ORIGINAL ARTICLE

Growth of the anterior dental arch in black American children:

A longitudinal study from 3 to 18 years of age

Ruth Elaine Ross-Powell, DDS, MDS, and Edward F. Harris, PhD

Memphis, Tenn

Dental arch size and form change systematically because of tooth emergence and because teeth migrate into
shorter and broader arch forms in the deciduous dentition and again in the permanent dentition. The present
longitudinal analysis describes changes in arch form in a cohort of 52 black American children (Nashville,
Tenn) between the ages of 3 and 18 years. The anterior (incisor-canine) arch dimensions were analyzed.
Incisor-to-canine depth remained static in both arches between 3 and 5 years but shortened significantly
between 12 and 18 years. Intercanine width broadened significantly in both arches, first during the deciduous
dentition, then again as the primary teeth were supplanted by the permanent incisors and canines. But there
was no change in intercanine width once the permanent canines were in functional occlusion (approximately
11-18 years). These changes alter anterior arch form (the ratio depth/width). This index decreased significantly
during the deciduous phase as the arches broadened; the index increased from 6 to 10 years as teeth were
replaced, then again decreased during the duration of the study (approximately 10-18 years). Dimensions of
these black American children all exceed comparable values for white American children, although the
anterior shapes are indistinguishable. The present data focus attention on the dynamics of arch form in which
considerable, protracted change occurs by physiologic migration, not just during the short phase of tooth
replacement. (Am J Orthod Dentofacial Orthop 2000;118:649-57)

S ize and shape of the dental arch are not static; they
change systematically with age during the deciduous
and permanent dentitions and during the successional
phase.1-4 Causes of the changes in size and form probably
are multifactorial and location-specific, but sutural expan-
sion in the maxillae, remodeling of alveolar bone with
mesiodistal and transverse components of force brought
on by the axial inclinations of the teeth,5-6 contractile
properties of supracrestal fibers, and interarch relation-
ships of the teeth all appear to play important roles.7
Goldstein and Stanton,8 Moorrees,2 Knott,9 and
others have shown that the arches become broader and
shorter with age; Lundström10 has made the point that
changes in size and form actually occur twice, once
within the deciduous dentition (approximately 3-6
years) and again during the permanent dentition
(approximately 12-18 years).
These growth changes are subtle, but they occur
systematically with age, and the effects are additive. Of
note, virtually all that is known about the growth of the
dental arches is based on children of western European
Supported in part by the Foundation for Orthodontic Research and the Southern
Society of Orthodontists.
From the Department of Orthodontics, University of Tennessee.
Reprint requests to: Edward F. Harris, PhD, Department of Orthodontics, Uni-
versity of Tennessee, 875 Union Avenue, Memphis, TN 38163; e-mail, eharris
@utmem.edu.
Submitted, May 2000; revised and accepted, June 2000.
Copyright © 2000 by the American Association of Orthodontists.
0889-5406/2000/$12.00 + 0 8/1/110811
doi:10.1067/mod.2000.110811
origin. Nothing is known of the growth and development
of the arches of black American children, even though it
is recognized that black individuals have significantly
larger deciduous and permanent teeth than white indi-
viduals11-12 and different facial proportions.13-16 Collins
and Harris17 and Burris and Harris18 have shown that
arch size and form are distinctively different between
American black and white adults, but it is not known
when and how during growth these differences emerge.
The purpose of the present study was to analyze a
longitudinal series of dental casts of black American
children to characterize the anteroposterior and trans-
verse changes from early childhood through late ado-
lescence. Emphasis is placed here on changes in the
anterior segment of the arch (that region that consists of
the incisors and canines) because these are the teeth
that are most visible and that are responsible for the
prominence of the lower facial region.19-20
MATERIAL AND METHODS
Full-mouth dental casts were taken at least annu-
ally, typically on or very near the birthday, as part of a
broad study of craniofacial growth in black American
children.21 Children had been selected from the greater
metropolitan region of Nashville, Tenn, with the use of
a stratified sampling technique. All children were
healthy and free from any chronic problems known to
affect growth. Fifty-two of these children (25 male, 27
female) were selected for the present study; these were
the children with the longest and most complete series
649
650 Ross-Powell and Harris
A B
Fig 1. Measurements of intercanine widths in (A) maxilla and (B) mandible. Arch depth was mea-
sured anteroposteriorly from average of mesial line angles of the central incisors distally to line
defined by canine cusp tips. In mandible (B), depth was computed by measurement of arch chords
on left and right quadrants, then computation of depth geometrically.
of dental casts. Casts were studied here at 16 annual
examinations between the ages of 3 and 18, inclusive.
All subjects had acceptable Class I occlusions, and
none had been treated orthodontically.
The line angles of each incisor were marked with a
pencil dot on each cast, as were the canine cusp tips; the
casts were photocopied at 1 × magnification, as described
by Cassidy et al22 and others.23 Landmarks then were
digitized and converted to Cartesian coordinates. Dis-
tances were computer-generated trigonometrically from
the coordinates with the use of custom software.
In the maxilla, anteroposterior arch depth was cal-
culated parallel with the midpalatal raphe,24 specifi-
cally the distance from the mesial line angle of the cen-
tral incisor distally to where the line connecting the
canine cusp tips crosses the midpalatal raphe (Fig 1, A).
Intercanine width was the straight-line distance
between antimeric cusp tips. An additional step was
required in the mandible. Arch chords, the distances
from the mesial line angles of the central incisors to the
canine cusp tips were generated for the left and right
quadrants (Fig 1, B). Intercanine width was measured
just as in the maxilla, then the chords and width were
used to compute arch depth as:

