IJCRR - Vol 05 Issue 01, January
Date of Publication: 30-Nov--0001
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STUDY OF ERUPTION OF TEMPORARY TEETH FOR THE DETERMINATION OF AGE
Author: Pragnesh Parmar, Gunvanti B. Rathod
Abstract:Identification means determination of individuality of a person. Teeth are very important indicators in medico-legal cases as they help in identification and age estimation in the living as well as in the dead because they resist putrefaction, heat, chemicals etc. and are constant in their appearance. Eruption of teeth depends upon climate, race and sex, nutritional and geographical variations. India is a very big country, with different climates. Hence it is not correct to apply same data to whole of the country. In our study, 101 children up to the age of 36 months were studied for the time of eruption of their temporary teeth at our place where such type of study has not been performed recently. It was studied in correlation with age, sex, right and left side of both upper and lower jaw. From the findings, it was concluded that there was a delayed pattern of eruption in case of upper central incisor, upper lateral incisor, first molar and canine. Teeth appeared earlier in the male except upper canine, lower canine and lower first molar and teeth appeared earlier in the upper jaw except in case of lower central incisor.
Keywords: Eruption, Temporary teeth, Mean age.
Teeth are helpful in estimation of age from eruption, as teeth are very durable; resist heat, chemicals, putrefaction etc. From eruption of temporary teeth, one can estimate the age of a child from 6 months to 36 months. Eruption of teeth is affected by climate, race, sex, nutritional and geographical factors.  India is a very big country, with different climates, race, nutritional and geographical variability. Hence it is not correct to apply same data to whole of the country. However no recent study on age estimation from eruption of temporary teeth has been performed in our region. Because of this, present work was undertaken.
MATERIAL AND METHOD In this study, a total of 101 subjects were examined for eruption of temporary teeth. The cases were taken from outdoor and indoor patient departments of Dentistry and Paediatrics. Their teeth were examined for eruption and charting of teeth was done on Palmer’s notation chart. This system uses numbers 1 to 5 starting from centre to periphery for each half of jaw. Only healthy children who did not show any diseased tooth or chronic illness in the form of endocrinal disorder or nutritional disorder or musculoskeletal disorder, with good and moderate nutrition after doing their general physical examination along with height and weight were considered. The visual examination was done in good light using probe, spatula and mirror. The teeth were examined either in good day light or by using a torch having a fine focusing of light. A tooth is considered erupted, if it has pierced through gums and not erupted if not present in oral cavity. Only those cases were considered whose records were available for date of birth from school records, ration cards, horoscope, birth certificates, identity cards, driving licence and immunisation card. After examination of teeth, statistical tables were prepared for mean age, range and Standard Deviation (S.D.) for eruption of each tooth in the upper and lower jaw and also for right and left sides of the same jaw. The statistical tables were also prepared for both sexes separately and were analysed statistically.
After doing the statistical analyses, it was found the mean age of eruption of central incisors of upper jaw was 9.48 + 1.02 months and of lower jaw was 7.55 + 0.76 months. In case of lateral incisors, the mean age of eruption was 9.71 + 0.96 months for upper and 11.87 + 0.99 months for lower jaws. The first molars of lower jaw erupted at a mean age of 14.65 + 1.09 months and of upper jaw at 14.54 + 0.70 months of age. For canines, mean age of eruption was 18.29 + 0.81 months and 18.79 + 0.91 months in upper and lower jaws respectively. Second molars of upper and lower jaw erupted at the mean age of 26.15 + 3.47 months and 26.34 + 3.22 months respectively (Table - 1). Comparison of mean age of eruption of teeth according to the sex of the individuals was done (Table - 2).
DISCUSSION Kuldeep Singh et al. (2004) described in their study that eruption of lower central incisor, upper central incisor, lateral incisor, lower first molar, upper first molar, upper canine, lower canine and second molar occurred at 8.28 + 0.84 months, 9.48 + 0.96 months, 10.20 + 1.08 months, 15.56 + 0.72 months, 15.84 + 0.72 months, 19.20 + 1.44 months, 19.32 + 1.56 months and 27.72 + 3.36 months respectively.  Findings of our study were correlating with above mentioned study.
