2. PREDENTATE PERIOD
Definition: Refers to the period from birth to the eruption of the
first deciduous teeth in the oral cavity.
GUM PADS :-
The alveolar arches of an infant are called gum pads.
Gum pads are firm & pink in color
Gum pads develop in 2 parts.
- Labial portion
- Lingual portion
These portions are separated from each other by a
dental groove which is the site of origin of the dental lamina
3. UPPER GUM PAD
• Horseshoe Shaped
• Upper Gum pad is divided into 10 Segments by transverse
groove.
• Gingival groove separates the gum pad from palate.
• Dental groove originates in the incisive papilla region &
extends backwards to touch gingival groove in the camine
region.
• Lateral Sulcus:- Present between deciduous canine & first
molar segment.
4. LOWER GUM PAD
• U-Shaped with its anterior portion
averted labially
• Lower gum pad is divided into 10
segments by Transverse groove.
• Gingival groove separates the gum
pad from floor of the mouth.
• Dental groove – Running
backwards and join the gingival
groove in the canine region.
• Lateral sulcus – Present between
deciduous canine & first molar
segment.
5. RELATIONSHIP OF THE
GUM PADS
• At rest gum pads are separated by
the tongue.
• The lateral sulcus of lower gum
pad lies distal to that of the upper.
• Variable overjet with contact only
In the first molar segment.
• During function –
Mandible moves vertically & in
anteroposterior direction.
Lateral movements are absent.
6. Growth of gum Pads:
• At birth the width of gum pads are inadequate to
accommodate all the incisors.
• Growth of gum pad is rapid in first year after birth.
• More in transverse & labio-lingual direction.
CLEANING OF GUM PADS
• Started within the first week of birth
• The parent can be instructed to:- Lay the baby down with
his/her head in your lap & feet pointing away.
• Take a small gauze ( 2” x2”) between thumb and forefinger
& wipe vigorously over the gum pad
7. • Now a days specially designed:-
– infant tooth brush
– Finger coats
– Wipes are used
• Use adequate pressure just to remove the
film that covers the gum pad.
• Clean at least every day twice after
morning & last feed in the night.
• Duration of cleaning :- 2 to 3 minutes.
8. PRECOCIOUSLY ERUPTED TEETH.
2. Natal Teeth :- Present since birth
2. Neonatal teeth: Erupt during neonatal period.
( upto 28 days after birth)
3. Predeciduous dentition:- Erupted after 28 days and before six
months after birth.
9. Soft Tissue lesions which are seen
during predentate period.
• CONGENITAL EPULIS :-
Soft tissue tumer that occurs on the gum pads
Clinical features :- Pink to red in color
Smooth surfaced
Polypoid mass.
size – 2 cm. – 7.5 cm.
Maxillary > mandibular
Lateral to midline ( in lateral
insisor and canine region)
Female > Male
Treatment :-
Can be seen in utero by ultrasound
After birth :- It diminishes in size.
Otherwise :- Surgical excision
10. Epstein pearls or Bohn’s
nodule
Small superficial, Keratin filled cysts that are found
on the alveolar mucosa of infant.
Clinical Feature:-
– Small, usually multiple,
whitish papules on
the mucosa overlying
the alveolar process of
neonate.
– Size of individual :- 2 to 3 mm.
– Maxilla > mandible
Treatment:- Spontaneous involute at a result of
rupture of cyst.
Rarely seen after 3 months of age.
11. Rega fede disease
• Ulceration on the ventral surface of tongue caused
by sharp edges of natal & neonatal teeth.
Clinical Feature:-
– Mild to severe ulcerations
on ventral surface of
tongue.
– Interfere with infants
feeding & suckling
12. Treatment:-
– If the tooth is mature & root is sufficient to retain the tooth than
• Smoothening of the incisal edge
• Placement of a smooth & rounded composite
– In case of larger lesion
• Extraction of offending tooth with vitamin K supplementation
ERUPTION CYST
• Associated with natal and
neonatal teeth.
13. • Clinical Feature:-
– Usually symptomless
– Sometimes : Interfere with feeding
Bleed intermittently
– Appear as clear or blood tinged, fluid filled masses on the
crest of the alveolar ridge.
• Treatment:-
– Usually disappear when the underlying tooth erupt.
– If it is painful or infected or if the lesion bleeds than it should
be drained and natal or neonatal teeth are removed.
14. Transient Malocclusion During
Predentate Period
1. RETROGNATHIC MANDIBLE
• Mandible is severely retruded during predentate
period.
• It is retruded 14 degree at birth
• Corrected by forward growth of mandible
15. 2. OPEN BITE OF GUM PAD:-
• Corrected when incisor teeth fully erupts.
16. References:
• Textbook of pedodontics- Shobha Tandon
• Oral & maxillofacial pathology- 2nd edi.-
Neville, Damm , Allen, Bouquot
• A textbook of oral pathology- 4th edi.-
Shafer
