Palmer notation

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Palmer notation is a system used by dentists to associate information to a specific tooth. Although supposedly superseded by the FDI World Dental Federation notation, it overwhelming continues to be the preferred method used by dental students and practitioners in the United Kingdom.[1]

It was originally termed the Zsigmondy system after the Hungarian dentist Adolf Zsigmondy who developed the idea in 1861, using a Zsigmondy cross to record quadrants of tooth positions.[1]. 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. This makes 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, "└".

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.


Palmer notation
Permanent Teeth
upper right upper left
8765432112345678
8765432112345678
lower right lower left
Deciduous teeth (baby teeth)
upper right upper left
EDCBAABCDE
EDCBAABCDE
lower right lower left


With the move from written dental notes to electronic records, some difficulty in reproducing the symbols has been encountered.[1] 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

One advantage of Palmer notation is that it can produce a very graphical image, akin to a 'map' of the dentition; tooth transpositions or edentulous spaces can easily be depicted if desired. It would also be feasible to introduce additional alphabetic characters or other symbols, for example to denote supernumerary teeth or bridge pontics, to which a purely numerical method such as the FDI system does not lend itself easily.[1]

Palmer notation for an upper right first premolar tooth
Palmer notation for an upper right first premolar tooth
Palmer notation for a deciduous lower right central incisor tooth
Palmer notation for a deciduous lower right central incisor tooth
Palmer notation for a normal adult full set of teeth
Palmer notation for a normal adult full set of teeth
Palmer notation for a normal child full set of teeth
Palmer notation for a normal child full set of teeth

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

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