Growth and development

Growth And DevelopmentGrowth And Development
www.indiandentalacademy.comwww.indiandentalacademy.com

DEFINITION OF GROWTHDEFINITION OF GROWTH
Growth is programmed increase in:Growth is programmed increase in:
sizesize
maturitymaturity
from birth and encompasses physical,from birth and encompasses physical,
mental and emotional development.mental and emotional development.

Clinical SignificanceClinical Significance
Assessment begins as soon as the child entersAssessment begins as soon as the child enters
surgery. Things to look at :surgery. Things to look at :
 Child’s sizeChild’s size
 DevelopmentDevelopment
 AppearanceAppearance
 Behaviour in relation to chronological ageBehaviour in relation to chronological age

ASSESSMENT OF AGEASSESSMENT OF AGE
NeurologicalNeurological
ChronologicalChronological
MorphologicalMorphological
SkeletalSkeletal
MentalMental
Secondary Sex Character AgeSecondary Sex Character Age
Dental AgeDental Age

Neurological AgeNeurological Age
Definition:Definition:
Development of simple reflexes and theDevelopment of simple reflexes and the
increasing complexity and development ofincreasing complexity and development of
the nervous system and its dependentthe nervous system and its dependent
functions.functions.
Examples:Examples:
Smiling, sitting up, walking with supportSmiling, sitting up, walking with support
(Developmental Milestones)(Developmental Milestones)

Neurological AgeNeurological Age
Paedodontic significance:Paedodontic significance:
Failure of teething on scheduleFailure of teething on schedule
Learning to walk increases the incidenceLearning to walk increases the incidence
of trauma to upper A’sof trauma to upper A’s
Differential diagnosis of NAIDifferential diagnosis of NAI

Morphological AgeMorphological Age
Involves assessment of somaticInvolves assessment of somatic
growth & developmentgrowth & development
Basic indicators include:Basic indicators include:
a.a. HeightHeight
b.b. WeightWeight

Morphological AgeMorphological Age
Paedodontic Significance:Paedodontic Significance:
 Prediction of adolescent growth spurtPrediction of adolescent growth spurt
which may influence the subsequentwhich may influence the subsequent
timing of orthodontic treatment.timing of orthodontic treatment.
 Underweight :Underweight : consider anorexia/bulimiaconsider anorexia/bulimia
 Overweight :Overweight : may indicate nutritional problems.may indicate nutritional problems.

Skeletal AgeSkeletal Age
 measure of how far along the course ofmeasure of how far along the course of
development an individual is.development an individual is.
 indicated by the maturity of the skeletonindicated by the maturity of the skeleton
 points are given for each developmental stagepoints are given for each developmental stage
 total score for skeletal maturity is giventotal score for skeletal maturity is given

Methods of Assessment:Methods of Assessment:
Hand-wrist radiographs using Greulich-Hand-wrist radiographs using Greulich-
PylePyle
or Tanner-Whitehouse systems.or Tanner-Whitehouse systems.
These methods assume that all bonesThese methods assume that all bones
go through the same sequence ofgo through the same sequence of
development but at different rates.development but at different rates.

 Used to calculate potential for further increaseUsed to calculate potential for further increase
in heightin height
 Predict adolescent growth spurt for timing ofPredict adolescent growth spurt for timing of
orthodontic treatmentorthodontic treatment
 Monitor growth abnormalities.Monitor growth abnormalities.

Mental AgeMental Age
 Indicator of Intellectual DevelopmentIndicator of Intellectual Development
 Guide to child’s ability to co-operate withGuide to child’s ability to co-operate with
treatment.treatment.
 Mentally handicapped patients need specialMentally handicapped patients need special
care :care :
 With treatmentWith treatment
 Oral Hygiene measuresOral Hygiene measures
 Diet controlDiet control

Secondary Sex Character AgeSecondary Sex Character Age
Boys attain a ‘pubertal voice’-0.2 yearsBoys attain a ‘pubertal voice’-0.2 years
before PHVbefore PHV
‘‘Male voice’ (pitch of adult voice)-0.9 yearsMale voice’ (pitch of adult voice)-0.9 years
after PHVafter PHV
SSCA is rarely of value in boys.SSCA is rarely of value in boys.

Secondary Sex Character AgeSecondary Sex Character Age
 Girls menarche occurred 1.1 years after PHVGirls menarche occurred 1.1 years after PHV
 Menarache occurs at a bone age of 13.1Menarache occurs at a bone age of 13.1
years ( this is a highly reliable indicator ofyears ( this is a highly reliable indicator of
PHV)PHV)
 Therefore when planning for orthodonticTherefore when planning for orthodontic
treatment if menarche has occurred then PHVtreatment if menarche has occurred then PHV
has passedhas passed

Secondary Sex CharacterSecondary Sex Character
AgeAge
10y 11y 12y 13y 14y
Age
HeightVelocitycm/year
Line 1

Dental AgeDental Age
Measure of how far along the course ofMeasure of how far along the course of
stages of tooth development thestages of tooth development the
dentition is.dentition is.
Dental age correlates well withDental age correlates well with
chronological but less with skeletal age.chronological but less with skeletal age.
Racial variationsRacial variations
 Early eruption in asiansEarly eruption in asians
 Late eruption in Eastern & South EuropeanLate eruption in Eastern & South European
groupsgroups
Emergence of teeth is affected byEmergence of teeth is affected by
environmental factors:environmental factors:
 Early extraction of primary teethEarly extraction of primary teeth
 Late extraction of primary teethLate extraction of primary teeth

Understanding of the chronology of theUnderstanding of the chronology of the
development of the dentition is essentialdevelopment of the dentition is essential
for sound practice of Paediatrics &for sound practice of Paediatrics &
OrthodonticsOrthodontics
Tooth eruption of A’s important milestoneTooth eruption of A’s important milestone
and indicator of normalityand indicator of normality

Tooth emergence in the permanentTooth emergence in the permanent
dentition is important in relation todentition is important in relation to
orthodontic treatment i.e whenorthodontic treatment i.e when
appliances can be fitted.appliances can be fitted.
 Stages of development are critical whenStages of development are critical when
considering loss of 6’sconsidering loss of 6’s

Important in early life when advisingImportant in early life when advising
systemic fluorides e.g. fluoride dropssystemic fluorides e.g. fluoride drops
and/or tabletsand/or tablets
Important when diagnosing the state ofImportant when diagnosing the state of
apical development of traumatised anteriorapical development of traumatised anterior
teeth i.e open apicesteeth i.e open apices

Growth and development

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