Dental notation

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This article is about human tooth numbering. For the general mammalian dental formula see dentition.

Dental professionals, in writing or speech, use several different dental notation systems for associating information with a specific tooth. The three most common systems are the ISO System, Universal Numbering System, and Palmer notation method. The ISO system is used worldwide, and the Universal is used widely in the USA. The ISO System can be easily adapted to computerized charting.

History[edit]

A committee of the American Dental Association (ADA) recommended the use of the Palmer notation method in 1947. Since this method required the use of symbols, its use was difficult on keyboards. As a result, the association officially supported the Universal system in 1968. The World Health Organization and the Fédération Dentaire Internationale officially uses the two-digit numbering system of the FDI system. However, in 1996, the ADA adopted the ISO System as an alternative to the Universal System.

ISO System by the World Health Organization[edit]

FDI Notation, teeth's quadrants


The International Standards Organization Designation System (ISO System) by the World Health Organization notation system is widely used by dental professionals internationally to associate information with a specific tooth. Based on the Fédération Dentaire Internationale (FDI), it is also known as ISO 3950[1] notation. Thus the ISO System uses a two-digit numbering system in which the first number represents a tooth's quadrant and the second number represents the number of the tooth from the midline of the face. For permanent teeth, the upper right teeth begin with the number, "1". The upper left teeth begin with the number, "2". The lower left teeth begin with the number, "3". The lower right teeth begin with the number, "4". For primary teeth, the sequence of numbers goes 5, 6, 7, and 8 for the teeth in the upper right, upper left, lower left, and lower right respectively. When speaking about a certain tooth such as the permanent maxillary central incisor, the notation is pronounced “one, one”. Beware of mixing up the teeth in written form such as 11, 12, 13, 14, 15, 16, 17, 18 between the Universal and ISO systems.

For example: retention of a primary molar tooth in the otherwise regular intact lower right jaw, position 5, would be noted as: 41, 42, 43, 44, 85, 46, 47, 48.

                          Permanent Dentition
            upper right - 1             upper left - 2
        18 17 16 15 14 13 12 11 | 21 22 23 24 25 26 27 28 
     R --------------------------------------------------- L
        48 47 46 45 44 43 42 41 | 31 32 33 34 35 36 37 38 
            lower right - 4             lower left - 3 

                        Primary Dentition
            upper right - 5             upper left - 6
                 55 54 53 52 51 | 61 62 63 64 65 
              R --------------------------------- L
                 85 84 83 82 81 | 71 72 73 74 75 
            lower right - 8             lower left - 7

 I - Incisor
 C - Canine
 P - premolar
 M - molar

Palmer notation method[edit]

The Palmer notation is a system used by dentists to associate information with a specific tooth. Although supposedly superseded by the FDI World Dental Federation notation, it overwhelmingly continues to be the preferred method used by dental students and practitioners in the United Kingdom.[2] It was originally termed the "Zsigmondy system" after the Hungarian dentist Adolf Zsigmondy who developed the idea in 1861, using a Zsigmondy cross to record quadrants of tooth positions.[3] Permanent teeth (adult) were numbered 1 to 8, and the child primary dentition (also called deciduous, milk or baby teeth) were depicted with a quadrant grid using Roman numerals I, II, III, IV, V to number the teeth from the midline distally. Palmer changed this to A, B, C, D, E.

The Palmer notation consists of a symbol (┘└ ┐┌) designating in which quadrant the tooth is found and a number indicating the position from the midline. Adult teeth are numbered 1 to 8, with primary teeth indicated by a letter A to E. Hence the left and right maxillary central incisor would have the same number, "1", but the right one would have the symbol, "┘", underneath it, while the left one would have, "└".

                          Permanent Dentition
            upper right - 1x            upper left - 2x
                8 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7 8 
     R --------------------------------------------------- L
                8 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7 8 
            lower right - 4x            lower left - 3x

                         Primary Dentition
           upper right - 5x            upper left - 6x
                     E D C B A | A B C D E 
              R --------------------------------- L
                     E D C B A | A B C D E 
            lower right - 8x            lower left - 7x

I - Incisor
C - Canine
P - premolar
M - molar

Universal numbering system[edit]

Although it is termed "universal numbering system", it is commonly used in the United States. It is also called the "American system".[4] The uppercase letters A through T are used for primary teeth and the numbers 1 - 32 are used for permanent teeth. The tooth designated "1" is the maxillary right third molar ("wisdom tooth") and the count continues along the upper teeth to the left side. Then the count begins at the mandibular left third molar, designated number 17, and continues along the bottom teeth to the right side. Each tooth has a unique number or letter, allowing for easier use on keyboards.

Universal numbering system table
Permanent Dentition
upper left upper right
16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
lower left lower right
Primary Dentition
upper left upper right
J I H G F E D C B A
K L M N O P Q R S T
lower left lower right
Alternate system for Primary Dentition
upper left upper right
10d 9d 8d 7d 6d 5d 4d 3d 2d 1d
11d 12d 13d 14d 15d 16d 17d 18d 19d 20d
lower left lower right

Letters and numbers system[edit]

The 4 quadrants are designated:

  • UR - upper right
  • UL - upper left
  • LR - lower right
  • LL - lower left

The teeth are numbered 1-8 for permanent and A-E for deciduous.

For example, permanent upper left first molar: UL6

References[edit]

  1. ^ ISO 3950:2009 Dentistry — Designation system for teeth and areas of the oral cavity
  2. ^ Blinkhorn A, Choi C, Paget H (1998). "An investigation into the use of the FDI tooth notation system by dental schools in the UK.". Eur J Dent Educ 2 (1): 39–41. doi:10.1111/j.1600-0579.1998.tb00034.x. PMID 9588962. 
  3. ^ Huszár G (1989). "[The role of the life and works of Adolf Zsigmondy and Ottó Zsigmondy in the history of dentistry][Article in Hungarian]". Fogorv Sz 82 (12): 357–63. PMID 2689240. 
  4. ^ "Histology: A Text and Atlas by Michael H. Ross • Wojciech Pawlina".