Teeth Numbers Dentist Australia
Placido Teofilo
To give you an example, the front teeth (your incisors) on the top and bottom of your mouth are all given the number 1. The incisors next to that are number 2. Here are the numbers for each of the different types of teeth.
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To break this down, a number is used to denote a specific tooth. These are numbered according to the internationally designed two-digit FDI (Federation Dentaire Internationale) numbering system that is used by dentists, not just in Australia.
The dentist uses these numbers to determine which teeth are present and which are not and reference those that are impacted in any way. The dentist will likely perform this count during your initial examination at a check-up.
For example, five-five in the upper right first molar for a child, with five-one and six-one being the upper front teeth and the seven-one and eighty-one being the bottom two front teeth (all central incisors).
Facial trauma that results in displaced, fractured, or lost teeth can have significant negative functional, aesthetic and psychological effects on patients. Initial management of all patients with trauma should include a primary survey at a minimum. Dental trauma is commonly caused by sporting injuries, falls, motor vehicle accidents or interpersonal violence. The practitioner should obtain relevant medical and dental history (including mechanism of injury), as this information will determine appropriate management.1
The outer layer of the crown of a tooth is made up of hard, mostly inorganic and insensate enamel. The outer layer of the root is cementum, a softer mixture of inorganic and organic materials that provides attachment for the periodontal ligament to hold the tooth firmly in the alveolar bone. Underlying the enamel is the sensate dentine, which is a mineralised connective tissue substance. This supports the enamel and cementum, which separates them from the pulp chamber. The pulp chamber is the neurovascular nest of the tooth. This is where nerves and vessels enter the tooth through the roots. Covering the bone is the gingiva (gum), which acts to protect and surround the necks of erupted teeth and cover the crowns of un-erupted teeth. The periodontal ligament, cementum, alveolar bone and gingiva encircle the tooth and provide it with strength and stability. These are collectively referred to as periodontal tissues.
A relevant history should be taken after the primary survey has been completed and other injuries managed. Tetanus status should be elicited and the vaccine administered if indicated. The dental history should include missing teeth, history of trauma, previous orthodontics, root canal therapy and fillings. Reported dental pain or sensitivity can guide the examination.
The practitioner should ask the patient to bite down and assess any occlusal disturbances, and enquire if these changes are new.4 An altered occlusion can be a sign of maxillofacial injuries (eg mandibular or midface fractures). This must be followed by appropriate imaging (eg orthopantomogram and computed tomograph) if indicated. The oral cavity should be examined using a light source to look for any abnormalities of the lips and intraoral structures. It is not uncommon for teeth, or fragments of teeth, to be imbedded in the lips and cheeks. Lacerations of the vestibule (eg degloving injuries) may contain gravel or dirt.5
Andreasen developed a classification system in 1972 that encompassed primary and permanent dentition.6 A comprehensive, easy-to-use website was also created by the Rigshospitalet, Denmark and the International Association of Dental Trauma (www.dentaltraumaguide.org). The injuries are divided into the following categories, and have been summarised by the authors to make them relevant to the general practice setting.
Fractures limited to the crown and root can be difficult to view without transilluminating light or special equipment. These may not be available to GPs. It is therefore best to assess these injuries based on the following clinical features:
Fractures that involve the pulp may result in red soft tissue being visible in the area of the fracture. These injuries require referral to a general dentist who will take intra-oral radiographs to visualise the fracture.
It is appropriate to place the tooth in a plastic wrap and ask the patient to spit some saliva (which may contain some blood, which is desirable) into the plastic before wrapping the tooth if it is not safe for the patient to hold the avulsed tooth inside their cheek (eg risk of aspiration).
