# Palmer notation
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{{Short description|Tooth numbering system}}
{{update|reason=The usage survey is over 20 years old|date=July 2021}}
'''Palmer notation''' (sometimes called the '''military system''') is a [dental notation](/source/dental_notation) system (tooth numbering system) named for 19th-century American dentist Corydon Palmer from [Warren, Ohio](/source/Warren%2C_Ohio)[{{cite journal |author=Edward F. Harris |year=2005 |title=Tooth-Coding Systems in the Clinical Dental Setting |journal=Dental Anthropology |volume=18 |issue=2 |page=44 |issn=1096-9411 |url=http://anthropology.osu.edu/DAA/back%20issues/DAVol18%202.pdf |url-status=dead |archiveurl=https://web.archive.org/web/20120106031551/http://anthropology.osu.edu/DAA/back%20issues/DAVol18%202.pdf |archivedate=2012-01-06 }}]. Despite the adoption of the [FDI World Dental Federation notation](/source/FDI_World_Dental_Federation_notation) (ISO 3950) in most of the world and by the [World Health Organization](/source/World_Health_Organization), the Palmer notation continued to be the overwhelmingly preferred method used by orthodontists, dental students and practitioners in the [United Kingdom](/source/United_Kingdom) as of 1998.[{{cite journal |vauthors=Blinkhorn A, Choi C, Paget H | title = An investigon into the use of the FDI tooth notation system by dental schools in the UK. | journal = European Journal of Dental Education | volume = 2 | issue = 1 | pages = 39–41 | year = 1998 | pmid = 9588962 | doi=10.1111/j.1600-0579.1998.tb00034.x}}]
The notation was originally termed the '''Zsigmondy system''' after Hungarian dentist [Adolf Zsigmondy](/source/Adolf_Zsigmondy), who developed the idea in 1861 using a '''Zsigmondy cross''' to record quadrants of tooth positions.[{{cite journal | author = Huszár G | title = [The role of the life and works of Adolf Zsigmondy and Ottó Zsigmondy in the history of dentistry] | journal = Fogorv Sz | volume = 82 | issue = 12 | pages = 357–63 | year = 1989 | pmid = 2689240}}] Adult teeth were numbered 1 to 8, and the child primary dentition (also called deciduous, milk or baby teeth) were depicted with a quadrant grid using Roman numerals I, II, III, IV, V to number the teeth from the midline. Palmer changed this to A, B, C, D, E, which made it less confusing and less prone to errors in interpretation.
The Palmer notation consists of a symbol (⏌⎿ ⏋⎾) designating in which quadrant the tooth is found and a number indicating the position from the midline. Adult teeth are numbered 1 to 8, with deciduous (baby) teeth indicated by a letter A to E. Hence the left and right maxillary central incisor would have the same number, "1", but the right one would have the symbol "⏌" underneath it, while the left one would have "⎿".
{{comparison_of_dental_notations.svg}}
==Table of codes==
Orientation of the chart is traditionally "dentist's view", i.e. patient's right corresponds to notation chart left. The designations "left" and "right" on the chart, however, nonetheless correspond to the patient's left and right, respectively.
{| class="wikitable"
|+ Palmer notation
|-
! colspan=16 align="center"| Permanent Dentition
|-
! colspan=8 align="center"| upper right !! colspan=8 align="center"| upper left
|-
|8⏌||7⏌||6⏌||5⏌||4⏌||3⏌||2⏌||1⏌||⎿1||⎿2||⎿3||⎿4||⎿5||⎿6||⎿7||⎿8
|-
|8⏋||7⏋||6⏋||5⏋||4⏋||3⏋||2⏋||1⏋||⎾1||⎾2||⎾3||⎾4||⎾5||⎾6||⎾7||⎾8
|-
! colspan=8 align="center"| lower right !! colspan=8 align="center"| lower left
|-
| colspan=16 align="center"|
|-
! colspan=16 align="center"| Primary Dentition
|-
! colspan=8 align="center"| upper right !! colspan=8 align="center"| upper left
|-
| || || ||E⏌||D⏌||C⏌||B⏌||A⏌||⎿A||⎿B||⎿C||⎿D||⎿E|| || ||
|-
| || || ||E⏋||D⏋||C⏋||B⏋||A⏋||⎾A||⎾B||⎾C||⎾D||⎾E|| || ||
|-
! colspan=8 align="center"| lower right !! colspan=8 align="center"| lower left
|}
One advantage of Palmer notation is that it can produce a very graphical image, akin to a 'map' of the dentition; [tooth transposition](/source/tooth_transposition)s or [edentulous space](/source/edentulous)s can easily be depicted if desired. It would also be feasible to introduce additional alphabetic characters or other symbols, for example to denote [supernumerary](/source/Supernumerary_body_part) teeth or [bridge pontics](/source/dental_bridge), to which a purely numerical method such as the FDI system does not lend itself easily.[{{cite journal | author=Ferguson J | title=The Palmer notation system and its use with personal computer applications | journal=British Dental Journal | year=2005 | volume=198 | pages=551–3 | doi=10.1038/sj.bdj.4812303 | pmid=15895048 | issue=9| doi-access=free }}]
On a standard keyboard 'slash' and 'backslash' may be used as a crude approximation to the symbols with numbers placed before or afterwards; hence '''3/''' is '''3⏌''' and '''/5''' is '''⎾5'''.
