The association between childhood obesity and tooth eruption

Obesity is a growth-promoting process as evidenced by its effect on the timing of puberty. Although studies are limited, obesity has been shown to affect the timing of tooth eruption. Both the timing and sequence of tooth eruption are important to overall oral health. The purpose of this study was to examine the association between obesity and tooth eruption. Data were combined from three consecutive cycles (2001-2006) of the National Health and Nutrition Examination Survey (NHANES) and analyzed to examine associations between the number of teeth erupted (NET) and obesity status (BMI z-score >95th percentile BMI relative to the Centers for Disease Control and Prevention (CDC) growth reference) among children 5 up to 14 years of age, controlling for potential confounding by age, gender, race, and socioeconomic status (SES). Obesity is significantly associated with having a higher average NET during the mixed dentition period. On average, teeth of obese children erupted earlier than nonobese children with obese children having on average 1.44 more teeth erupted than nonobese children, after adjusting for age, gender, and race/ethnicity (P < 0.0001). SES was not a confounder of the observed associations. Obese children, on average, have significantly more teeth erupted than nonobese children after adjusting for gender, age, and race. These findings may have clinical importance in the area of dental and orthodontic medicine both in terms of risk for dental caries due to extended length of time exposed in the oral cavity and sequencing which may increase the likelihood of malocclusions.     

Growth and development in the saddle-back tamarin: The sequence and timing of dental eruption and epiphyseal union

A cross-sectional sample of 121 colony-born saddle-back tamarins, Saguinus fuscicollis, was examined to identify the sequence and timing of dental eruption and epiphyseal union. The state of dental development of the deciduous and permanent dentitions was recorded as erupted or non-erupted on the basis of gingival penetration. Eighteen areas of union of long bone epiphyseal and other secondary centers, the union of the primary elements of the innominate, and the spheno-occipital synchondrosis were examined. The state of union at the areas was recorded on a three-point scale of not united, uniting, and united. The data indicated that deciduous incisors and canines were present at birth and that all deciduous teeth were erupted by 12 weeks. The first permanent tooth, M(1), erupted between weeks 16 and 23; the permanent dentition was fully erupted by 45 weeks. Union of the long bone epiphyses began in the third month at the distal humerus and continued until the first quarter of the second year. The secondary centers at the ischial tuberosity and iliac crest were united slightly later than four and six years of age, respectively. Regression analysis of the data indicate their potential use as parameters for predicting age in feral specimens.     

Formation of a successional dental lamina in the zebrafish (Danio rerio): support for a local control of replacement tooth initiation

In order to test whether the formation of a replacement tooth bud in a continuously replacing dentition is linked to the functional state of the tooth predecessor, I examined the timing of development of replacement teeth with respect to their functional predecessors in the pharyngeal dentition of the zebrafish. Observations based on serial semithin sections of ten specimens, ranging in age from four week old juveniles to adults, indicate that (i) a replacement tooth germ develops at the distal end of an epithelial structure, called the successional dental lamina, budding off from the crypt epithelium surrounding the erupted part of a functional tooth; (ii) there appears to be a developmental link between the eruption of a tooth and the formation of a successional dental lamina and (iii) there can be a time difference between successional lamina formation and initiation of the new tooth germ, i.e., the successional dental lamina can remain quiescent for some time. The data suggest that the formation of a successional lamina and the differentiation of a replacement tooth germ from this lamina, are two distinct phases of a process and possibly under a different control. The strong spatio-temporal coincidence of eruption of a tooth and development of a successional dental lamina is seen as evidence for a local control over tooth replacement.     

Development of the dentition in Alligator mississippiensis: upper jaw dental and craniofacial development in embryos, hatchlings, and young juveniles, with a comparison to lower jaw development

Development of the upper dentition in Alligator mississippiensis was investigated using a close series of accurately staged and aged embryos, hatchlings, and young juveniles up to 11 days posthatching, as well as some young and old adult specimens. Studies from scanning electron microscopy, light microscopy, acetate and computer reconstructions, radiography and macroscopy were combined to elucidate the details of embryonic dental development, tooth initiation pattern, dentitional growth, and erupted functional dentition. The results were compared with those from the lower jaw and related to the development of other craniofacial structures. Approximately 17 early teeth in each jaw half develop as surface teeth, of which 13 project for 1 to 12 days before sinking into the mesenchyme. The first three teeth initiate directly from the oral epithelium at Ferguson stages 14-15 (days 15-19 after egg laying), before there is any local trace of dental lamina formation. All other teeth develop from a dental prolamina or lamina; and with progressive lamina development, submerged teeth initiate from the aboral end leading to the formation of replacement teeth. All teeth form dentin matrix, but 12 early teeth do not form enamel. Approximately 20 embryonic teeth are resorbed, 6 are transitional, and 42 function for longer periods after hatching. The embryonic tooth initiation pattern (illustrated by defining a tooth position formula) does not support the previous models of Odontostichi, Zahnreihen, and Tooth Families, each of which postulates perfect regularity. Up to three interstitial tooth positions develop between sites of primary tooth initiation, and families with up to five generations at hatching are at first arbitrarily defined.     

