Teeth Names and the Tooth Numbering System

Ever wondered what your dentist was talking about when they are describing your teeth to the nurse? When they say that tooth “44” as a filling… Which tooth is this?

One of the top dental searches on Google is for teeth names and also for the numbering system used to classify each of the human teeth. There is also a difference between the standard numbering systems in the UK and the international system so will go through both of these in this article.

There are quite a few different ways of using a notational system, including the international standard or universal numbering system which is widely used internationally. Let’s start by looking at the teeth names first…

The Names for Adult Teeth

Starting at the tooth in the front and working backwards the tooth names are:

  1. Central.
  2. Lateral.
  3. Canine.
  4. 1st premolar.
  5. 2nd premolar.
  6. 1st molar.
  7. 2nd molar.
  8. 3rd molar.

This is the same on the left and right side making 16 teeth on the top, it is also reflected on the bottom with another 16 teeth making 32 teeth in total.

tooth names

Adult tooth numbering system

Very often in the UK the Palmer notation method is used, this was named after Dr Corydon Palmer a dentist from Ohio. It uses a simple system to represent the quadrant in the mouth and whether it is up, lower, left or right. It is always indicated by the PATIENTS left and right, never the person sitting opposite the patient and viewing.

Palmer tooth notation

So if a dentist wanted to talk about the permanent dentition 1st premolar on the right-hand side (remember it’s always the patient’s right) you would hear them talk about upper right 4, sometimes abbreviated to UR4, this would then have the notation:

upper right 4

… They would be talking about this tooth…

1st premolar tooth notation

The last tooth in the mouth, the 3rd molar, numbered 8 is what is otherwise known as the wisdom teeth. These can be problematic as there is often not enough room in the mouth meaning they can be impacted and push against the other teeth.

International Standards Organisation

In addition to both the methods above there is also the ISO system which is used widely by dentists internationally. It uses a 2 digit system, the 1st digit indicates the quadrant as follows:

  1. upper right
  2. upper left
  3. lower left
  4. lower right

In the ISO system, the 2nd number indicates which tooth, start counting from the front tooth and work backwards.

international standard organisation notational system

The uses of different teeth

There are different types of teeth in the mouth or groups of teeth, they all have specific uses:

  • Incisors for biting into food and tearing off bite-size pieces.
  • Canines for sharper biting forces concentrated into a point and also, historically for display in our ancestors. Think of a gorilla who has large canines but does not use them for tearing food, rather they are used for display.
  • Premolars and molars for grinding food into smaller sized amounts.

The names for children’s teeth

Baby teeth are also known as deciduous teeth, they are the primary teeth that a human has and are lost in early childhood through to teenage years. This is because an adult needs larger teeth but the baby jaw is not big enough for them to come through at the beginning. Starting at the tooth in the front and working backwards the tooth names are:

  1. Central.
  2. Lateral.
  3. Canine.
  4. 1st premolar.
  5. 1st molar.

This is the same on the left and right side making 10 teeth on the top, it is also reflected on the bottom with another 10 teeth making 20 teeth in total.

Most commonly they are referred to in lettering format.

  • A – Central.
  • B – Lateral.
  • C – Canine.
  • D – 1st premolar.
  • E – 1st molar.

With deciduous teeth many people believe there is no need to look after the children’s teeth as much as possible, after all, the permanent teeth are going to come through afterwards so what is the point as they will have another set of teeth, right?

This however is a dangerous viewpoint.

If children get into bad habits by consuming large amounts of sugar or not following a good oral health care routine then those habits will inevitably work their way through into teenage years and affect adult teeth as they erupt.

If a child has dental decay then the bacteria will be present in the mouth, the higher level of bacteria can then mean that the permanent teeth are also subject to a higher risk of decay.

On top of all of this the bacteria which cause dental decay have also been shown to cause other problems in the body, this could then put the child at risk from a wide variety of other health-related issues.

In summary

If you have any concerns about your teeth in any way at all please do contact your local dentist who will always be happy to help. We recommend taking the children to the dentist as soon as the teeth begin to wrapped as babies, this can help to get used to the dental environment and allow your dentist the opportunity to monitor the baby tooth development as it happens, always watching out for gum disease.

The Signs of Gum Disease

Spotting the early warning signs of gum disease is a key factor in ensuring that your dental health space in tiptop condition. Gum disease can progress painlessly on the whole and is often not until the disease has spread to the more advanced stages you will actually notice at home.
Our latest blog post answer some of the most common questions asked about gum disease and looks at how you can prevent it in the 1st place.

What are the causes of gum disease?

Gingivitis or Pyria, commonly known as gum disease is an inflammation of the soft tissue area (gum) which surrounds your teeth.

Throughout the day a thin layer called biofilm forms over your teeth, this is known as plaque. This is a sticky and natural layer made up primarily of bacteria. As these bacteria in plaque feed on the sugar, you ingest they excrete acid and it is this acid which causes tooth decay.

