Eruption Chronology in Children: A Cross-sectional Study

Prediction of deciduous teeth eruption in Brazilian children: A cross-sectional study nested in a prospective birth cohort (BRISA)

BACKGROUND

Dental eruption is part of a set of children´s somatic growth phenomena. The worldwide accepted human dental eruption chronology is still based on a small sample of European children. However, evidence points to some population variations with the eruption at least two months later in low-income countries, and local standards may be useful. So, this study aimed to predict deciduous teeth eruption from 12 months of age in a Brazilian infant population.

METHODS

We developed a cross-sectional study nested in four prospective cohorts - the Brazilian Ribeirão Preto and São Luís Cohort Study (BRISA) - in a sample of 3,733 children aged 12 to 36 months old, corrected by gestational age. We made a reference curve with the number of teeth erupted by age using the Generalized Additive Models for location, scale, and shape (GAMLSS) technique. The explanatory variable was the corrected children´s age. The dependent variable was the number of erupted teeth, by gender, evaluated according to some different outcome distributional forms. The generalized Akaike information criterion (GAIC) and the model residuals were used as the model selection criterion.

RESULTS

The Box-Cox Power Exponential method was the GAMLSS model with better-fit indexes. Our estimation curve was able to predict the number of erupted deciduous teeth by age, similar to the real values, in addition to describing the evolution of children's development, with comparative patterns. There was no difference in the mean number of erupted teeth between the sexes. According to the reference curve, at 12 months old, 25% of children had four erupted teeth or less, while 75% had seven or fewer and 95% had 11 or fewer. At 24 months old, 5% had less than 12, and 75% had 18 or more. At 36 months old, around 50% of the population had deciduous dentition completed (20 teeth).

CONCLUSION

The adjusted age was an important predictor of the number of erupted deciduous teeth. This outcome can be a variable incorporated into children's growth and development curves, such as weight and height curves for age to help dentists and physicians in the monitoring the children's health.

Timing of Primary Tooth Eruption in Infants Observed by Their Parents

BACKGROUND

The timing of primary teeth eruption is a visible indicator of infant physical growth other than body weight or height. It also reflects neurological integrity and development as well as nutrition, socioeconomic state, or underlying diseases. Therefore, the timing of primary teeth eruption is one of the major concerns for parents in health checkups for infants and children. However, the detailed developmental timing of teeth eruption differs depending on the survey methodology, country, or generation. We hypothesized that the timing of primary teeth eruption differs between the medical checkup by dentists and the daily records by parents.

METHODS

We conducted a questionnaire survey on the date of eruption of primary teeth as an adjunct study among Miyagi Regional Center participants in the Japan Environment and Children's Study (JECS), a large-scale birth cohort study. A total of 1695 responses (3793 participants) were analyzed.

RESULTS

The median ages of eruption were 7.1 months (male) and 7.6 months (female) for mandibular primary central incisors, 8.7 months (male) and 9.2 months (female) for maxillary primary central incisors, 10.0 months (male) and 10.3 months (female) for maxillary primary lateral incisors, and 10.4 months (male) and 10.8 months (female) for mandibular primary lateral incisors, which were earlier than the reported timings based on dental check-ups. Comparing the eruption time of preterm and term infants, the eruption time was earlier in preterm infants in the corrected ages.

CONCLUSIONS

The eruption timing observed and described by the parents is earlier than that examined by dentists at regular check-ups. In addition to examining the primary teeth eruption of full-term birth children, we also examined that of preterm birth children because of the increasing number of premature births. To the best of our knowledge, this is the first report from a large cohort study to clarify the eruption time of primary teeth monitored by parents.

Influence of Birth Characteristics and Feeding Practices on Eruption of Primary Teeth in Children: A Preliminary Cross-sectional Observational Study

Background

The eruption process is under strong genetic control, external environmental factors also significantly contribute to this process. Therefore the present study was undertaken to identify the influence of birth characteristics and feeding practices on the eruption of the first primary tooth among healthy children in Pune, Maharashtra, India.