Gorden, Turner and Price (1953) described that during infancy and childhood, a fairly accurate estimate of age can be made from the study of teeth. The temporary teeth appear usually with the lower central incisor at 6 months, then the other incisors. The first temporary molars appear at about 12 months, the canine at about 18 months, and second temporary molars at about 2 years. Between 2 to 6 years, the temporary dentition is complete.  In our study, eruption of lower central incisor, first molar and second molar was delayed in compare to above study. Gonzales et al (1954) described the teeth may give, reliable information as to the age in childhood and youth. Beyond adult life, the changes are too uncertain to be of value. The temporary dentition appears at 6 to 8 months and is completed by 22 to 24 months, and is 20 in number. 
Polson (1955) described that when a tooth of the first dentition has erupted, the infant is probably 6 to 8 months old (in our study 7.55 + 0.76 months). An infant, who has completed first dentition, has reached about 2 years of age (in our study 26.34 + 3.22 months).  Smith (1955) described the earlier eruption of teeth in the lower jaw than in the upper jaw. Temporary dentition begins at 6-8 months of age by eruption of lower central incisors (in our study 7.55 + 0.76 months) and is completed at 24 months by eruption of second molars (in our study 26.15 + 3.47 months and 26.34 + 3.22 months in upper and lower jaw respectively).  Kerr (1957) described in his text book of Forensic Medicine, eruption of central incisors lateral incisors, canine, first molars and second Molars at 5-8 months, 7-9 months, 16-20 months, 12-16 months, 20-24 months respectively.  In our study, eruption of central upper incisor, lateral lower incisor and second molar was delayed compared to above study.
Edgar and Hamilton (1973) described eruption of lower central incisor earlier (6-8 months) than upper central incisors (7-9 months).The eruption of lateral incisor is at 9-10 months, first molar at 12 months, canine at 18 months and second molar at 2 years. The temporary teeth begin to shed at 5 to 7 year.  In our study, eruption of upper central incisor, lower lateral incisor, first molar, canine and second molar was delayed compared to above study.
Grewal (1973) described eruption of temporary teeth in children at 6 months for lower central Incisors, 7 months for upper central incisors, 7 to 9 months for upper lateral incisors, 10 to 12 months for lower lateral incisors, 1 year for first molar, 18 months for canine and 24 months for second molar.  In our study, eruptions of all teeth were delayed compared to above study. Tedechi, Eckert and Tedechi (1977) described that from birth to 6 months of life, accurate age estimation can be based on the mineralization of the deciduous crowns and from then up to 13 months of age, estimation may be determined by the state of eruption. There is no significant influence of external factors on eruption of deciduous teeth.  Ghai (1987) has described the earlier eruption of teeth in the upper jaw than in the lower jaw except lower central incisors. The lower central incisors appear usually between ages of 5 and 8 months, upper a month later and lateral incisors in next 3 months, first molar at 12 to 15 months, canine teeth at 18 to 21 months and second molar at 21-24 months.  In our study, eruption of second molar was delayed compared to above mentioned study.
Reddy KSN (2010) described that temporary teeth are 20 in number and in weak children and in rickets dentition may be delayed, while in syphilis, teeth may be premature or even present at birth. In both deciduous and permanent teeth, dentition occurs earlier in lower jaw except for the lateral incisors which erupts earlier in upper jaw. Tooth eruption in females may be one year earlier than that of males. The eruption occurs in case of lower central incisor at 6-8 months, Upper central and lateral incisor at 7-9 months, lower lateral incisor at 10-12 months, first molar at 12- 14 months, canine at 17-18 months and second molar at 20-30 months.  In our study, eruption occurred earlier in upper jaw except in case of lower central incisor and eruption of upper central incisor, upper lateral incisor, first molar and canine was delayed compared to above study.