When you clean your teeth you will be removing this biofilm layer but if the film is not removed adequately enough then it can begin to harden, particularly in between teeth where it’s difficult to clean. As it hardens it turns into a thick cream coloured layer called tartar.

This tartar can then irritate the gums whilst also giving the bacteria a really good place to read and hide.

This inflammation of the gums, caused by the buildup of tartar then turns into gum disease.

How to catch gum disease?

Gum disease isn’t something you can catch as it is not an infectious disease. However, there are other diseases which are infectious which can lower your resistance and mean you are more inclined to develop gum disease.
Gum disease is caused by poor oral hygiene, not by catching it from anyone else. There are however certain other risk factors which can increase the likelihood of catching gum disease including various medical conditions and of course, smoking.
It’s also possible to be more susceptible to gum disease if you are wearing orthodontic braces, it is therefore really important that you keep your teeth and orthodontic appliance clean whilst having teeth straightening treatments.

What are the symptoms of gum disease?

red and inflamed gums

Gum disease has a series of symptoms depending on its severity, but classically:
  • Gums become red, puffy and inflamed. Typically they will look red and swollen.
  • Bleeding can occur, initially only on vigorous brushing or when using an interdental floss or stick.
  • Gums can then begin to bleed spontaneously as the gingivitis progresses.

What is periodontal disease?

dreaming of periodontitis

If gum disease is left untreated it can then turn into the more serious periodontal disease. This is where the layer surrounding the root of your tooth becomes inflamed and infected. Gingivitis is an inflammation of the gum, the part of the mouth you can see, periodontitis is an inflammation underneath the gum around the bone, the part of the mouth you can’t see.

Periodontal disease, because it affects the support around the tooth and root if left unchecked can ultimately lead to tooth loss, so it should be treated as a serious condition.

What are the symptoms of periodontal disease?

If you have periodontal disease then you will almost certainly have all of the signs and symptoms of gum disease, in addition, you may also have:

  • Gums which are pulling away from your teeth making your teeth look longer.
  • Loose or wobbly teeth.
  • Puss coming up between your gums and teeth.
  • Continuous bad breath.
  • Pain in your teeth caused by the pressure of the infection.
It’s important to bear in mind that gum colour varies enormously between individuals, gums can appear anything from dark black to light pink and both are perfectly normal.
Un-natural back gums can be caused by:
  • Smoking. Smokers black gums are known as melanosis, this is because there are cells in your gums called melanocytes, nicotine can stimulate these cells to produce more melanin than normal and this gives the dark black appearance on the gums.
  • Some medications. Some treatments for chlamydia or acne can result in a side-effect of discolouration of the gums. There are often alternatives so speak to your medical practitioner if you feel this is the cause.
  • Old silver fillings. Amalgam (Silver) fillings are extremely dark by nature, looking very black and grey. As you age you may find that the outside of your teeth where you have a filling wears down and becomes thinner, as this happens the amalgam filling can show through. If the amalgam is closed your gum it can give a grey/black appearance to the gum.
  • SEVERE gum disease. In some instances of severe gum disease the soft tissue can actually die. This necrosis, sometimes called trench mouth then gives the black appearance. It is often accompanied by extreme bad breath, mouth ulcers, and bleeding gums.
  • Hyperpigmentation caused by Addison’s disease. This is a condition which affects the adrenal glands, its symptoms include tiredness, lack of appetite, weak muscles and thirst. The condition has a side-effect that hyperpigmentation occurs in parts of the body and the gums can appear darkened or black.
very early onset gingivitis can easily be reversed at home by maintaining a good oral health plan and ensuring you brush your teeth twice a day for 2 min using the fluoride-containing toothpaste. However, if you have noticeable symptoms of gum disease then it may have already progressed to a more serious stage which requires intervention by your dental hygienist.
A dental hygienist is able to clean underneath the gum line, known as the cleaning or deep scaling. This can remove any detritus or plaque which has formed underneath the gum and caused the gum disease.
Your hygienist may recommend an intense course of professional cleaning in order to thoroughly clean the teeth, they will then give you advice on how you can do this at home yourself to prevent the condition coming back and the plaque building up again.

How can periodontitis be reversed?

Non-surgical intervention.

There are a range of nonsurgical techniques including scaling, root planing, and antibiotics. scaling can be done using instruments or with a laser or ultrasonic device. The root planing removes the bacteria around the route and encourages the soft tissue to reattach itself to the root and tooth. Antibiotics can then treat any infection.

Surgical intervention.