AC2
+ BC2 AB2
—— – ——
2 4
where AC and BC were chord distances and AB was
intercanine width.9 This provided directly comparable
arch widths and depths for the 2 dental arches.
Because homologous dental landmarks were refer-
enced on both the deciduous and permanent teeth, the
serial measurements are comparable across the whole
age span.2 In the literature, the landmarks used to mea-
sure arch width and depth vary among researchers,9,25
American Journal of Orthodontics and Dentofacial Orthopedics
December 2000
which considerably limits direct comparisons among
studies. Still, the patterns of growth should be compa-
rable, regardless of the dental landmarks located on the
same teeth by different researchers (eg, buccal mar-
gins, central fovea, cusp tips, occlusal centroids).
Conventional statistics were calculated for the data
at annual chronologic ages between 3 and 18 years
(Table I).26,27 Repeated-measures analysis of variance
was performed with generalized linear models to
account for the longitudinal nature of the data, with
appropriate within- and between-group error terms.28
Dedicated programs have been developed to deal with
the special requirements of longitudinal data,29,30 but
programs in the SAS (SAS Institute Inc) statistical
package31 were adapted for use in the present study.
Inspection of the growth curves makes it obvious
that dimensional changes occur within the whole span
of 3 to 18 years of age; statistical analysis focused on
testing for systematic changes within the deciduous
dentition (3-5 years of age) and within the permanent
dentition (12-18 years of age).
RESULTS
Maxilla
Maxillary incisor-to-canine arch depth (Fig 2) did
not change during the deciduous interval (P = .39), but
depth increased substantially (an increase of approxi-
mately 3 mm) as the permanent incisors emerged,
which peaked at about 10 years of age when the per-
manent canines emerged. The increase was discernibly
earlier in girls. The permanent phase of the dentition
(approximately 12-18 years) was characterized by a
slow but progressive decrease in depth of approxi-
mately 1.5 mm (P < .001). Anterior depth was greatest
in late childhood (approximately 10 years). Net change
from 3 to 18 years was an increase of approximately
1.5 mm in both boys and girls.
American Journal of Orthodontics and Dentofacial Orthopedics
Volume 118, Number 6
A B
Fig 2. A, Mean intercanine widths and B, incisor-canine depths by age and sex. Aberrations at 17
and 18 years of age are due to small sample sizes.
Maxillary arch width (ie, c-c and C-C width) fol-
lowed a fairly uniformly curvilinear path (Fig 2).
Except for the increase in width because of earlier
canine emergence in girls between 9 and 11 years, the 2
sexes possessed very similar average arch widths. Width
increase was about 2.5 mm during the primary dentition
(P < .001). Another 5 mm was gained between the start
of the mixed dentition and the end of this study at 18
years of age. Peak size occurred at approximately 14
years of age. The overall increase was from 30 to 37
mm, with almost all of the change occurring by 12 years
of age. Indeed, there was no statistically significant
change after age 11 years (P = .65).
Arch form can be expressed as an index, namely
depth divided by width.9,32 Data were calculated for
sexes pooled because the male-female differences were
trivial. This arch form index (depth/width) is higher
when depth is large relative to width. Fig 3, A, shows 3
broad intervals of growth: (1) The maxillary index
dropped during the deciduous dentition as the arches
shortened and broadened, with the nadir at 5 to 6 years.
(2) The index then increased between ages 6 and 10
years as the permanent incisors emerged along more
proclined axes than exhibited by the deciduous prede-
cessors, thus increasing arch depth.33,34 (3) The index
decreased between ages 10 and 15 years, during which
time the other permanent teeth emerged, including the
permanent canines. Most of the change involved con-
solidation of the arch, not emergence of new teeth,
however. The shape index appeared to be compara-
tively stable after age 15 years.
Ross-Powell and Harris 651
Mandible
Mandibular arch depth (Fig 2, B) paralleled the
growth pattern in the maxilla, although the size was
only one half of the maxillary values and the decidu-