Materials and methods

The study was undertaken among 200 children aged 3-24 months. Children with any underlying conditions, those not accompanied by their mother and with neonatal teeth/natal teeth were excluded. The birth weight, gestational age, and type of delivery were obtained from medical records of the child. Data on feeding practices and the age of eruption of the first primary tooth was recorded after a structured interview of the mother followed by oral examination of the child. Gestational age was categorized into >37 weeks and <37 weeks, birth weight was divided into three groups-<1500, 1500-2500, and >2500 gm and four groups according to feeding practice during the first 6 months of life (exclusively breastfed, exclusively bottle fed, combination of breastfeeding and bottle feeding, and spoon-feeding).

Results

The mean age of eruption in the study population was 9.17 months. A9.05 months in males and 9.44 in females. A statistically significant correlation was noted with gestational age, birth weight, and feeding practices. Infants with a gestational age of >37 weeks, higher birth weight and those who were exclusively breastfed for the first 6 months had an earlier eruption of first primary teeth.

Conclusion

External factors seem to influence the eruption of the primary tooth. More longitudinal studies with larger sample sizes and matching confounders are needed to clearly understand the factors affecting the primary tooth eruption.

How to cite this article

Shetty SS, Mathur A, Gopalakrishnan D, et al. Influence of Birth Characteristics and Feeding Practices on Eruption of Primary Teeth in Children: A Preliminary Cross-sectional Observational Study. Int J Clin Pediatr Dent 2023;16(5):724-727.

General correlation between neonatal factors, primary and permanent tooth eruption and their interrelation in a population in german orthodontic practices

BACKGROUND

The purpose of the study was to determine the possible relationship between the eruption of primary and permanent teeth and neonatal factors in German children according to gender.

METHODS

A cross-sectional survey study was performed in 10 German orthodontic practices. Using a questionnaire information about gender, time of birth (week of pregnancy), birth weight (g) and height (cm), and the age of first primary and first permanent tooth eruption (months/years) of 405 children (230 girls and 175 boys) were collected. A Mann-Whitney U-test was used for group comparisons, and correlations were verified using a Pearson test.

RESULTS

No correlation was found between neonatal factors (time of birth, birth weight, and birth height) and primary tooth eruption for male participants. However, for females a low correlation was found between the eruption of the first primary tooth and birth weight (r = -0.18, CI: -0.30 to -0.042, p = 0.011) and birth height (r = -0.19, CI: -0.32 to -0.054, p = 0.006). No correlations between neonatal factors and the eruption of the first permanent tooth were found for either gender. A moderate correlation was found between the first primary and first permanent tooth eruption (females: r = 0.30, CI: 0.16 to 0.43, p < 0.001; males: r = 0.22, CI: 0.059 to 0.35, p = 0.008).

CONCLUSIONS

An earlier eruption of the primary teeth can be assumed with greater body weight and height at the time of birth for girls. For boys, the tendency is the opposite. However, there seems to be a catch-up growth effect due to the missing differences between both permanent tooth eruption times. Nevertheless, the first primary and the first permanent tooth eruption correlates in a German children population.

NMR-Based Metabolomics Demonstrates a Metabolic Change during Early Developmental Stages from Healthy Infants to Young Children

The present study aims to identify the salivary metabolic profile of healthy infants and young children, and to correlate this with age, salivary gland maturation, and dentition. Forty-eight children were selected after clinical evaluation in which all intraoral structures were examined. Total unstimulated saliva was collected, and salivary metabolites were analyzed by 1H Nuclear Magnetic Resonance (NMR) at 25 °C. Partial least squares discriminant analysis (PLS-DA), orthogonal PLS-DA (O-PLS-DA), and univariate analysis were used, adopting a 95% confidence interval. The study showed a distinct salivary metabolomic profile related to age and developmental phase. The saliva of children in the pre-eruption teeth period showed a different metabolite profile than that of children after the eruption. However, more evident changes were observed in the saliva profile of children older than 30 months. Alanine, choline, ethanol, lactate, and sugar region were found in higher levels in the saliva of patients before 30 months old. Acetate, N-acetyl sugar, butyrate, caproate, creatinine, leucine, phenylalanine, propionate, valine, succinate, and valerate were found to be more abundant in the saliva of children after 30 months old. The saliva profile is a result of changes in age and dental eruption, and these findings can be useful for monitoring the physiological changes that occur in infancy.

