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# Upper right central incisor

The upper right central incisor (tooth 11) is a flat front tooth beside the midline that cuts food; it is the tooth most often hurt in falls and blows.

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## What it is

A front tooth with a thin, straight cutting edge and one root.

## What it does

Bites into and cuts food; shapes some speech sounds (f, v, th).

## Key points

- The permanent tooth most often hurt in dental trauma, above all when the upper incisors stick out beyond the lip
- Avulsion of a permanent incisor (the tooth knocked fully out of its socket) is a dental emergency: the root's periodontal ligament cells die quickly once dry
- Almost always 1 root canal; just after eruption its cutting edge shows three small bumps (mamelons) that wear away with use
- Narrow, notched upper central incisors (Hutchinson incisors) belong to the classic signs of congenital syphilis, with interstitial keratitis and eighth-nerve deafness

## Key facts

**Joints with**
Alveolar socket of the [maxilla](https://durgical.com/en/anatomy/maxilla/) (gomphosis held by the periodontal ligament); bites against the opposing teeth

**Landmarks**
FDI 11, upper right central incisor: 1 root; chisel-shaped crown for cutting; erupts at about 7–8 years; nerve: anterior superior alveolar nerve (V2)

## Relations

**Medial**
The [upper left central incisor](https://durgical.com/en/anatomy/upper-left-central-incisor/), across the midline; the incisive papilla of the palate lies just behind the two

**Lateral**
The [upper right lateral incisor](https://durgical.com/en/anatomy/upper-right-lateral-incisor/)

**In front**
Upper lip and the [orbicularis oris](https://durgical.com/en/anatomy/orbicularis-oris-muscle/); the upper labial frenum joins the gum between the two central incisors

**Below**
In a normal bite it overlaps, in front, the [lower right central incisor](https://durgical.com/en/anatomy/lower-right-central-incisor/) and the [lower right lateral incisor](https://durgical.com/en/anatomy/lower-right-lateral-incisor/) (overjet and overbite)

**Above**
Root tip below the floor of the [nasal cavity](https://durgical.com/en/anatomy/nasal-cavity/)

## How to find it

Lift the upper lip: it is the broad, flat front tooth just right of the midline (the patient's right), and in many young adults a few millimetres of its edge show below the relaxed lip.

## On imaging

A straight-on periapical shows its single canal and apex. After a blow, extra periapicals at different angles (sometimes a small-field CBCT) look for a horizontal root fracture that one view can miss.

## Common problems

- Chipped or broken front teeth after falls or blows.

## Clinical notes

- Anterior superior alveolar nerve (from the infraorbital nerve, V2): the labial bone of the maxilla is thin, so infiltration near the apex numbs it; the palatal gum is supplied by the nasopalatine nerve
- Crown fractures are graded by depth: enamel only, enamel and dentin, or into the pulp; a blow can also push the tooth into the bone (intrusion) or out of place (luxation)

## Anatomical variants

- Shovel-shaped crown, with thick ridges along the palatal margins, common in people of East Asian and Indigenous American ancestry
- A supernumerary tooth in the midline (mesiodens) can hold back its eruption or push it out of line

## Development

Replaces the primary upper right central incisor (FDI 51), whose root lies just in front of its germ; a blow to the primary incisor can mark this tooth's enamel.

## Memory aid

FDI 11: quadrant 1 (upper right), tooth 1 from the midline; in the US Universal system it is #8.

## Related conditions

- [Periodontitis](https://durgical.com/en/conditions/periodontitis/)

## Test yourself

Think of the answer, then tap the question to see it.

## Why is avulsion of the upper right central incisor a dental emergency?

The periodontal ligament cells on the root die quickly once dry.

## Which nerve supplies the upper right central incisor?

The anterior superior alveolar nerve, from the infraorbital nerve (V2); thin labial bone lets infiltration near the apex numb it.

## What does FDI number 11 mean, and what is the upper right central incisor in the US Universal system?

Quadrant 1 (upper right), tooth 1 from the midline; Universal #8.

## Why may several periapical views be taken of the upper right central incisor after a blow?

A horizontal root fracture can be invisible on a single view, so angled films (or a small CBCT) are added.

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Educational information, not medical advice. For any symptom, see a health professional.

## Related

- [Maxillae](https://durgical.com/en/anatomy/maxilla/)

Sources: [Anatomy, Head and Neck, Teeth](https://www.ncbi.nlm.nih.gov/books/NBK557543/); [Anatomy, Permanent Dentition](https://www.ncbi.nlm.nih.gov/books/NBK570590/); [Anatomy, Head and Neck, Tooth Eruption](https://www.ncbi.nlm.nih.gov/books/NBK549878/); [Anatomy, Head and Neck: Alveolar Nerve](https://www.ncbi.nlm.nih.gov/books/NBK546712/); [23.3 The Mouth, Pharynx, and Esophagus](https://openstax.org/books/anatomy-and-physiology-2e/pages/23-3-the-mouth-pharynx-and-esophagus) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/upper-right-central-incisor/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/upper-right-central-incisor/