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 â Running
backwards and join the gingival
groove in the canine region.
⢠Lateral sulcus â 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 â
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 ( 2â x2â) between thumb and forefinger
& wipe vigorously over the gum pad
7. ⢠Now a days specially designed:-
â infant tooth brush
â Finger coats
â 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 â 2 cm. â 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 Bohnâs
nodule
Small superficial, Keratin filled cysts that are found
on the alveolar mucosa of infant.
Clinical Feature:-
â Small, usually multiple,
whitish papules on
the mucosa overlying
the alveolar process of
neonate.
â Size of individual :- 2 to 3 mm.
â 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:-
â Mild to severe ulcerations
on ventral surface of
tongue.
â Interfere with infants
feeding & suckling
12. Treatment:-
â If the tooth is mature & root is sufficient to retain the tooth than
⢠Smoothening of the incisal edge
⢠Placement of a smooth & rounded composite
â In case of larger lesion
⢠Extraction of offending tooth with vitamin K supplementation
ERUPTION CYST
⢠Associated with natal and
neonatal teeth.
13. ⢠Clinical Feature:-
â Usually symptomless
â Sometimes : Interfere with feeding
Bleed intermittently
â Appear as clear or blood tinged, fluid filled masses on the
crest of the alveolar ridge.
⢠Treatment:-
â Usually disappear when the underlying tooth erupt.
â 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