The [Miscellaneous Technical](/source/Miscellaneous_Technical) block in [Unicode](/source/Unicode) provides Palmer notation symbols in U+23BE through U+23CC. The symbols are not to be confused with [box-drawing characters](/source/box-drawing_characters) (┘└ ┐┌), which have the horizontal line at the middle.[{{Cite web|url=https://www.unicode.org/charts/PDF/U2300.pdf|title=Unicode chart, U2300 Miscellaneous Technical|accessdate=22 August 2023}}] These symbols are inherited from [JIS X 0213](/source/JIS_X_0213) Dentist symbols.[{{cite web|url=https://www.unicode.org/L2/L1999/99238-non-kanji2.pdf
|title=Universal Multiple-Octet Coded Character Set International Organization for Standardization|website=unicode.org|access-date=22 August 2023}}]
Daniel Johnson has put together a Palmer Tooth Notation TrueType font called FreePalmer. It is covered by the GPL 3 license. This font is descended from [FreeSans](/source/FreeSans). It can be used in [OpenOffice](/source/OpenOffice.org) and other software. A "MP7" derivative which enables the grid patterns to be produced that correspond to handwritten Palmer tooth notations is available for download as well. The FreePalmer characters are placed in the [Latin-1](/source/Latin-1) part, overriding existing characters.[{{cite web | title=FreePalmer TrueType Font | url=http://www.markpreston.co.uk/fonts/}}] A more technically correct way would be to program [orthographic ligature](/source/orthographic_ligature)s into the font.
== Victor Haderup notation (Danish variant) ==
The Danish dentist [Victor Haderup](/source/Victor_Haderup) devised a variation of the Palmer notation where the (⏌⎿ ⏋⎾) symbols are replaced by plus/minus signs, which can either be placed in front or behind the number.[{{Cite journal|last=Havale|first=R.|last2=Sheetal|first2=B. S.|last3=Patil|first3=R.|last4=Hemant Kumar|first4=R.|last5=Anegundi|first5=R. T.|last6=Inushekar|first6=K. R.|date=2015-06-01|title=Dental notation for primary teeth: a review and suggestion of a novel system|journal=European Journal of Paediatric Dentistry|volume=16|issue=2|pages=163–166|issn=1591-996X|pmid=26147826}}][{{Cite web|url=http://denstoredanske.dk/Krop,_psyke_og_sundhed/Sundhedsvidenskab/Tandl%C3%A6ger/Victor_Haderup|title=Victor Haderup|last=|first=|date=|website=Den Store Danske|publisher=Gyldendal|language=Danish|access-date=}}] A plus (+) indicates upper position while minus (−) indicates lower. When the sign is in front of the number, it indicates left while after it indicates right. For instance −6 indicates the 6th lower left tooth, i.e. [first mandibular molar](/source/Mandibular_first_molar).
==See also==
* [Dental notation](/source/Dental_notation)
* [FDI World Dental Federation notation](/source/FDI_World_Dental_Federation_notation)
* [Universal numbering system](/source/Universal_numbering_system_(dental))
==References==
{{Reflist}}
===Sources===
* {{cite web | author=Bunn S | title=Tooth Numbering | url=http://www.drbunn.com/faq/tooth-numbering | date=19 May 2006 | accessdate=2010-04-21}}
==External links==
* [https://www.youtube.com/watch?v=yoGSQMIhGbY Palmer numbering system video demonstration]
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Adapted from the Wikipedia article [Palmer notation](https://en.wikipedia.org/wiki/Palmer_notation) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Palmer_notation?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.