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Dentistry 2009
Dental anatomy
Lecture #: 1

Dr.: Ashraf Shaweesh

Done by:Duaa Walid Abu Hmaid

Date: 9/2/2011

Introduction to Dental Anatomy

Today I will give this lecture about Dental Anatomy which introduction to Dental

Anatomy and we will also focus on Dental Notation Systems. you will see it is a

very joyful and nice lecture .

Human Dentition is set to be DIPHYODONT what does "di " mean ? Binary , two
DIPHYODONT means that we have two sets of dentition , we have the Primary dentition
and the Secondary dentition.
The primary dentition is also called the deciduous dentition , why is it called
deciduous??
Because it is serves for a limited time and then _ actually_ it is lost and replaced

by another dentition .

(( like just what we have , two types of trees we have Deciduous trees and we
have Permanent trees .
Deciduous tree :: the tree that loses it is leaves every winter and then these
leaves will be replaced again ))

Consequently , Deciduous teeth :: the teeth that serve for a limited period of
time and then theses will be replaced by Permanent teeth .
Permanent teeth are not going to be replaced because they are permanent !!

Something would say that deciduous teeth are also primary teeth because they
are the teeth that come first and the permanent teeth are the secondary teeth
because they are the one that comes second.
The doctor prefer the term of deciduous and permanent and he find that more
scientific to say permanent teeth than secondary teeth .

In the literature "the science of dentistry let's say " you will find that they can
use deciduous or primary but usually they do not use secondary , they use
permanent teeth.

Secondary teeth is not use because it does not actually give any information
whether this set of dentition is permanent or not that’s why they prefer
permanent .

The conclusion ::: we can use primary or deciduous teeth ,, on the other hand
it best or more scientific to use permanent teeth than secondary teeth .
Now ,, How many deciduous and permanent teeth do we have ??
We have 20 deciduous teeth and we have 32 permanent teeth .

That’s mean that the difference between the deciduous teeth and the permanent
teeth is 12 teeth ..
This mean that we have 20 permanent teeth that erupt after deciduous teeth
And we have 12 permanent teeth that erupt alone, without primary teeth
before them .
That’s why the permanent dentition as also classified to show categories ::
The successor teeth :: these teeth are succeed another set of teeth .
The non-successor teeth :: these teeth are erupt by them selves without
having a teeth before them .
Is premolar a successor or non-successor tooth??
It is successor tooth … example >> the first premolar succeed the first deciduous
molar .
But When we say the second permanent molar is it successor or non-successor ??
It is a non-successor tooth because this tooth erupt by it self without tooth
before it.

Important ::
The first and the second and the third permanent molars >> these are
non_successor teeth

So we have three teeth in each quadrant … of course we have four quadrant ::

 The maxillary right
 The maxillary left
 The mandible left
 The mandible right

So we have four quadrant in each one we have three non-successor teeth , so

that makes twelve non-successor teeth .

Did you understand this point because it is important ,, it is basic and for that’s
let's repeat it .
In general we have 32 permanent teeth ,, in each quadrant we have 8 teeth,,
among these 8 teeth we have 5 successor teeth and we have 3 non-successor
teeth .
The 5 successor permanent teeth are the ::
Central incisor ,, lateral incisor ,, canine ,, the fist premolar ,, and the second
premolar..
These are called the successor permanent teeth ,WHY ?? Because they come after
deciduous teeth .

The 3 non-successor teeth are the ::

First molar ,, second molar ,, and the third molar ..
These are called non-successor permanent teeth ,WHY ?? Because they came up
without any tooth before them .

Now ,The tooth that came after a tooth is called successor tooth
The tooth that came before a tooth is called predecessor tooth

So predecessor tooth is deciduous tooth, and Successor tooth is permanent tooth

Let's ask a question

Are all deciduous teeth predecessor teeth ?? Yes
Are all permanent teeth successor teeth ?? No
Please remember this!!