Age inTayassu pecari according to dental eruption

The determination of the age composition of a population is considered to be a fundamental parameter for the analysis of life-history strategy of the species. In the Tayassuidae, the determination of relative age has been primarily based on molar tooth wear, sometimes combined with other external characteristics, such as hair color or body size. The present study examined the dental composition of white-lipped peccariesTayassu pecari (Link, 1795) . Through the determination of the erupted dental pattern and its relation to the body weight of the animal, six age classes were established. The presence of molar teeth was considered the most accurate parameter for establishing age classes for white-lipped peccaries.     

Age estimation from dental eruption in infant and juvenile baboons (Papio sp.)

Two regression methods are proposed for estimating age in nonhuman primates from deciduous dental eruption data. The first method consists of step-wise multiple regression using dental eruption state (present/absent) of each tooth as independent variables. The second method uses the total number of teeth erupted as an independent variable in an exponential model. We applied both methods to a sample of 175 well nourished infant and juvenile baboons (Papio sp.), housed in an outdoor breeding corral, and ranging in age from birth to 763 days. From this sample, 129 animals were used to compute the regression formulae, and 46 animals were used for cross validation. Both models show good overall fits and high predictive accuracy with the independent cross validation sample.     

Increasing human tooth length between birth and 5.4 years

Most previous studies of tooth development have used fractional stages of tooth formation to construct growth standards suitable for aging juvenile skeletal material. A simple alternative for determining dental age is to measure tooth length throughout development. In this study, data on tooth length development are presented from 63 individuals of known age at death, between birth and 5.4 years, from an archeological population recovered from the crypt of Christ Church, Spitalfields, London. Isolated developing teeth (304 deciduous, 269 permanent) were measured in millimeters and plotted against individual age. Regression equations to estimate age from a given tooth length, are presented for each deciduous maxillary and mandibular tooth type and for permanent maxillary and mandibular incisors, canines, and first permanent molars. Data on the earliest age of root completion of deciduous teeth and initial mineralization and crown completion of some permanent teeth in this sample are given, as well as the average crown height and total tooth length from a small number of unworn teeth. This method provides an easy, quantitative and objective measure of dental formation appropriate for use by archeologists and anthropologists. © 1993 Wiley-Liss, Inc.     

Influence of parathyroid hormone and heparin on tooth development in mice homozygous for the microphthalmia mutation]

In mice, homozygous by microphthalmia (mi/mi) gene the disturbance of dental development was due to defects in dental pulp and to the absence of bone resorpion. Administration of heparin or parathyroid hormone stimulated dental eruption in mi/mi mice. Following combined action of heparin and parathyroid hormone the number of erupted teeth was practically the same as after the action of heparin alone. Possibly the level of heparin is insufficient, but secretion of parathyroid hormone is unimpaired in mi/mi mice.     

Tooth eruption in Reeves' muntjac (Muntiacus reevesi) and its use as a method of age estimation (Mammalia: Cervidae)

The sequence of tooth eruption and replacement in Reeves' muntjac was determined from captive animals of known age. Pronounced sexual dimorphism is shown by the permanent upper canine which in the male is large, tusk-like and is used as a weapon. The upper canine was the first deciduous tooth to be replaced in males, at approximately 21 weeks of age, compared with 53–57 weeks in the female. The permanent mandibular teeth erupted in the order: molars, first and second incisors, premolars, third incisor and canine. The maxillary teeth erupted in the order: first molar, canine (in male), second and third molars, canine (in female), premolars. The full complement of 34 functional permanent teeth was attained by 83–92 weeks of age.     

Patterns of dental wear in the Lengua Indians of Paraguay

Wear patterns were examined on dental casts of 202 living Lengua Indians from the Chaco area of Paraguay. Consideration was given to the development of the molar helicoidal plane, age-related changes in occlusal attrition, coalescence of dentine exposures, interproximal attrition, and erupted crown height. This study lends support to Osborn's theory of the helicoidal plane development by showing that attrition enhances rather than modifies posteruption molar occlusal planes. The rate of interproximal attrition was found to slow down with the eruption and functional initiation of the third molars. Sinuous and cavo-convex interproximal contact areas that are generated with age, however, appeared to be less abrasion resistant than straight surfaces, hence leading to an increase in interproximal attrition rates with advanced age. Maximum crown height reduction occurred between the ages of 20 and 40 years in central incisors, canines, and first molars. Kruskal-Wallis tests and log linera models failed to demonstrate significant sexually dimorphic or antimeric differences in wear patterns of Lengua teeth.     

