Grading of acquired dental disease (PSADD)

GradeClinical findingsRadiographic findings
Grade 1NormalNormal
Grade 2Horizontal ribbing of the incisors with or without slight deviation of the upper incisors
Palpable swellings along the ventral borders of the mandible
Infection of the nasolacrimal duct
Mild elongation of the rooths causing the ventral border of mandible to become thin and the line of alveolar bone at the apex of the roots indistinct
Grade 3Minor distortions of the molars or premolars causing spikes
Aberrant growth, malocclusion, discolouration or fracture of the incisors
Normal zigzag occlusal pattern of the cheek teeth is lost and uneven pattern takes place
Tooth roots elongate and distorted growth takes place
The incisors may be normal
Grade 4Gross distortion of some or all of the teeth with major pathological changes to the tooth roots
Abscesses from soft tissue penetration by elongated crowns
Appearance of the tooth roots changes completely
Periapical infection may occur
The teeth may become more radiodense and lose their linear pattern
Some roots resorb
Crowns may break off and the teeth stop growing
Loss of enamel gives the outline of the teeth a blurred appearance
Grade 5Periosteal penetration of the tooth roots causing abscessesSevere pathological changes in the roots and surrounding bone
It may be impossible to differentiate between one tooth and another due to dystrophic calcification
Periapical infection may result in the formation of abscesses
  • PSADD, progressive syndrome of acquired dental disease