Development of the occlusion: what to do and when to do it

This chapter presents the rationale for preventive and interceptive orthodontic monitoring in relation to the seven stages of dental occlusal development. Dental eruption is a biological process subject that is highly variable, both in sequence and in chronology. An early eruption pattern of the deciduous dentition may indicate a tendency for an early transition between deciduous and mixed dentition. Deciduous teeth roots in their bony bases are nearly perpendicular, and the dental crowns are vertically positioned with no buccal-lingual angulation. The relationship of the maxillary cuspids with the mandibular dental arch is the major reference for sagittal classification during deciduous stage. The first permanent molars are added to the deciduous dentition utilizing the space created by appositional growth distally to the second deciduous molars. From the point of view of occlusal development, eruption of the mandibular permanent canines prior to the adjacent first premolars is highly desirable, favoring space management and anterior tooth alignment.