If the periodontitis is more severe or nonsurgical interventions have not worked then treatment by a specialist periodontist may be required, typical techniques involve:
  • Pocket reduction – this is where the soft tissue around the infected area is gently lifted away, the underlying bone and root can then be extensively cleaned. The gum can then be stitched back into place.
  • Soft tissue grafting – if there has been extensive loss of soft tissue (gums) a craft can be taken, often from the roof of your mouth, and used to replace the soft tissue around your teeth.
  • Bone grafting – if the periodontitis has infected so much bone the bone has been lost then grafting from either your own bone or synthetic bone can be used to rebuild the area around your teeth.
Brushing and flossing really is the key to good oral hygiene, protecting your teeth and gums, soft tissues and bone. Regular dental health checks can also ensure that gingivitis isn’t progressing unnoticed.

I think I might have gum disease, what can I do?

One of the primary causes of tooth loss is the progression of gum disease if it’s not treated and caught early. We therefore decided to dedicate this entire blog post to looking at some of the most common questions and answers that people have about gum disease (gingivitis)

What is gum disease?

Gum disease or gingivitis occurs when the delicate gums around your teeth become inflamed. Gum disease progresses painlessly on the whole so you may not notice it until it is at a more severe stage.

How will I know if I have gum disease?

The first sign is that your gums may be slightly puffy, read or inflamed. At first this will be very mild and barely noticeable unless you look extremely closely (just as a dentist would during your regular dental health check).

As the gum disease progresses you may find that the gums bleed occasionally during cleaning with a toothbrush. You will also find that if you clean between your teeth with a brush or floss that the bleeding can be worse.

The problem is that people at this stage then tend to layoff cleaning their teeth quite so much as the gums bleed and become tender, however this can mean that the gum disease can progress further underneath the gum.

If the infection spreads below the gum line it can then turn into the more serious periodontitis which affects the bone and can ultimately lead to tooth extraction or loss.

Is it possible to catch gum disease?

No. Gum disease is not an infectious disease and is caused primarily by poor hygiene. However, if you have lower standards of oral hygiene without healthy gums your teeth may be more susceptible to any additional bacteria which are introduced into the oral environment.

What are the causes of gum disease?

because of gum disease is a buildup of plaque over the teeth, this is a sticky substance which if not removed daily can build up into hard tartar. This is where bacteria lurk, these bacteria are producing acid as they digest food and it is this acid which causes tooth decay.

In addition to poor oral hygiene there are additional risk factors which increase your likelihood of developing gum disease, these are:

  1. Smoking. Smoking as a tendency to dry out your mouth, this drying out means there is less saliva to wash away food stuff and neutralise the acid attack.
  2. Changes in hormones. Particularly in girls and women, hormone changes can lead to sensitivity in the gums making gingivitis more likely.
  3. Your genetics. Unfortunately some people are more prone to developing gum disease than others.
  4. Diabetes. There are direct links between people with diabetes and gum disease.
  5. Your medications. Any medication which alters the flow of saliva can leave you more susceptible to developing gum disease. There are also some medications which promote abnormal growth of the gums, these can then be difficult to clean.

Is it possible to reverse gum disease or cure it?

Yes, it is possible to reverse gum disease. Depending on how severe the disease is and how far it has progressed depends upon the best course of action. The very simplest thing you can do is to start a more thorough oral health care routine ensuring that you are brushing your teeth at least twice per day for 2 min with the fluoride toothpaste (This helps to strengthen your tooth enamel) and that they are cleaned once a day with an incidental brush or floss.

Do people with gum disease die early?

The recent any research to indicate that people with gum disease necessarily die early, however there is research which links gum disease to certain other conditions including heart attacks.

There has been research undertaken which is shown that people with heart conditions have the same bacteria present in their heart as is present with gum disease. More research is needed to establish if there is a causal link between gum disease and heart disease, however what is clear is that there is indeed a link between the two conditions.

What are some complications?

Additional complications from gum disease can include, but are not limited to:

  • Tooth removal. If your gum disease is not kept under control then it can turn into the more serious periodontitis which can then lead to floss.
  • Strokes. Studies have shown that up to 40% of the bacteria that cause the fatty deposits in People that have had a stroke come from their mouths which have inflamed gums.
  • Respiratory disease. Because dental plaque harbours a considerable amount of bacteria it is inevitable that some of these could be respiratory pathogens, therefore a complication of gum disease could potentially be pneumonia, emphysema and chronic obstructive lung disease.
  • Heart disease. Because the body is a complete system connected by its blood supply then any bacteria which gets into the blood in your mouth can make its way to your heart. These bacteria have been shown to lodge inside the walls of the blood vessels causing blood clots to form.
  • Gastric ulcers. The same bacteria that cause gastric ulcers are also responsible for gum disease, this means that if you have a particularly high bacteria count in your mouth then as you swallow your food these bacteria are transferred to your stomach.

Complications of gum disease

How to prevent gum disease

Preventing gingivitis is relatively straightforward and involves:

  • Regular dental checks by your dentist and hygienist to ensure that you are cleaning your teeth adequately.
  • Being aware of the food and drinks you consume to keep sugar amounts lower.
  • Ensuring that you have a good daily oral health care regime.
  • Watch out for the early warning signs like bleeding gums and if it doesn’t clear up contact your dentist.