Cystic lesion between a deciduous tooth and the succeeding permanent tooth: a retrospective analysis of 87 cases

Objectives

The purpose of this study is to investigate the characteristics of dentigerous and radicular cysts that occur between deciduous and succeeding permanent teeth and to propose considerations for differential diagnosis of cysts at the treatment planning stage in the outpatient clinic.

Materials and Methods

A total of 87 patients with a cystic lesion located between a deciduous tooth and the succeeding permanent tooth participated in the study. Twelve variables were analyzed to diagnose such a cyst. For data analysis, Fisher's exact test was used to determine the statistical significance of the variables.

Results

Of the total 87 patients who participated in this study, 69 were diagnosed with dentigerous cysts and 18 were diagnosed with radicular cysts. Seven of the 12 differential factors analyzed in this study were statistically significant: age, location, symptoms, dental caries, endodontic treatment, delayed eruption, and size.

Conclusion

Several criteria can be considered for diagnosis of dentigerous cysts or radicular cysts. Age, location, presence of symptoms and dental caries, previous endodontic treatment, cystic size, and delayed eruption of impacted permanent teeth are reliable factors that should be considered when diagnosing dentigerous and radicular cysts.

Influence of gestational age on eruption of primary teeth in Indian children - A prospective longitudinal study

Context

Eruption of primary teeth is the most anticipated event in a child's life. Genetics, gender, socio-economic status, gestational age are a few of the determinants of the primary teeth eruption. However, the effect of gestational age on the timing of primary teeth eruption among the Indian population has not been explored to date.

Aim

The study was conducted to evaluate the influence of gestational age on time and sequence of eruption of primary teeth among children of Mysore.

Settings and Design

A prospective longitudinal cohort study design was conducted at 'Baby Oral Health Promotion Clinic' at the Department of Paediatrics, JSS Hospital, Mysore.

Methods and Material

150 newborn babies were recruited by simple random sampling and followed up from birth to 36 months. Teeth present during each visit were recorded. Data were statistically analysed and interpreted.

Statistical Analysis Used

Descriptive statistics, t-test for an independent sample, and Pearson's Chi-squared test were applied.

Results

The mandibular central incisor was the first tooth to erupt. Statistically insignificant early eruption in males was noted in both term and preterm children. When the chronological ages were compared, the preterm group showed a statistically significant delay in the eruption of all the teeth. However, when the age was adjusted for prematurity, only the central incisors and second molars showed a statistically significant delay.

Conclusions

Gestational age has a strong significant association with the eruption of primary teeth and maybe one of the strong predictors for delayed eruption among children of Mysore.

Nutritional Status is Associated with Permanent Tooth Eruption in a Group of Brazilian School Children

The present study aimed to investigate the association between nutritional status with delayed tooth eruption (DTE). Oral examination was performed in schoolchildren (8-11 years old), and DTE was defined by absence of dental gingival emergence or when primary tooth was still present in the oral cavity after the expected time. BMI z-score of each child were collected and nutritional status was defined. Chi-square test and binary logistic regression adjusted by age and gender were performed. Odds ratio (OR) and 95% Confidence Interval (95% CI) were calculated. The established alpha was 5%. Among 353 included children, 247 were classified as eutrophic, 16 as underweight, 64 as overweight, and 26 as obese. Underweight was associated as a risk factor to DTE (P = .014; OR = 3.5; 95% CI = 1.3-9.8), and underweight girls had more chance to present DTE than eutrophic girls (P = .048; OR = 4.4; 95% CI = 1.1-17.2) in chi square test. In logistic regression, underweight was associated as a risk factor to DTE (OR = 4.21; CI 95% = 1.42-12.43; P = .009). Underweight children have a higher risk of DTE in permanents.