Prevalence and age at development of enamel hypoplasias in Mexican children

Enamel hypoplasias, deficiencies in enamel thickness resulting from disturbances during the secretory phase of enamel development, are generally believed to result from nonspecific metabolic and nutritional disruptions. However, data are scare on the prevalence and chronological distributions. of hypoplasias in populations experiencing mild to moderate malnutrition. The purpose of this article is to present baseline data on the prevalences and chronological distributions of enamel hypoplasias, by sex and for all deciduous and permanent anterior teeth, in 300 5 to 15-year-old rural Mexican children. Identification of hypoplasias was aided by comparison to a published standard (Federation Dentaire Internationale: Int. Dent. J. 32(2):159-167, 1982). The location of defects, by transverse sixths of tooth crowns, was used to construct distributions of defects by age at development. One or more hypoplasias were detected in 46.7% (95% CI = 40.9-52.5%) of children. Among the unworn and completely erupted teeth, the highest prevalence of defects was found on the permanent maxillary central incisors (44.4% with one or more hypoplasias), followed by the permanent maxillary canine (28.0%) and the remaining permanent teeth (26.2 to 22.2%) Only 6.1% of the completely erupted and unworn deciduous teeth were hypoplastic. The prevalence of enamel defects on the permanent teeth was up to tenfold greater than that found in studies of less marginal populations that used the FDI method. The prevalence of defects in transverse zones suggests a peak frequency of hypoplasias during the second and third years for the permanent teeth, corresponding to the age at weaning in this group. In the deciduous teeth, a smaller peak occurs between 30 and 40 weeks post gestation. The frequency of defects after three years of age is slightly higher in females than males, suggesting a sex difference in access to critical resources.     

Patterns of dental wear and the role of the canine in Cercopithecinae.

The importance of dental wear patterns in understanding masticatory functions in primates has long been appreciated. However, studies of wear patterns among populations of nonhuman primates are few. The purpose of this investigation is to establish the developmental aspects of dental wear in the Cercopithecinae and to describe certain relevant morphological traits. Studies were made of dental casts from 200 primate specimens of Macaca nemestrina, Macaca mulatta, and Papio cynocephalus. These casts were taken at four-month intervals, beginning at two years of age and continuing over a period of six to seven years. The wear pattern starts with the rounding and eventual flattening of the protoconid and protocone of the erupted first molars. Once this stage is reached, the hypoconid and metaconid of the mandibular, and the hypocone and paracone of the maxillary molars are rounded and eventually flattened. This pattern is maintained until the cusp tips are removed and the dentin exposed, however, the entoconid and metacone are not subjected to significant wear at this stage. Analysis of these dental casts and museum specimens has provided data on the development of dental wear during the maturation of these primates. The distribution of forces acting upon the teeth produce diagnostic patterns of wear, which provide evidence of the force location and magnitude. In examining the data, the hypothesis of canine guidance and its limitation of mandibular motion was evaluated. Specimens whose canines were removed demonstrate that the canines play no significant role in the development or maintenance of dental wear planes.     

First Fossil Evidence for the Advance of Replacement Teeth Coupled with Life History Evolution along an Anagenetic Mammalian Lineage

In mammals that grow up more slowly and live longer, replacement teeth tend to appear earlier in sequence than in fast growing mammals. This trend, known as ‘Schultz''s Rule’, is a useful tool for inferring life histories of fossil taxa. Deviations from this rule, however, suggest that in addition to the pace of life history, ecological factors may also drive dental ontogeny. Myotragus balearicus is an extinct insular caprine that has been proved to be an excellent test case to correlate morphological traits with life history. Here we show that Myotragus balearicus exhibits a slow signature of dental eruption sequence that is in agreement with the exceptionally slow life history of this species, thus conforming to ‘Schultz''s Rule’. However, our results also show an acceleration of the absolute pace of development of the permanent incisors in relation to that of the posterior teeth. The rodent-like incisors of Myotragus balearicus erupted early not only in relative but also in absolute terms (chronological age), suggesting that feeding characteristics also plays an important role in dental ontogeny. This is in agreement with ecological hypotheses based on primates. Our study documents a decoupling of the pace of development of teeth in mammals that is triggered by different selection pressures on dental ontogeny. Moreover, we show that Myotragus kopperi from the early Pleistocene (a direct ancestor of the late Pleistocene-Holocene M. balearicus) follows the pattern of first incisor replacement known in living bovids. Hence, the advance in the eruption sequence of the first incisors occurs along the Myotragus evolutionary lineage over a period of about 2.5 Myr. To our knowledge, this is the first fossil evidence of an advance of the emergence of the permanent first incisor along an anagenetic mammalian lineage.     