ous-to-permanent increase was smaller. There was no
significant change in depth during the deciduous inter-
val (P = .27), but anterior arch depth increased approx-
imately 2 mm from 6 to 10 years of age, followed by a
subtle decline from 10 years onward (P = .06). Boys
and girls had indistinguishable dimensions until about
10 years of age; the dimensions of the male patients
were bigger (approximately 15%) after the onset of
adolescence (P = .02).
Mandibular intercanine width (Fig 2, B) increased
about 4 mm from 3 to 10 years, which is well within
the interval before emergence of the permanent
canines. In fact, significant expansion occurred
between 3 and 5 years of age (P = .003), which is well
before any permanent teeth emerged (Fig 2, B). Emer-
gence of the larger permanent incisors at 6 to 7 years of
age appears to drive the deciduous canines laterally,
just as suggested by Moorrees.2 No change in width
occurred with replacement by the permanent canines,
but sexual dimorphism increased during the teen years
(P < .001). Intercanine width did not change signifi-
cantly after 11 years of age (P = .95).
Form of the mandibular anterior segment defined 3
age intervals (Fig 3, B): Arch form (1) got shorter and
broader during the deciduous dentition (approximately
3-5 years), (2) got appreciably deeper relative to width
as the permanent incisors and canines replaced the
652 Ross-Powell and Harris
Fig 3. Arch index (incisor-canine depth/intercanine width) plotted by age in (A) maxilla and (B)
mandible. Curves are fifth-order polynomials fit to data by least-squares method.
deciduous teeth (approximately 5-11 years), then (3)
got shorter and broader during the permanent dentition.
Velocity
Annualized rates of growth (Fig 4) emphasize the
growth spurts that occurred between 5 and 9 years of
age for all 4 of the variables described here, and the
peak velocities appear to be coincident at approxi-
mately 7 years of age. After about 10 years of age, ante-
rior arch widths and depths behaved differently. Arch
widths experienced attenuated, secondary spurts
between ages 9 and 13 years; this was more obvious in
the maxilla where the rate of widening continued at
about 0.5 mm/y. Thereafter, arch width velocities hov-
ered just above zero. This “secondary” spurt probably
is driven by the emergence of the permanent canines. In
contrast, velocities for the 2 arch depths fell to just
below 0 from about 9 to 10 years of age and remained
there because anterior arch depth continued to shorten
during the teen years.
Comparative Data
Differences among researchers’ methods limit com-
parisons with the bulk of the literature, but there are 2
data sets measured in identical ways as were used in the
present study (Fig 5), although only for adolescents.
American Journal of Orthodontics and Dentofacial Orthopedics
December 2000
Comparisons are shown for data at 15 years of age. The
1 published sample of black American adolescents35
has an intercanine width that is narrower by 1.2 mm (P
= .01), which is understandable because that sample
consisted of children seeking orthodontic treatment,
but arch depth is statistically equivalent.
Two comparisons with white American children
disclose significantly smaller anterior arch lengths
and widths than in the present study (P < .0001),
although the 2 white samples were, themselves, sta-
tistically indistinguishable. Intercanine width and
anterior arch depth both are 12% smaller in white
individuals than black individuals in the present
study. Mean sizes of these black American children
also exceed data on white American children, as
reported by Goldstein and Stanton,8 Knott,9 Bishara
et al,36 and others. Comparison with the literature also
emphasizes the minor sexual dimorphism in black
children compared with white children. For example,
Knott4,9 and Bishara et al36 document sexual dimor-
phism in intercanine widths of about 10% in white
children during adolescence.
Focusing just on the anterior segment of the arch,
the depth-to-width index is the same in black children
and white children (Fig 5). This means that, in this
incisor-canine region, form of the arch is scaled iso-
American Journal of Orthodontics and Dentofacial Orthopedics Ross-Powell and Harris 653
Volume 118, Number 6

