Pediatric Dentistry · patient case question
Her mandibular permanent central incisors have erupted at age 5. What does this indicate?
Patient case: A young patient in the mixed dentition
demo: 5-year-old female
chief: Routine examination. Her mother is worried that her front teeth are coming through early.
history: Healthy. The family moved recently from a community with fluoridated water to one with none. Her mother reports the older sibling had a similar early pattern.
meds: None.
findings: Both mandibular permanent central incisors are fully erupted. A 3 mm midline diastema is present in the maxilla between the primary central incisors. A periapical film of a maxillary lateral incisor shows an invagination of enamel and dentin extending into the pulp chamber.
Show answer and explanation
Correct answer: C. Her dental age is ahead of her chronological age
- A. Early eruption within a year of the norm is a normal variation, not pathology. Markedly premature eruption would prompt a look at endocrine causes such as hyperthyroidism or precocious puberty.
- B. Delayed dental age would mean teeth erupting later than expected, which is the reverse of what is described.
- C. Correct. Mandibular permanent central incisors normally erupt at 6 to 7 years. Eruption at 5 means dental development has run ahead of chronological age, which is a normal variation. Dental age is judged from calcification stages and eruption sequence and is a more reliable developmental index than eruption timing alone.
- D. If the two matched, eruption would occur at the expected 6 to 7 years.
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