Replantation can be attempted if it does not delay presentation to a general dentist. The medical practitioner can administer a local anaesthetic nerve block if they are appropriately trained. Gently irrigate the tooth and socket before inserting the tooth. Ensure that the correct tooth is in the correct socket and it is in the correct orientation. Apply a splint if materials are available. Prescribe an appropriate antibiotic such as amoxicillin 500 mg orally every 8 hours for 7 days and chlorhexidine 0.2% mouthwash 10 ml rinsed for 1 minute every 8 hours for 14 days. Urgently refer to a general dentist (as early as possible). Immobilising teeth in their correct anatomical position as soon as possible provides the best chance of replantation and prevents further damage from occurring.14 Advise a soft diet until review by the dental officer.
General practices and emergency departments generally have access to simple materials to fashion a splint. The simplest splints can be made with moulding blu-tack (Figure 4) or aluminium foil (Figure 5) to bridge the loose teeth. A more stable splint can be made by drying the teeth and applying a pre-moulded piece of malleable metal from a Hudson mask with skin glue.16
Dental professionals, in writing or speech, use several different dental notation systems for associating information with a specific tooth. The three most common systems are the FDI World Dental Federation notation (ISO 3950), the Universal Numbering System, and the Palmer notation. The FDI notation is used worldwide, and the Universal is used widely in the United States. The FDI notation can be easily adapted to computerized charting.
Since Palmer notation method required the use of symbols, its use was difficult on keyboards. As a result, the association officially supported the Universal system in 1968. The World Health Organization and the Fdration Dentaire Internationale officially uses the two-digit numbering system of the FDI system.
Palmer notation is a system used by dentists to associate information with a specific tooth. It was originally termed the "Zsigmondy system" after the Hungarian dentist Adolf Zsigmondy who developed the idea in 1861, using a Zsigmondy cross to record quadrants of tooth positions.[2]
Permanent teeth (adult) were numbered 1 to 8, and the child primary dentition (also called deciduous, milk or baby teeth) were depicted with a quadrant grid using Roman numerals I, II, III, IV, V to number the teeth from the midline distally. Palmer changed this to A, B, C, D, E.
To prevent uncertainty or ambiguity, teeth may be indicated using more than one notation, particularly when referring for an extraction; this makes it less likely for the incorrect tooth to be needlessly extracted. For instance, a dentist may give an instruction to "extract the 24 (UL4)" for the upper left first premolar tooth.
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Health card holders are a financially disadvantaged group and are the target population eligible for publicly-funded dental care. While their health status is generally worse compared with other Australians, there is also considerable variation among card holders. The aims of this study were to describe the oral health status of publicly-funded dental patients by type of care, geographic location and age, and to compare trends over time against other Australian studies. Patients were sampled randomly, based on date of birth, by State/Territory dental services in 1995-96. Dentists recorded oral health measures at the initial visit of a course of care using written instructions, but there was no formal calibration. The 6109 patients sampled were weighted in proportion to the numbers of publicly-funded dental patients for each State/Territory. Multiple linear regression analysis indicated that caries experience measured by the DMFT index increased across older age groups (p < 0.05). For rural compared with urban patients, mean numbers of decayed and filled teeth tended to be higher. For emergency compared with non-emergency care, mean numbers of decayed and missing teeth were higher, and filled teeth lower. The findings of this monitoring survey document high levels of previous disease and treatment and indicate variation between subgroups of users of publicly-funded dental care. This included an uneven geographic distribution of oral health and disease, and variation in unmet treatment needs by type of course of care. Temporal comparisons indicate publicly-funded patients have experienced the population trend towards lower levels of tooth loss over time but have higher levels of untreated decayed teeth compared with the general population.
If you have severe pain after a tooth extraction, see your dentist or oral surgeon. They will talk to you and examine you. You may need an x-ray to rule out other conditions such as osteomyelitis (a bone infection).
The Australian Dental Association of WA has teamed up with LiveLighter to create a new campaign to help ditch sugary drinks and keep dentist visits quick and painless. Dr Rebecca Williams, paediatric dentist, gives us the rundown on why sugary drinks are rotten for teeth.
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