Fig 4. Growth velocities (millimeters/year) of arch widths and depths.

B
Fig 5. Comparisons of anterior arch forms in boys. Horizontal dimensions are intercanine widths; ver-
tical dimensions are arch depths; plots are registered on the mesial line angles of the maxillary cen-
tral incisors. A, Growth differences in black American boys show status at 5 years of age, increased
depth by 10 years of age, then decrease in depth, but broader intercanine width by 15 years of age.
B, Ethnic comparisons of maxilla between 2 samples of white American boys,17,22 another sample
of black American boys,17 and present study. Data are plotted for 15 years of age. The 2 white sam-
ples are statistically equivalent for width and depth, but both are significantly shorter anteroposteri-
orly and narrower mediolaterally than the 2 black samples (P < .001).

metrically in black and white American children (ratio, The measurement technique for intercanine width in
0.27), which is in contrast to arch depth-and-width the present study is directly comparable to data
ratios that incorporate larger segments of the arch.18,37 obtained by several other researchers (Fig 6). The fun-
654 Ross-Powell and Harris
A B
Fig 6. Comparisons of (A) maxillary and (B) mandibular intercanine widths in present study and data
from Cohen1 and Moorrees2 show substantially larger arch widths in black Americans. Tempos of
growth essentially same among all groups.
damental growth patterns clearly are the same in black
and white American children, the obvious difference is
1 of scale. From onset of the full deciduous dentition by
3 years of age, black children have significantly larger
arch dimensions. The difference between the groups
increases during the second decade of life (Fig 6), but it
is evident from extrapolation that the timing of diver-
gence stems from early development. An early (prena-
tal) origin for this black-white size difference is consis-
tent with our understanding of arch formation.38-41
DISCUSSION
Teeth do not remain in the positions in which they
emerge into the oral cavity. Instead, tooth relationships
change systematically within the deciduous dentition,
again during the permanent dentition, and during the
mixed dentition phase. One assumes that the changes
are in accommodation to functional, perioral, and
other forces placed on the teeth. Changes in the ante-
rior arch segment alter its size and they also alter arch
form (ie, depth-width proportionality). The anterior
segment elongates in proportion to intercanine width
as the permanent incisors emerge, but then arch width
“catches up” from approximately 10 years of age
onward, as intercanine width increases and the incisors
upright and, perhaps, drift lingually.
The changes in width and depth occur primarily as
room is required for the substantially larger permanent
American Journal of Orthodontics and Dentofacial Orthopedics
December 2000
teeth. The sum of the 4 mesiodistal diameters of the
maxillary incisors is 24.5 mm,11 which increases to an
average of 32.2 mm in the permanent dentition,12 a 31%
increase. Corresponding change in the mandible is from
17.7 mm to 23.0 mm, a 23% increase in space required.
Arch Form
Form of the anterior segment of the arch, as
expressed by the arch index (Fig 3), undergoes several
patterned changes from onset of the deciduous dentition
to late adolescence. It is noteworthy that the form of
each arch becomes significantly shorter and broader
within the deciduous dentition because the changes are
not due to the shedding or emergence of teeth, but to the
drift of the deciduous teeth themselves. This is what
Baume42,43 termed physiologic change (in contrast to
shedding or emergence). Incisor-to-canine depth
decreased about 0.5 mm, although it is not possible from
this analysis to specify whether the incisors or canines or
both migrated. Baume42 suggested that emergence of the
permanent first molars at the start of the mixed dentition
helps drive the deciduous molars forward, closing any
interdental spaces and pushing the deciduous canines
mesially, thus diminishing anterior arch depth.
Meanwhile, intercanine width is increasing, which
could be due to expansion at the maxillary-premaxillary
sutures44,45 and the intermaxillary and interpalatine
sutures, but that would not explain the comparable
American Journal of Orthodontics and Dentofacial Orthopedics Ross-Powell and Harris 655
Volume 118, Number 6

