Department Of Paediatric dentistry

PREDENTATE
PERIOD

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 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

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 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.

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 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 – Running
backwards and join the gingival
groove in the canine region.
• Lateral sulcus – Present between
deciduous canine & first molar
segment.

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 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 –
Mandible moves vertically & in
anteroposterior direction.
Lateral movements are absent.

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 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 ( 2” x2”) between thumb and forefinger &
wipe vigorously over the gum pad
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• Now a days specially designed:-
– infant tooth brush
– Finger coats
– 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.

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 PRECOCIOUSLY ERUPTED TEETH.
1. 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.

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 Soft Tissue lesions which are seen
during predentate period.
1. CONGENITAL EPULIS :-
Soft tissue tumer that occurs on the gum pads
Clinical features :- Pink to red in color
Smooth surfaced
Polypoid mass.
size – 2 cm. – 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

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 Epstein pearls or Bohn’s
nodule
Small superficial, Keratin filled cysts that are found
on the alveolar mucosa of infant.
Clinical Feature:-
– Small, usually multiple,
whitish papules on
the mucosa overlying
the alveolar process of
neonate.
– Size of individual :- 2 to 3 mm.
– Maxilla > mandible

Treatment:- Spontaneous involute at a result of

rupture of cyst.
Rarely seen after 3 months of age.

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 Rega fede disease
• Ulceration on the ventral surface of tongue caused
by sharp edges of natal & neonatal teeth.

Clinical Feature:-
– Mild to severe ulcerations
on ventral surface of
tongue.
– Interfere with infants
feeding & suckling

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Treatment:-
– If the tooth is mature & root is sufficient to retain the tooth than
• Smoothening of the incisal edge
• Placement of a smooth & rounded composite
– In case of larger lesion
• Extraction of offending tooth with vitamin K supplementation

ERUPTION CYST
• Associated with natal and
neonatal teeth.

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• Clinical Feature:-
– Usually symptomless
– Sometimes : Interfere with feeding
Bleed intermittently
– Appear as clear or blood tinged, fluid filled masses on the
crest of the alveolar ridge.
• Treatment:-
– Usually disappear when the underlying tooth erupt.
– If it is painful or infected or if the lesion bleeds than it should
be drained and natal or neonatal teeth are removed.

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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

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2. OPEN BITE OF GUM PAD:-

• Corrected when incisor teeth fully erupts.

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 References:
• Textbook of pedodontics- Shobha Tandon

• Oral & maxillofacial pathology- 2nd edi.-

Neville, Damm , Allen, Bouquot

• A textbook of oral pathology- 4th edi.-

Shafer

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