The first permanent tooth to erupt is the mandible first molar or let's say in
general the first molar but this tooth is not a successor tooth so that’s why if I
say what is the first permanent tooth to erupt ?? your answer will be the first
molar
But if I ask what is the first successor tooth to erupt ?? the answer will be
central incisor

So is not the same ,,, please remember ,, some student get confuse in the exam

The deciduous dentition is classified into 3 classes :

We have incisor , we have canine , we have molar
But permanent dentition is classified into :
Incisor , canine , molar , and we have also premolar

So that’s why when we say premolar we do not need to say permanent

premolar because we do not have deciduous premolar. { premolar is enough}
But when we say molar or canine or incisor we have to say deciduous or
permanent .
Also deciduous teeth are small in size ,, the permanent teeth are bigger in size

Now , let's ask this important question , Why do we have 2 sets of teeth ?? Why
didn’t we actually have one set of dentition ?? who can answer this question ?

(( One of the students answer and the doctor repeat his answer and say yes
that's very important , very good ))

The answer ::
As we grow our demand is different , imagine that we grow in size ,our upper
and lower jaw become very big and you still have the tiny small teeth ,you will
not be able to function ,you will not be able to chew food or to eat food , so this
one which is important .
But let's say that ,why we do not have a big teeth from the beginning?? can we
accommodate this big size of teeth?!! No we can't
So because the baby or the child is grow in size and the maxilla and mandible
also grow in size we need a second set of dentition .

Remember something important !!

Born grow in size But the teeth does not grow in size , once you have a tooth it
is stable in size .

Imagine you have one set of dentition and then when you becomes adult you will
have a big mandible and a big maxilla and then you will have only 20 teeth that
are very small and tiny , as I said and as your colleague said this will not be
possible human will die of hunger or starvation they do not able to chew food
properly
What we do ??
we must have or we need a second set of dentition that has two characteristics
the first characteristic this second set of dentition has to be composed of teeth
from bigger size and the second one it has to composed of more teeth,,, WHY ??
because the maxilla and mandible does not only grow in size they also grow in
length.

Imagine that we have 2 set of dentition of the same teeth number the
permanent dentition is only 20 teeth not 32 in this case you will have big upper
and lower jaw and you have good and big teeth but the posterior part or the
back of your mouth will not actually having teeth ,WHY?? Because you do not
have teeth in the posterior part , so we want in addition of having teeth with
bigger size we also want teeth with also a more in number to cover the length or
to accommodate the length in upper and lower jaw ..

Remember these two important things :

We should have two set of dentition because of two things ; our teeth do not
grow in size and our body grow in size so we want a second set of dentition
because we want bigger teeth and also we want more teeth .

Refer to slide number (3)

See here this is the size of upper and lower jaw in an infant , and this is the size
of adult upper and lower jaw …
It is important to see the difference of size between the two pictures and also the
number of the teeth ..
So the jaw has to accommodate the increase number of permanent teeth and
the bigger size .

Dental Formula

It is important to remember something important called Dental Formula , this is

not have been covered or mentioned before
We all the time give the teeth of human so all of us know that how many incisor
do we have per quadrant ?? two
And we have one canine ,, We have two premolar ,, And we have three molar
but it is not the case in other mammals
For example : the cat , if you look at the cat :
The cat has 3 incisor,, one canine ,, 4 premolar ,, one molar

So that’s why if we want to understand the difference between the teeth of

human compared with animal or the difference between the teeth of one
animal compared to another animal we have to use Dental Formula

The dental formula is composed of initials like :

I >>>> for incisor
C >>>> for canine
PM >>>> for premolar
M >>>>for molar
For the deciduous teeth we give the letter D before the initial

For example : if we say

DI >>>>>>>>>> Deciduous Incisor
DC >>>>>>>>> Deciduous Canine
DM >>>>>>>>> Deciduous Molar
Can I say DPM (deciduous premolar) ?? No because we know we do not have
deciduous pre molar.

Refer to slide number (6)

This is the Human Dental Formula … the human dental formula only describes
the teeth of one side not the other side because as we know the other side _all
the time_ is reflection to the first side … all the time our teeth on the left side
are similar to the teeth in the right side (mirror as you know ) so that why we
do not have to use all the teeth we use only one side .