Table I. Anterior arch dimensions (mm) by arch, age, and sex

Intercanine width Incisor-canine depth

Maxilla Mandible Maxilla Mandible

Age (y) Sex –x SD n –x SD n –x SD n –x SD n

3 F 30.2 2.2 8 23.9 1.7 8 8.3 1.4 8 3.2 1.8 6

M 29.7 2.1 7 24.2 1.4 6 8.7 0.7 7 3.9 0.9 6
4 F 30.8 2.2 23 23.6 1.6 23 8.4 1.2 22 3.2 1.2 17
M 31.0 2.5 17 24.9 2.5 16 8.7 1.1 17 3.4 1.3 15
5 F 31.6 2.2 26 24.6 2.0 25 8.0 2.1 25 2.9 1.4 19
M 31.1 2.6 22 25.1 1.9 21 8.5 1.4 21 3.0 1.2 16
6 F 32.1 2.5 27 25.6 2.0 24 8.6 2.2 25 3.1 1.4 19
M 32.2 2.9 25 26.1 2.0 24 8.3 1.7 21 2.8 1.3 18
7 F 33.2 2.4 27 26.8 1.8 23 10.0 2.0 25 3.8 1.3 16
M 33.2 2.5 24 27.1 2.4 23 9.3 2.3 22 3.5 1.6 22
8 F 34.5 2.0 25 27.7 1.7 24 10.6 1.6 23 4.3 1.6 22
M 34.3 2.6 23 28.0 2.1 22 10.5 1.9 23 4.3 1.3 21
9 F 35.5 2.7 26 28.0 1.4 24 11.5 1.6 26 4.4 1.6 23
M 34.7 2.4 24 27.7 2.0 21 11.1 1.6 24 4.4 1.2 18
10 F 36.1 2.3 25 28.3 2.0 20 11.4 1.5 25 5.2 1.8 18
M 35.2 2.6 22 28.1 1.9 19 11.6 1.7 22 5.4 1.4 17
11 F 36.5 2.5 24 28.8 1.8 23 11.0 1.6 24 4.7 1.3 23
M 36.0 2.8 23 28.1 2.2 21 11.4 1.6 23 5.5 1.3 21
12 F 36.7 2.8 25 28.6 1.9 26 11.1 1.9 25 4.8 1.3 25
M 36.9 2.3 23 28.4 2.1 25 11.1 1.7 23 5.3 1.5 25
13 F 37.3 2.6 27 28.6 1.8 25 11.0 1.7 27 4.5 1.6 24
M 37.1 2.2 24 28.1 2.2 24 10.6 1.5 24 5.4 1.4 23
14 F 37.1 2.8 27 28.8 2.1 26 10.6 1.6 27 4.6 1.5 23
M 37.5 2.3 24 28.0 2.2 22 10.6 1.8 24 5.1 1.4 21
15 F 37.3 3.1 21 28.8 1.9 19 10.6 1.3 21 4.6 1.6 16
M 37.5 2.0 20 28.0 2.3 21 10.1 1.7 20 5.0 1.6 21
16 F 37.4 3.1 20 28.7 1.9 20 10.6 0.9 20 4.5 1.8 17
M 37.2 2.6 19 28.1 2.3 20 10.0 1.6 19 5.3 1.4 19
17 F 37.1 2.2 13 29.2 1.6 16 10.6 0.9 13 4.2 1.9 15
M 37.0 2.5 16 27.4 1.6 17 9.8 1.8 16 5.0 1.5 17
18 F 37.1 15.6 9 29.6 2.3 7 9.9 2.6 9 4.5 1.0 7
M 37.1 2.1 8 27.2 1.3 9 8.8 1.5 8 4.6 1.4 9