Swami et al (1992) conducted study on 1250 (625 males and 625 females) from Himachal Pradesh for eruption of temporary teeth for age estimation. Only healthy residents of Himachal Pradesh between age group of 6 months to 30 months were studied. They found no difference of mean ages of eruption between right and left halves of same jaw. All the teeth appeared earlier in males except second molar tooth. Lower central incisors appeared earlier in both sexes in case of females.  In our study, eruption of upper canine, lower canine and lower first molar occurred earlier in female compared to male.
CONCLUSION Following conclusions are drawn from our study:
1. Average age and range for eruption of temporary teeth in general is given in Table No. 1.
2. Average age for eruption of temporary teeth in male and female is given in Table No. 2.
3. No significant difference of means ages in the eruption of temporary teeth for right and left halves of the same jaw was found.
4. No significant difference was observed in the eruption of teeth in upper and lower jaw for canine, first molar and second molar.
5. For all teeth, eruption occurred earlier in upper jaw except in case of lower central incisor.
6. Order of eruption of temporary teeth was started from lower central incisor followed by upper central incisor followed by upper lateral incisor followed by lower lateral incisor followed by first molar followed by canine followed by second molar.
7. Eruption of lower central incisor, upper central incisor, upper lateral incisor, lower lateral incisor, upper first molar, upper second molar and lower second molar occurred earlier in male compared to female.
8. Eruption of upper canine, lower canine and lower first molar occurred earlier in female compared to male.
9. Eruption of upper central incisor, upper lateral incisor, first molar and canine was delayed compared to Reddy KSN (2010).
ACKNOWLEDGEMENT Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors /publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
1. J.B. Mukherjee’s Forensic Medicine and Toxicology, 4th edition, Academic publishers, 2011, p. 121-131.
2. Kuldeep Singh, R.K. Gorea, Vipin Bharti, Age estimation from eruption of temporary teeth, Journal of Indian Academy of Forensic Medicine, 2004, 26(3): 107-109.
3. Gordon I, Turner R, Price TW., Medical jurisprudence, 3rd edition, Livingstone Ltd, Edinburgh and London, 1953, p. 343-72.
4. Gonzales TA, Vance M, Helpern M, Umberger CJ., Legal medicine pathology and toxicology, 2nd edition, Appleton Century Crofts, Inc; NY, USA, 1954, p. 46.
5. Polson CJ., The essential of forensic medicine, English Universities Press Limited, London, 1955, p. 51.
6. Smith SS, Fiddes FS, Forensic medicine: A text book for students and practitioners, 10th edition, J. and A. Churchill Ltd, London, 1955, p. 88-89.
7. Kerr DJA, Forensic medicine: A text book for students and a guide for the practitioners. 6th edition, Adam and Charles Black; London, 1957, p. 42-43.
8. Edgar R, Hamilton S. Glaister’s medical Jurisprudence and toxicology, 13th edition, Churchil Livingstone; Edinburgh and London, 1973, p. 77-78.
9. Grewal RS, Medical jurisprudence and toxicology, 1st edition, Scientific Book Agency; Calcutta, India, 1973, p. 40-41.
10. Tedeschi CG, Eckert WG, Tedeschi LG, Age determination - Forensic medicine, a study in trauma and environmental hazards, Vol 2, W. B. Saunders Company; Philadelphia, London, Toronto, 1977, p. 1124-1134.
11. Ghai OP, The essential paediatrics, 6th edition, Interprint; New Delhi, India, 1987, p. 5.
12. Reddy KSN, The Essentials of Forensic Medicine and Toxicology, 29th edition, K. Suguna Devi, Om Sai Laser Graphics, Hyderabad, India, 2010, p. 61-64.
13. Swami D, Mishra VK, Bahal L and Rao CM, Age estimation from eruption of temporary teeth in Himachal Pradesh, Journal of Forensic Medicine and Toxicology, 1992; 9: 3-7.