Here for deciduous teeth :

DI >> we have 2 DI in the upper jaw for one side then / and 2 DI in the lower
jaw (2/2)
DC >> we have one DC in the upper jaw / one in the lower jaw (1/1)
DM>> we have 2 in upper and two in the lower (2/2)
Always remember for one side of the jaw
If you count these >>> (2/2) ,(1/1),(2/2) >>>> these are 10
10 times 2 >>>> 20
20 which the number of teeth in both side but 10 is the number of teeth in one
side

For permanent teeth :

I >>> we have 2 upper over 2 lower
C >>> we have 1 over 1
PM >>> we have 2 over 2
M >>> we have 3 over 3
This is together >>>> 16 for one side
16 times 2 >>>> 32 for both side

This is the Human Dental Formula ,,, the mammal dental formula is different
For example: the cat for permanent teeth :
I >>> 3 over 3 (because the cat have three incisor in this case we don’t use
central and lateral we say first, second , third …)
C >>> 1 over 1
PM >>> 4 over 4
M >>> 1 over 1

This together >>> 18 for one side

18 times 2 >>>> 36 for both side

Let's discuss the maximum number of allowed teeth of each classes , there is a
limit, for placental mammal ::
The maximum number of possible Incisor is 3 in upper jaw and three in lower
jaw for one side, of course .
The maximum number of Canine is 1 , in all mammal ,, it is impossible to have
any animal with 2 canine in one quadrant , in summation there are 4 canine .
Premolar can goes up to 4 , but no more than 4 .
Molar can goes up to 3 .

So human have the maximum number of teeth in molar and canine , but we do
not have the maximum number in premolar and incisor classes

Student asked :: Are these number include extinct animals ??

Doctor :: I don’t have idea but I think so … yes ,, I guess so ….

Let's ask this question .. let's suppose that we are have an animal with the
maximum number of possible teeth in all of these four classes (permanent teeth),
How many teeth would we have ?? 44

Let's see how 44 ??

The maximum number of Incisor is 3 over 3
The maximum number of Canine is 1 over 1
The maximum number of Premolar is 4 over 4
The maximum number of Molar is 3 over 3
Always remember for one side of the jaw
That’s will make >> 22 in one side
22 times 2 >>> 44 in both side

Then , The maximum number possible for permanent dentition in any existing
placental mammal is forty four (44) ,,it does not include extinct mammal,,
By the way ,, it is important to remember that the dental formula is not
actually displayed in this slash (/) but it is display as numerator
and denominator but because I could not produce this vertical line ,, I think the
doctor mean horizontal line,, on the computer .

Quadrant
We have four quadrant … the jaw is the region which carry the teeth can be
divided into four quadrant … :
The right maxillary quadrant
The left maxillary quadrant
The left mandible quadrant
The right mandible quadrant

Remember that we start with the right side .

Now I'm facing you ,my right and left just opposite to your right and left , so in
my case this is my right maxillary quadrant_ which in your left side_ and this the
maxillary left then the left mandible then right mandible ..

In your case I'm going clockwise … so if you want to move from quadrant one to
quadrant four you have to go (of course I'm doing that on you as you are the
patient or if you want to consider me as your patient ) clockwise ,, of course
that’s for me is counter clockwise,,

And that’s what we do actually … for example , when my fifth year student
present a patient to me they have to present it in this way .. so they have to
start in maxillary right then the maxillary left then the mandible left then the
mandible right .. this is the proper way of description the dentition ..

As we said we have four quadrant we use 1,2,3,4 for permanent quadrant ,and
5,6,7,8 for deciduous quadrant and we start from the right side of the
patient ,although it is my left side , so remember that let your left just opposite
to the right of your patient .

Refer to slide number (8)

This here this quadrant is 1 or 5 .. and this quadrant is 2 or 6 … and this
quadrant is 3 or 7 and this quadrant is 4 or 8 and this line ( the vertical line )
represent the midline and this line ( the horizontal line ) represent the occlusal
plan which is the plan between the upper teeth and lower teeth .

