Eruption Age And Sequence Of Permanent Teeth Among School Children In The Dravidian Population
Lakshimi Lakshmanan1*, Sujatha Somasundaram2
1 Post Graduate Student, Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and
Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
2 Saveetha University, Chennai, Tamil Nadu, India.
*Corresponding Author
Dr. Lakshimi Lakshmanan,
Post Graduate Student, Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha
University 162, Poonamallee high road, Chennai-600 077, Tamil Nadu, India.
Tel: +91-8939346341
Email Id: lachulaxmanan@gmail.com
Received: March 18, 2021; Accepted: April 04, 2021; Published: April 08, 2021
Citation: Lakshimi Lakshmanan, Sujatha Somasundaram. Eruption Age And Sequence Of Permanent Teeth Among School Children In The Dravidian Population. Int J Dentistry Oral Sci. 2021;08(04):2302-2308. doi: dx.doi.org/10.19070/2377-8075-21000455
Copyright: Lakshimi Lakshmanan©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction: Significant knowledge on timing and pattern of permanent teeth eruption in a given population is essential for
the diagnosis and treatment planning. Already established but changes to every population. The purpose of this study was to
determine the eruption age and sequence of permanent teeth among school children in the Dravidian population.
Material and Methods: This cross-sectional study was conducted among 1,650 Dravidian children (886 girls and 764 boys)
ranging in age from 5 to 15 years. Descriptive statistics and paired t-test were used to compare the mean time of eruption of
permanent teeth between gender and upper and lower jaws.
Results: The permanent tooth started to erupt in 7.06 years of age and ended at 13.60 years of age in girls and in boys between
the ages of 6.45 years and 13.40 years. In both the gender, the first tooth to erupt was the lower 1st molar, while the last
was the upper 2nd molar. Statistically significant difference was noted between the eruption of permanent teeth in girls and
boys except upper and lower canines and 2nd premolars.
Conclusion: Boys showed earlier eruption of permanent teeth than girls. All the mandibular teeth erupted earlier than their
maxillary counterpart, with the exception of right premolars in girls and left incisors in boys. A delay in eruption of lower
canines was noticed in girls.
2.Introduction
3.COVID 19 and Dental Treatment
4.Materials and Methods
5.Results
6.Discussion
7.Conclusion
8.References
Keywords
Eruption; Permanent Teeth; Sequence.
Introduction
Tooth eruption is a continuous physiological process, in which
tooth move from its developmental position within the jaws to
break the mucosa towards the oral cavity [1].
The maturation status of an individual can be assessed based on
skeletal development, dental development and chronological age.
Eruption of teeth are considered as markers of maturity and an
important milestone in an individual’s life. Timing and pattern of
tooth eruption has been associated with parameters, such as skeletal
and dental maturity, to indicate the level of somatic development
of individuals [2].
Significant knowledge on the timing and pattern of tooth eruption
are vital for diagnosis, prevention and treatment planning
in pediatric dentistry, orthodontics and also essential in forensic
dentistry to determine the age [3]. Estimation of age by the number
of teeth erupted has been recognized as having paramount
importance in demographic surveys, forensic sciences and anthropology
[3, 4].
Tooth eruption time varies widely for every individual. A trend
toward earlier eruption of permanent teeth has been reported in
industrialized countries which are thought to be primarily caused
by early puberty that in turn, is a result of modified diet and nutrition.
Other factors such as gender, ethnic origin, racial group,
gestational age, geographical conditions also influence the timing
of eruption [5, 6]. Therefore, the developmental patterns cannot
be universally applied owing to ethnic diversity. The standards for tooth eruption patterns derived for a western population cannot
be speculated to every other population as there is wide difference
racially, culturally, and environmentally. Therefore, this study
aimed at evaluating the eruption time and sequence of permanent
teeth among school going Dravidian children.
Material And Method
Ethical clearance for the present study was obtained from the Institutional
Ethical Review Board (SRB/MDS/PEDO/18-19/015)
and in accordance with the 1964 Helsinki declaration and its later
amendments. This cross-sectional study was conducted among a
group of 1,650 school Dravidian children ranging in age from 5
to 15 years. Permission was obtained from the school authorities
to conduct the study. Informed verbal consent was obtained from
the participants’ parents and that was approved by institutional
review board.
The exclusion criteria were children with systemic diseases, developmental
syndromes or craniofacial skeletal deformities like cleft
lip and palate and children undergoing orthodontic treatment, or
with any history of extraction of permanent teeth.
At the start, basic information, that is, age and gender of the child
was recorded. The age was calculated from date of birth to the
date of examination and rounded off to the full month. Oral examination
was then carried out using mouth mirror with participant
seated on an ordinary chair.
A tooth was considered to be erupted even if a small part of the
crown had perforated the gum, becoming visible in the oral cavity
[7-9]. The teeth were recorded according to the two-digit system
of Federation Dentaire Internatioanale (FDI).
The collected data were recorded in spreadsheet (Excel 2017: Microsoft
office) and analyzed using SPSS software (Version 21.0).
The calculations were performed according to previous studies
on tooth emergence. Student t-test were used to determine the
differences between gender and between contralateral sides. Pvalue
of less than 0.05 was considered statistically significant.