An effect of zinc deficiency on dental caries.

Rat pups suckled by dams fed a zinc-deficient diet developed higher levels of dental caries following a caries-test challenge than pups suckled by dams fed a zinc-adequate diet. The zinc deficient treatment was administered during the mineralization stage of tooth development before the molars erupted. The data shows that suboptimal zinc nutriture was associated with an increase in dental caries.Fluoride, a trace element, is recognized as a factor in preventing dental caries and its use has had a significant impact on dental health in this country. However, the possible roles of other trace elements have not been closely examined. Zinc is a trace element important to bone mineralization as well as in general nutrition.The effects on dental caries produced by the addition of zinc to rat diets have been reported (1, 2, 3). In those investigations, however, zinc supplements were added to diets that were adequate in zinc. Moreover, zinc supplements were fed after the teeth had appeared in the oral cavity. Because the critical period of tooth maturation occurs before eruption (4), post-eruptive zinc supplements probably should not markedly influence the development and, specifically, the mineralization of the tooth. Therefore, we investigated the influence of pre-eruptive zinc deficiency on caries development in rats.     

Teeth, brains, and primate life histories

This paper explores the correlates of variation in dental development across the order Primates. We are particularly interested in how 1) dental precocity (percentage of total postcanine primary and secondary teeth that have erupted at selected absolute ages and life cycle stages) and 2) dental endowment at weaning (percentage of adult postcanine occlusal area that is present at weaning) are related to variation in body or brain size and diet in primates. We ask whether folivores have more accelerated dental schedules than do like-sized frugivores, and if so, to what extent this is part and parcel of a general pattern of acceleration of life histories in more folivorous taxa. What is the adaptive significance of variation in dental eruption schedules across the order Primates? We show that folivorous primate species tend to exhibit more rapid dental development (on an absolute scale) than comparably sized frugivores, and their dental development tends to be more advanced at weaning. Our data affirm an important role for brain (rather than body) size as a predictor of both absolute and relative dental development. Tests of alternative dietary hypotheses offer the strongest support for the foraging independence and food processing hypotheses.     

Dental wear and oral pathology: possible evidence and consequences of habitual use of teeth in a Swedish Neolithic sample

Atypical wear and oral lesions were studied in the dental remains from the Middle Neolithic Pitted Ware Culture site Ajvide on the island of Gotland in the Baltic Sea. Teeth (n = 764) from 17 males and 11 females were examined microscopically to document unusual wear, assess wear patterns and oral lesions as evidence of habitual behavior, and determine their effect on the oral health of this population. Five atypical wear types were observed: occlusal facets, occlusal excessive load, labial vertical striae, labial horizontal striae, and interproximal striae. Three oral lesions were recorded: chipping, periapical lesions, and dental tilting. Results indicate that teeth were used in a habitual manner at Ajvide, based on the morphology and regularity of the patterns of atypical wear. Differences were observed between the sexes, indicating gender-related differences in the habitual use of teeth. Some wear categories showed a significant correlation with age, signifying increased or accumulated wear with age. Statistically significant positive correlations were found in the molars between occlusal excessive load wear and periapical lesions as well as tilting. Other apparent links were also observed between chipping and vertical striae as well as excessive load, although these were not significant. This suggests a relationship between dental wear and dental pathologies at this site, suggesting that habitual use of teeth indirectly affected the general oral health at the site. Wear patterns, furthermore, seem to mirror both frequent activities as well as single events.     

Dental health of elderly confederate veterans: evidence from the Texas State Cemetery

Analysis of the skeletal remains of 50 Confederate veterans provided a unique opportunity to explore the dental health of a geriatric sample. These men, who died between 1907-1932, had an average age at death of 76.7 years. Ninety percent were institutionalized at the Confederate Home for Men (Austin, TX) prior to their deaths. This elderly sample was assessed in terms of caries, antemortem tooth loss (AMTL), abscesses, and linear enamel hypoplasias. On a per tooth basis, the AMTL rate was 57.2%. Of 39 dentate men, 33 (84.6%) had dental caries, and 24.4% (121 of 496) of teeth were carious. Ten (25.0%) of the dentate men had hypoplastic teeth. At least one abscess was seen in 14 (28%) of 50 individuals. Results from this geriatric institutionalized sample are compared to contemporaneous historical samples. Disparities in dental health among these groups may be due to differences in average age at death, and these comparisons allow a better understanding of dental changes that occur with age. The sample is also compared to modern elderly samples: modern groups have higher caries rates, possibly because they retained more teeth. This finding may be due in part to diets in the United States becoming increasingly cariogenic over time. In addition, dental care has moved from the reactive practices seen in the nineteenth and early twentieth centuries (such as tooth extractions) to modern proactive solutions dedicated to preserving and restoring teeth (such as tooth brushing, fluoride treatments, and dental fillings).     

