The Sequence of Shedding of Deciduous and Emergence of Permanent Teeth in Children of Dakshina Kannada Region: A Probit Regression Model

Aim: To assess the primary teeth exfoliation and permanent teeth emergence sequence of children belonging to Dakshina Kannada district, Karnataka, India. Materials and methods: According to the inclusion and exclusion criteria, a cross-sectional study was conducted on 700 children aged 18 months to 14 years, belonging to the Dakshina Kannada district, Karnataka, India. The record of the teeth that emerged was done through intraoral examination. Age, gender, and date/year of birth were noted and correlated with the sequence of emergence using probit regression analysis. Results: The sequence of emergence in the maxilla was predominantly first molar (M1), central incisor (CI), lateral incisor (LI), first premolar (PM1), second premolar (PM2), canine (C), and second molar (M2) in males and females. However, polymorphisms in the eruption sequence of CI and LI were noted. The sequence of emergence in the mandible was M1, CI, LI, PM1, C, PM2, and M2 in both males and females. The shedding pattern in the maxilla was CI, LI, M1, C, and M2; and in the mandible was CI, LI, C, M1, and M2. Conclusion: Tooth emergence and exfoliation sequence is largely population-based and is dependent on numerous factors. The sequence of permanent tooth emergence in the Dakshina Kannada population was unique and showed some variations as reported by researchers from other parts of India. To the best of our knowledge, this is the first study to report the deciduous tooth-shedding pattern in maxilla and mandible in this population. Clinical significance: Knowing the population-based primary teeth exfoliation and permanent teeth emergence sequence is of clinical importance for accurate diagnosis and appropriate treatment planning. It may also help the clinician in correlating dental age estimation with the maturation status of the individual. These may be useful not only in treatment planning but also in forensic dentistry. While the present study sheds light on the primary tooth exfoliation sequence and permanent teeth emergence sequence of the Dakshina Kannada population, it has certain limitations.