Results
A total of 886 girls (54%) and 764 boys (46%) between the age
group of 5-15 years of age participated in the study.
The mean age, standard deviation and median for eruption of
permanent teeth of both genders are shown in [Table 1] and [Table
2].
The results show that the permanent tooth starts to erupt in 7.06
years of age and ends at 13.60 years of age in girls. Whereas this
occurs between the ages of 6.45 years and 13.40 years in boys. In
both the gender, the first tooth to erupt is the lower 1st molar,
while the last is the upper 2nd molar.
[Table 3] and [Table 4] compares the mean age of permanent
teeth eruption between genders.
Statistically significant difference was noted between the eruption
of permanent teeth in girls and boys except upper and lower canines
and 2nd premolars. Majority of permanent teeth emerged
earlier in boys than in girls. In the age group of 15 years, all the
permanent teeth erupted except 3rd molars.
Mandibular teeth erupted earlier than their maxillary counterparts
except right 1st and 2nd premolars, left central and lateral incisors.
[Table 5] and [Table 6] shows the comparison of mean age of
permanent teeth eruption between contra-lateral sides of maxillary
and mandibular arches among both genders.
In girls, statistically significant difference was noted in case of
eruption of right and left upper premolars and lower 1st premolar.
In boys, statistically significant difference was noted in the
eruption of right and left upper incisors, premolars, and 2nd molar;
lower lateral incisor, and 1st premolar.
Table 1. Sensitivity and specificity of caries detection under amalgam restorations by the restorative dentist.
Table 2. Sensitivity and specificity of caries detection under amalgam restorations by the radiologist.
Table 3. Sensitivity and specificity of caries detection under composite restorations by the restorative dentist.
Table 4. Sensitivity and specificity of caries detection under composite restorations by the radiologist.
Table 5. Interobserver agreements.
Table 6. Interobserver agreements.
Table 7. Interobserver agreements.
Table 8. Interobserver agreements.
Based on the mean time of eruption, the sequence of eruption of permanent teeth in both genders are as follows: Maxilla_ 6-1-2-4- 3-5-7; Mandible_ 6-1-2-3-4-5-7. On comparison with standard eruption time, there was considerable delay in the eruption of lower canines in girls [Table 7], [Table 8].
Discussion
Interpretation on the timing and sequence of permanent teeth
eruption is vital for managing dental problem in children and also
used to supplement other maturity indicators in the diagnosis
of growth disturbances and in forensic medicine to estimate the
chronological age of children with unknown birth records [10].
The demographic, racial and nutritional factors which vary in each
geographical location, might have an effect on tooth eruption [6,
8]. Therefore, the standard eruption chart derived from western
population cannot be applied for every other population. The
current study aimed at determining the eruption age and sequence
of permanent teeth in Dravidian children.
Eruption of teeth can be determined either clinically or radiographically.
However, in community-based studies, radiographic
methods may not be appropriate considering ethics and feasibility.
Therefore, this study determined the tooth eruption clinically
[10].
Most of the earlier studies done in children from Malaysia, Turkey,
Australia, Japan, Hawaii, Kingston confirm that the girls
were ahead of boys in the permanent tooth eruption [5, 7, 10,
14]. Contradicting to these, in the present study, the mean age of
eruption of permanent teeth were earlier in boys than in girls. In
the maxillary arch, right and left molars, left incisors and left 2nd
premolar showed earlier eruption in boys. In mandibular arch,
right canine, premolars, molars, and left lateral incisor, canine and
1st molar were earlier in boys. However, in studies conducted in
other regions of India, girls showed earlier eruption than boys
[6, 15].
Significant difference in the eruption of contra-lateral permanent
teeth in boys can be noted in the present study. Similar to this, in a
study conducted among Spanish children, a slight earlier eruption
of teeth was noted on the left side with a tendency toward early
eruption in boys [16].
In the present study, eruption of all the mandibular teeth, with
exception of right premolars in girls and left incisors in boys, were
earlier than their maxillary counterparts. This is in accordance
with the studies done in Kingston, Malaysia, Turkey and Greece
children [5, 7, 10, 14].
The sequence of eruption in this study was similar to other studies
reported in Australia, Japan, Kenya, and Indian studies from
Hyderabad and Delhi [6, 11, 12, 17, 18]. When the mean age of
eruption of permanent teeth was compared with standard eruption
time given by Logan and Kornfeld, a delayed eruption was
noticed in the eruption of lower canines [19]. Alike, a study conducted
among Kerman Province children reported a delay in the
eruption of lower canines [20]. This delay has a significant clinical
correlation with the development of malocclusion. The risk of
a dystrophic eruption of canine is high in an eruption sequence
with the canine following premolars when the 1st molar erupts
mesially.
However, cross-sectional study gives only the mean age of eruption
and precise pattern of eruption could be found only through
longitudinal studies.
Conclusion
The eruption age of permanent teeth among these children were
comparable to the standard eruption chart except lower canines.
The permanent teeth eruption was found to be earlier in boys.
However, the time and sequence of eruption may vary with
changes in social status and health care. Further research involving
large population could provide more insight into tooth emergence
trends and possible factors influencing the same.
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