Arresting rampant dental caries with silver diamine fluoride in a young teenager suffering from chronic oral graft versus host disease post-bone marrow transplantation: a case report

Background

Rampant caries is an advanced and severe dental disease that affects multiple teeth. This case describes the management of rampant caries in a young teenager suffering from chronic oral graft versus host disease after allogeneic bone marrow transplantation.

Case presentation

A 14-year-old Chinese boy suffering from β–thalassemia major was referred to the dental clinic for the management of rampant dental caries. An oral examination revealed pale conjunctiva, bruising of lips, and depapillation of tongue indicating an underlying condition of anemia. The poor oral condition due to topical and systemic immunosuppressants was seriously aggravated, and rampant caries developed rapidly, affecting all newly erupted, permanent teeth. The teeth were hypersensitive and halitosis was apparent. Strategies for oral health education and diet modification were given to the patient. Xylitol chewing gum was used to stimulate saliva flow to promote remineralization of teeth. Silver diamine fluoride was topically applied to arrest rampant caries and to relieve pain from hypersensitivity. Carious teeth with pulpal involvement were endodontically treated. Stainless steel crowns were provided on molars to restore chewing function, and polycarbonate crowns were placed on premolars, upper canines and incisors.

Conclusion

This case report demonstrates success in treating a young teenager with severe rampant dental decay by contemporary caries control and preventive strategy.     

Dental development and the evolution of life history in Hominidae

Development of the dentition is critically integrated into the life cycle in living mammals. Recent work on dental development has given rise to three separate lines of evidence on the evolution of human growth and aging; these three, based on several independent studies, are reviewed and integrated here. First, comparative study of living primate species demonstrates that measures of development (e.g., age of emergence of the first permanent molar) are highly correlated with the morphological attributes brain and body weight (as highly as r = 0.98, N = 21 species). These data predict that small-bodied, small-brained Australopithecus erupted M₁ at 3–3.5 years and possessed a life span comparable to that of a chimpanzee. Second, chronological age at death for three australopithecines who died at or near emergence of M₁ is now estimated as ～3.25 years based on incremental lines in teeth; this differs substantially from expectations based on human growth schedules (5.5–6 years). Third, developmental sequences (assessed by the coefficient of variation of human dental age) observed in gracile Australopithecus and great apes diverge from those of humans to a comparable degree; sequences become more like modern humans after the appearance of the genus Homo. These three lines of evidence agree that the unique rate and pattern of human life history did not exist at the australopithecine stage of human evolution. It is proposed that the life history of early Homo matched no living model precisely and that growth and aging evolved substantially in the Hominidae during the last 2 million years.     

Sexual dimorphism of the human mandible and its association with dental development

The present study investigates whether the human mandible is sexually dimorphic during early postnatal development and whether early dimorphic features persist during subsequent ontogeny. We also examine whether mandibular dimorphism is linked to dimorphism of dental development. Dense CT-derived mandibular meshes of 84 females and 75 males, ranging from birth to adulthood, were analyzed using geometric morphometric methods. On the basis of the specimen's chronological ages and mineralization stages of the deciduous and permanent teeth, we compute dental age as proxy for dental development by the additive conjoint measurement method. By birth, males have, on average, more advanced age-specific shapes than females. However, sex differences decrease quickly as females catch up via a different association between shape and size. This leads to an almost complete reduction of sexual dimorphism between the ages of 4 and 14. From puberty to adulthood, males are characterized by allometric shape changes while the shape of the female mandible continues to change even after size has ceased to increase. Dimorphism of dental maturation becomes visible only at puberty. Sexual dimorphism, concentrated at the ramus and the mental region during the earliest ontogenetic stages and again at adulthood, is not associated with the development of the teeth. At puberty there is a simultaneous peak in size increase, shape development, and dental maturation likely controlled by the surge of sex hormones with a dimorphic onset age. We argue that the infant and adult dimorphism of the mental region may be associated with the development of supralaryngeal structures.