Slide (9)
Let's see here this is the set of primary teeth and this is the set of permanent
teeth . See here this the maxillary right or left? This the maxillary right and this
is the left

Refer to first picture ( to the left ) ,,So this quadrant is 5 and this 6 ,7,8
Refer to second picture .. this is quadrant 1 ,2 , 3, 4 ,,,Notice that these three
are non-successor teeth (first ,second ,third molar),these teeth are erupt by
them selves without predecessor but 1 ,2 ,3 ,4 ,5 these are called the successor
teeth because they come after deciduous teeth .

Teeth Order
You can order the teeth from 1 to 8 .. refer to the slid (10) these teeth in
quadrants take a number or a letter .
If you want to give tooth a letter you give it from A to E ,as the slid show ,
Why we do that ??!! because this is for deciduous teeth we have 5 teeth in
deciduous dentition .
But If you want to give tooth a number give it from 1 to 8 because we are deal
with the permanent dentition .

Now where do we start the number ??

We start from the area close to the midline .. so the tooth that is very close to
the midline is given number one and the tooth a way from midline is given
number 8 , of course this is for permanent teeth .
For deciduous teeth we use the letter from A to E ..this notation system is called
Palmer Notation System .

Now, we will talk about the Dental Nomenclature or the Dental Notation

We can give name to teeth according to :

 1. Set : whether the tooth is deciduous or permanent
2. Jaw : whether the tooth is maxillary or mandible
3. Class : whether the tooth is incisor or canine or premolar or molar
4. Order within the class : if the tooth is central or lateral or first ,second,
or third
5. The side : right or left

But you know if you want to name the teeth by this way the teeth will have a
long name
For example ; if I want to refer my patient to other colleague I could say please
make the filling in the permanent maxillary right central incisor, It is too
long??!!

So I have to use one of the three Dental Notation Systems which are :
1. Palmer or Zsigmondy Notation System
In this notation system we give the tooth a number or a letter .
If you give a number from 1 to 8 … this is the permanent teeth and we
give a letter from A to E for.. deciduous teeth and we use these line ( the
vertical and horizontal line ) refer to the slide (12)

Please!! Look to the example in the slide

2. FDI Notation System

In this Notation System I do not use the vertical and horizontal line ,
Why?? Because these line are difficult to display in the computer

Notice when I write with my hand I use Palmer Notation System because
it easy for me to draw the line ( quadrant ) but when you type on the
computer you can't draw the line easily instead we use another system
called FDI Notation System

In the FDI Notation System we use the number of the quadrant (instead
of line ). In this system we use number composed of two digits; the digit
in the left side represent the number of quadrant and the digit in the
right side represent the order of that tooth in the quadrant

For example : one one (11) or six four (6 4)

 64 >> this tooth located in the quadrant six which is the deciduous
maxillary left quadrant and this tooth is number 4 >> that mean this is
the Deciduous First Molar

Look to the slide (14) for more example

Notice that we don’t use letter at all in this system ,ONLY numbers !!
We use number from 1 to 8 >> for the order of permanent teeth
We use number from 1 to 5 >> for the order of deciduous teeth
We use number from 1 to 4 >> for number of permanent quadrant
We use number from 5 to 8 >> for number of deciduous quadrant

Never ever use letter for FDI Notation System !!

The last notice about this system :

We pronounced 11 one one is not eleven
Please remember this it's wrong ,in this system, to say tooth twenty eight
28 it is tooth two eight . because twenty eight means the other system
which is Universal Notation System

3. Universal Notation System

Is the American numbering system .in this system what we do ?
we numbered the permanent tooth from 1 to 32 ,, ,, and the
deciduous tooth from A to T
So in this way we don’t actually refer to the number of quadrant but also
actually we don’t use it in Jordan we only use palmer or FDI Notation
Systems ..this system is used in America.

Even actually for me as a practicing dentist if somebody told me do the

tooth number thirteen I need to write it down and then to figure it out
but it is very easy for me to know FDI or Palmer Notation System.

I hope this is enough for you en shallah … see you next Monday .. and
sorry for being late.

Done by : Duaa Walid Abu Hmaid