Sir, a seven year old girl of Ghanaian origin presented to our department as a casualty patient complaining of pain from an exfoliating lower left D. On examination the lower left D was indeed exfoliating with the lower left four beginning to erupt. However, what was of particular interest about this child was the developmental stage of her dentition. Clinical examination revealed the lower left D to be the sole remaining deciduous tooth and that three second permanent molars were fully erupted. Radiological examination (see Figure 1) revealed closed apices of all four first permanent molars plus both upper central and lateral incisors. In addition all four third permanent molars were shown to be developing.

figure 1

Figure 1

Furthermore how interesting it is that caries is present in both lower second permanent molars, the most recently erupted teeth. Although it is well reported that children of African origin are well advanced in dental development compared with Caucasian children, this noteworthy patient is five years ahead of our textbook averages! Incidentally a thirteen year old girl of Nigerian origin recently presented with fully erupted upper third permanent molars and pericoronitis of almost fully erupted lower third permanent molars. Although this second patient was just a teenager her dentition was most certainly adult.