Mixed Dentition Period: When Primary and Permanent Teeth Coexist

The mixed-dentition period is a stage in a person's life when both primary and permanent teeth are present. During this period, the crown of the tooth forms before the roots, and it is common for children to have both primary and permanent teeth. Fusion and claw cusps are rare developmental dental anomalies that can affect both primary and permanent dentition. Claw-shaped cusps are usually found on the palatine surface of the permanent maxillary incisors, while fused teeth are more common in the primary anterior dentition.

It is important to understand these dental anomalies and their associated problems in order to provide prophylactic measures that can avoid or minimize potential complications. This article presents a unique case of permanent mandibular incisors fused with a lingual claw cusp associated with hypodontia in an adjacent tooth. Babies' immune systems begin to change when they are around 6 months old, making them more prone to diseases. Symptoms of common childhood illnesses, such as changes in sleep and eating patterns, irritability, rash, drooling, runny nose and diarrhea, are often related to teething when that is not the case.

If your child has these symptoms, talk to your child's doctor about other possible causes. Teething usually lasts about 8 days, including 4 days before and 3 days after the tooth comes out of the gum. You may also see a blue-gray bubble on the gum where the tooth is about to appear; this is called an eruptive cyst and will usually go away without treatment. Primary teeth are placeholders for adult permanent teeth. They fall out and allow permanent teeth to grow in their place as part of human growth and development.

Primary and permanent teeth differ in composition, structure and number; some children may cut their first tooth when they are just a few months old, while others may not start to come out until they are 12 months or older. Fusion is a rare developmental disorder characterized by the union of two adjacent teeth at the level of the crown (enamel and dentin), which causes the formation of a tooth with an enlarged clinical crown. A panoramic X-ray showed the presence of a permanent dentition with normal development, except for the lower right central incisor, which was found congenitally absent. Based on clinical and radiographic findings, a cusp of type 1 lingual claw was diagnosed in fused permanent mandibular incisors associated with hypodontia in an adjacent tooth. In severe hypodontia, six or more teeth are missing; this can cause a reduction in the bone level in the area and cause neighboring teeth to lean over the fixed primary tooth.

Primary teeth allow children to chew food and speak properly, as well as reserve gum spaces for future adult teeth. It is important to take care of primary teeth as neglecting them can lead to problems such as orthodontic space closure (orthopedic appliances) resulting in better bone condition and nicer gums between the teeth. The use of teething gels containing benzocaine in children is not recommended as research suggests that teething gels may not relieve teething pain but massaging them into the gum is what helps. Ultimately, it is important to take care of both primary and permanent teeth for optimal oral health.

Eloise Cuttitta
Eloise Cuttitta

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