Wich factors influencing the number of teeth at 12 months of age: a birth cohort study

This study aimed to verify, through a longitudinal follow-up, the pre-, peri- and postnatal factors associated with the eruption of deciduous teeth. The study was nested in a Birth Cohort Study conducted in Pelotas, a Southern Brazilian city. Mothers were followed prenatally and their children were followed-up perinatally, at 3 and 12 months of age. The outcome was the number of teeth at 12 months, and exploratory variables included maternal habits and characteristics, anthropometric measures of children and mothers, and socioeconomic and demographic information. Data were collected through interviews with the mother and children's clinical exam. Poisson regression models were used for the analysis. Participants included 4,014 children with a mean number of erupted teeth at 12 months of 5.50. After adjustments, a lower mean number of teeth was observed in children from non-white mothers, early preterm children, and shorter children at birth and at 12 months. A higher number of teeth was observed for mothers with excessive weight gain during pregnancy, mothers who smoked during pregnancy, weightier children at birth and at 12 months, and for children with larger heads at birth and at 12 months. Our findings suggest that maternal and children characteristics influenced primary tooth eruption.

Association between snoring and deciduous dental development and soft tissue profile in 3-year-old children

INTRODUCTION

The aim was to study the association between snoring and development of occlusion, maxillary dental arch, and soft tissue profile in children with newly completed deciduous dentition.

METHODS

Thirty-two (18 female, 14 male) parent-reported snorers (snoring ≥3 nights/week) and 19 (14 female, 6 male) nonsnorers were recruited. Breathing preference (nose or mouth) was assessed at the mean age of 27 months by otorhinolaryngologist. At the mean age of 33 months, an orthodontic examination was performed, including sagittal relationship of second deciduous molars, overjet, overbite, and occurrence of crowding and lateral crossbite. Bite index was obtained to measure maxillary dental arch dimensions (intercanine and intermolar width, arch length). A profile photograph was obtained to measure facial convexity.

RESULTS

No significant differences were found between nonsnorers and snorers in any of the studied occlusal characteristics or in measurements of maxillary dental arch dimensions. Snorers were found to have a more convex profile than nonsnorers. Occurrence of mouth breathing was more common among snorers.

CONCLUSIONS

Parent-reported snoring (≥3 nights/week) does not seem to be associated with an adverse effect on the early development of deciduous dentition, but snoring children seem to have more convex profile than nonsnorers. Snoring is a mild sign of sleep-disordered breathing, and in the present study its short time lapse may not have had adequate functional impact on occlusion.

Chronology and sequence of deciduous teeth eruption in children with microcephaly associated to the Zika virus

INTRODUCTION

Deciduous teeth eruption is connected to children's growth and development. In Brazil, with the increase in the occurrence of children born with microcephaly associated to exposure to Zika virus, studies about orofacial alterations were necessary.

OBJECTIVE

Describe the chronology and sequence of deciduous teeth in children with microcephaly due to the fetal exposure to Zika virus.

METHODOLOGY

A cross-sectional study involving 74 children of a neuropediatric reference unit in Salvador, Bahia, in 2017 was conducted. Through use of secondary data, interviews with mothers and children's exam, the population was characterized, the chronology and sequence of deciduous teeth eruption was registered, and the analysis of the variables was proceeded.

RESULTS

The first eruption happened between 4 and 17 months of age and 52.70% had a delay in the eruption of incisors. The average eruption time for the maxilla varies from 17.92 (16.56-19.28; 95% CI) to 20.43 (19.35-21.51; 95% CI) months, and the jaw from 11.57 (6.85-18.99; 95% CI) to 20.20 (19.09-21.31; 95% CI) months. In 77.94% of population, the eruption of the first teeth was in the lower arch and in 33.82%, molars and/or canines erupted before the incisors.

CONCLUSIONS

There were alteration in the chronology and sequence of deciduous teeth eruption.

Maxillary arch dimensions in the first 6 months of life and their relationship with pacifier use

PURPOSE

This study evaluated the maxillary arch dimensions at birth and 6 months of life, and to verify the influence of pacifier use on palatal development.

METHODS

Maxillary arch impressions were taken from 80 full-term newborns, appropriate for gestational age, from 24 to 72 h of life, and repeated after 6 months. Anatomical references were mapped on dental casts and measurements were taken. Parents were questioned about feeding practices and sucking habits. Data were analysed by Kruskal-Wallis test and hierarchical mixed regression model (p < 0.05).

