This document discusses normal dental development and common oral pathologies that may present in a primary care setting. It covers the eruption schedule of primary and permanent teeth, common causes of malocclusion, and lesions that may occur on the lips, tongue, oral mucosa, or gums. It also describes the dental caries process, from the initial demineralization of enamel by bacteria to cavity formation if left untreated. Screening examinations are recommended to identify oral diseases and discuss prevention with patients.

1. Normal Dental Development and Oral Pathology Rebecca L. Slayton, DDS, PhD Department of Pediatric Dentistry Amanda Keerbs, MD Department of Family Medicine

2. PRIMARY DENTITION

3. Eruption Schedule

4. Eruption Schedule

6. Mesial surface – towards the front of the mouth Distal surface – towards the back of the mouth Midline

7. Upper (Maxillary) Arch Labial/Buccal Surface Palatal Surface Occlusal Surface Incisal Surface

8. Lower (Mandibular) Arch Labial/Buccal Surface Lingual Surface Occlusal Surface Incisal Surface

16. Caries Caries Caries are an infectious, communicable disease resulting in the destruction of tooth structure by the acid produced by the metabolism of sugar by bacteria found in dental plaque Plaque is a dense bacterial aggregate containing about 10% bacteria per milligram that accumulates on tooth surfaces.

17. Dental Caries Process DENTAL CARIES Host Bacteria Substrate TEETH MUTAN STREPTOCOCCI LACTOBACILLI FRUCTOSE SUCROSE

18. Dental Caries Stages The acid created by the caries bacteria’s metabolism of sugar leads to demineralization. Demineralization is the loss of calcium, phosphate and carbonate from the enamel

19. Dental Caries Stages If demineralization is allowed to continue, the tooth will eventually be eroded enough for a cavity to form. Incipient Lesion (caries not more than halfway into enamel) Lesion has reached the dentinoenamel junction (DEJ) Lesion is progressing laterally and towards the pulp Lesion extended into the pulp