believe while formation of the crowns is later in canines and premolars. Development of roots begins at increasingly later ages,” said Sherwood. 

The researchers assessed more than 6,000 radiographs of 590 children that were taken between 1940 and 1982 and gathered in the Fels Longitudinal Study. They then evaluated radiographs of the canine and post-canine teeth to determine the precise timing of the beginning and ending of each tooth’s growth process. 

Traditionally, most clinicians use a 14-stage system published by Moorees, Fanning, and Hunt in 1963. The new study expands on this system and uses an extremely sophisticated statistical system to analyze the wide range of variability in tooth maturation. Through this method, the researchers can provide a clinically usable reference guide with more accurate results.

“These findings directly impact the timing of the clinical care in several fields including dentistry. This means that a dentist can assess whether a child’s dental development is progressing along a normal timeframe according to these new standards,” Sherwood said. 

“If, after consulting our paper, the dentist believes a child’s dental development is delayed enough to be considered normal, the child may then be tested for possible causes such as nutrition deficiency, hormone issues, and genetic problems,” Sherwood said. 

The study also provides a new reference guide for forensic pathologists who use dental development to estimate chronological age in immature individuals. 

The study, “Timing of Development of the Permanent Mandibular Dentition: New Reference Values from the Fels Longitudinal Study,” was published by The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology.

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