RESULTS

Anterior maxillary segment (median [interquartile range]) presented an increase in transverse (Δ% = 81.90 [74.40-89.70]) and in length (Δ% = 76.20 [49.10-102.70]) relative growth. No differences were detected in palatine depth from birth (11.00 mm [10.30-11.70]) to 6 months (12.60 mm [12.0-13.90]).

CONCLUSIONS

Pacifier use was positively related to the increase in anterior segment length. In the first 6 months of life, the greatest relative growth of the maxillary arch occurs in the anterior region, showing this growth does not occur homogeneously. The use of pacifiers came to influence this process, even before the eruption of the upper incisors.

Low birth weight and the delay on the eruption of deciduous teething in children

Abstract Objectives: To analyze the association between low birth weight (LBW) and the occurrence of the delay on the eruption of deciduous teething (DEDT) in children from 04 to 30 months, living in Salvador, Bahia. Methods: A cross-sectional study involved 520 children at four to thirty months of age, from public, private and philanthropic daycares from two districts in Salvador. A descriptive analysis and unconditional logistic regression were done to estimate the odds ratios (ORs), using the Confidence Interval of 95% as a criterion for accepting associations. Poisson regression was used as an analytical strategy to obtain the prevalence ratio. Results: the prevalence of the delay on the eruption was 10.29%. There was a positive association between LBW and occurrence of DEDT among children with less than 24 months, both in the unadjusted model (PR=2.07, 95%CI= 0.96 4.44) as in the adjusted (adjusted PR=2, 27, 95%CI= 1.02 5.07). Conclusions: the variables of development and nutritional at birth and during the early life may be important predictors of the chronology of eruption. Further investigations should be carried out towards the adequate evaluation of the LBW role in the occurrence of the delay on the eruption.

Elements of morphology: Standard terminology for the teeth and classifying genetic dental disorders

Dental anomalies occur frequently in a number of genetic disorders and act as major signs in diagnosing these disorders. We present definitions of the most common dental signs and propose a classification usable as a diagnostic tool by dentists, clinical geneticists, and other health care providers. The definitions are part of the series Elements of Morphology and have been established after careful discussions within an international group of experienced dentists and geneticists. The classification system was elaborated in the French collaborative network "TÊTECOU" and the affiliated O-Rares reference/competence centers. The classification includes isolated and syndromic disorders with oral and dental anomalies, to which causative genes and main extraoral signs and symptoms are added. A systematic literature analysis yielded 408 entities of which a causal gene has been identified in 79%. We classified dental disorders in eight groups: dental agenesis, supernumerary teeth, dental size and/or shape, enamel, dentin, dental eruption, periodontal and gingival, and tumor-like anomalies. We aim the classification to act as a shared reference for clinical and epidemiological studies. We welcome critical evaluations of the definitions and classification and will regularly update the classification for newly recognized conditions.

Associations of maternal, perinatal and postnatal factors with the eruption timing of the first primary tooth

We recruited 1296 mothers in their first trimester from the Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University between May 2014 and September 2015 to investigate the associations of maternal, perinatal and postnatal factors with the eruption timing of the first primary tooth (ETFPT) in a Chinese population. We collected maternal demographic information and clinical data during the perinatal and postnatal period, and oral examinations of the infants were performed by a doctor at 6, 9 and 12 months of age. Multiple regression analysis was used to identify significant explanatory variables for ETFPT. The mean age at eruption of the first primary tooth for all the infants was 6.82 ± 1.90 months. After adjustment for confounders, higher maternal childbearing age (β = 0.57; 95%CI = 0.13–1.02), female sex (β = 0.26; 95%CI = 0.07–0.52), and low birth weight (β = 0.98; 95%CI = 0.20–1.76) were significantly associated with delayed eruption of the first primary tooth, while macrosomia (β = −0.79; 95%CI = −1.30–−0.28) was significantly associated with earlier eruption of the first primary tooth. Maternal childbearing age, infant sex and infant birth weight were significant determinants of ETFPT.