expansion between the mandibular canines, which would
seem to be due to drift alone because the mandibular
symphysis fuses within the first year of life; so there is no
potential source for bony expansion mediolaterally.46,47
Dempster et al5 and others48-51 have shown that the
shapes of the crowns and roots of the teeth in the buccal
segments and their orientations to the occlusal plane cre-
ate an anterior component of force; this seems to account
in part for persistent tight contacts and mesial drift of the
teeth. It would appear from the gross anatomy of the
deciduous teeth52,53 that the same mesial drift can occur
in the primary dentition. This would account for the
mesial migration of canines (thus lessening incisor-
canine distance) and the canines’ mediolateral separation
as they move toward the corners of the arch.
As noted earlier, this same kind of change in ante-
rior arch form occurs again in the permanent denti-
tion, and the change is most obvious between 10 and
15 years of age (Fig 3). The “second transition,” as
described by van der Linden and Duterloo,33 takes up
the first portion of this age span (approximately 10-12
years), when the permanent canines and premolars
replace the primary canines and molars, but consider-
able change in size and shape occurs after these
events because of “consolidation” of existing teeth as
they migrate into mature relationships. Physiologic
migration42 does not cease at any identifiable age;
Lundström,10 Bishara et al,36,54-56 and others6,57 have
shown that decreases in arch depth proceed well into
adulthood, albeit at slow rates. These changes are at
least as great in the mandible, and it may be more
overt in the lower, contained arch because it is prone
to constriction by the overhanging outer cusps of the
maxillary teeth.58
656 Ross-Powell and Harris
Both arches gain length in excess of width from 5
to 10 years of age. Active emergence of the incisors
between 6 and 7 years certainly elongates anterior arch
length, but the trend continues on for another 2 years.
Riolo et al59 and Richardson21 have shown that,
cephalometrically, the axial inclinations of the perma-
nent teeth procline for a period of time after they
emerge, which would account for the progressive
increase in anterior arch depth during the late mixed
dentition. Moreover, emergence of the mesiodistally
larger permanent teeth creates a transient tooth-size
excess (crowding) that pushes the deciduous canines
buccally, thus increasing intercanine width well before
emergence of the permanent canines.2
CONCLUSIONS
This study of black American children, primarily
descriptive, quantifies 2 substantive changes in the
depth-width ratio of the incisor-canine region of the
anterior arch during the subadult period, 1 because of
tooth migration during the deciduous phase of the den-
tition, and the second because of migration during the
permanent phase.
1. The anterior arch segment broadens significantly
in proportion to its depth from about 3 to 5 years
of age and again from 12 to 18 years of age. These
shifts in arch form are highly significant statisti-
cally given longitudinal data.
2. Intercanine widths increase significantly during
the deciduous phase but exhibit no systematic
change after emergence of the permanent canines.
3. The black American children who were analyzed
in the present study have significantly larger arch
dimensions than their white counterparts, with a
difference of approximately 12% for the variables
reported here. In contrast, arch form in the anterior
segment has the same shape index in black and
white American children.
4. Sexual dimorphism is very low in this series of
black Americans children, which agrees with pre-
vious findings and contrasts with white American
children who are more sexually dimorphic.
5. Significant black-white arch size differences are
extant from the onset of the full deciduous denti-
tion at 3 years of age and probably stem from quite
early in arch formation.
We thank Dr Elisha R. Richardson for granting us
access to the dental casts.
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