THE UGLY DUCKLING STAGE

Jul 30, 2017 Dental Health, Features / Columnists

By Dr. NerominiFagu

The eruption of both the baby and adult teeth occurs during stages. In order for the adult teeth to come into place, the roots of the baby teeth are slowly resorbed eventually rendering the baby tooth mobile and easily manipulated out of the mouth.
During certain periods, the positions of the newly erupted adult teeth may sometimes create spaces between the teeth giving a child an unaesthetic appearance.
The mixed dentition phase is when both baby and adult or permanent teeth are present in the mouth and normally occurs between the ages of 6 and 12. During this time period, when the permanent maxillary incisors erupt they tend to flare laterally and are widely spread creating spaces between the teeth. This stage of eruption is known as the Ugly Duckling Stage.
Broadbent’s Phenomena and Physiologic Median Diastema are other names that are sometimes used.
This position of teeth at this stage is compared to that of an ugly look of a duckling and hence the name Ugly Duckling Stage. The term is directly borrowed from Hans Christian Andersen’s fictional fable of the same name.
Spacing is a very common occurrence between the incisors in anterior teeth. The spacing may be caused by multiple factors that can be grouped into developmental or physiological causes and pathological causes.
This type of physiological spacing is usually seen between the upper front teeth and may sometimes be interpreted as malocclusion. However, this is not the case as permanent incisors are larger in size and develop in a more restricted area as compared to their baby counterparts.
The space is created when the crowns of the adult or permanent canines in young jaws impinge on the developing roots of the lateral incisors causing the roots of the incisors to move to the centre and the crowns to flare to the sides.
The roots of the central incisors are also forced together thus causing a midline diastema or space between these teeth.
Normal physiological space is about 2mm. When larger spaces are present it may signify an underlying pathological condition such as an intra bony lesion or a supernumerary tooth both of which would require additional investigation.
As a guideline, space between teeth in the upper arch that are 2mm or less would close on its own but spaces greater than that are unlikely to do so.
However, attempts at closure should not be done during the Ugly Duckling Stage as injury to the incisors and canines may occur. The root tip of the lateral incisors may be damaged and the canines may deflect from the normal path of eruption and may even result in their impaction.
The Ugly Duckling Stage of development is a normal occurrence and requires no orthodontic treatment or cause for concern. The teeth arrangement usually corrects itself when the canines erupt and the pressure is transferred from the roots to the crowns of the incisors.
However, regular check-ups are necessary to rule out the possibility of crowding or other conditions and if crowding is suspected then growth modification appliances may be used to assist in early correction.
Also, counseling the child to let them know that this is a transient stage will help them deal with any negative emotional consequences of this phase of their development.
For more information contact OMNI DENTAL at 295 Quamina Street, Georgetown Tel: 227-0025, Parika Tel: 260-3133 or send emails to nerominifagu@hotmail.com.

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