Palmer Notation Chart: Tooth Numbers, Symbols & Printable Guide

Palmer notation identifies a tooth using a number or letter and a quadrant bracket. Permanent teeth use 1–8, counted from the centre of the mouth. Primary teeth use A–E. The bracket tells you which quarter of the patient's mouth you mean.

The reference above shows the mouth as you face the patient: their right is on your left. Download the one-page Palmer chart to keep beside your workstation or use when teaching notation. No registration is needed.

How to read Palmer notation

Start at the midline, choose the tooth, then check the quadrant. A number on its own is incomplete: there are four permanent first molars, so “6” does not identify which one.

The corner points towards the centre of the chart. The number sits inside that corner. UR6 is a convenient alphanumeric alternative to the upper-right Palmer symbol; the letters are not the bracket itself. Make the notation system explicit when transferring records between systems.

The quadrant convention is illustrated in the IHACPA tooth-notation reference, Palmer notation section. That document is an archived coding publication; it is linked here for the notation diagram, not as current coding guidance.

Adult teeth: the complete 32-tooth reference

Each quadrant contains the same sequence. “First” and “second” describe the tooth's position within its type, counted away from the midline.

This is a reference for the full permanent dentition, not a statement that every patient has all 32 teeth. Record the patient's actual dentition, including absent teeth, separately.

Primary teeth: A to E

The same brackets identify the quadrants for primary teeth. Use letters to avoid confusing a primary tooth with its permanent successor.

For mixed dentition, check the individual tooth rather than choosing a notation from the patient's age alone.

Palmer, FDI and dental charting symbols

Tooth notation identifies a tooth. A charting symbol describes a finding or treatment. A restoration mark, missing-tooth mark or surface abbreviation is a separate piece of information. Follow your practice software's legend rather than assuming every package uses the same colours and symbols.

The UK uses three notations side by side. Palmer's grid is the traditional paper chart and is examined by NEBDN, the dental nurse exam board. The alphanumeric form (UR6, LL1, URE) uses the same quadrant logic written out, and is now the most used in UK dental hospitals and referral letters (Pemberton & Ashley, 2017). FDI two-digit numbering (16, 31) is the international standard, BS EN ISO 3950, and is how the BSP writes BPE sextants.

FDI uses two digits instead of a bracket. The first identifies the quadrant and dentition; the second identifies the tooth's position. Examples for permanent first molars are UR6 = FDI 16, UL6 = 26, LL6 = 36 and LR6 = 46. Do not read FDI 16 as tooth sixteen in the Universal system.

When copying a record or referral, check three things: tooth, surface and notation system. A correctly formatted note can still contain the wrong tooth if the original detail was unclear.

For the wider reference, see our UK dental charting symbols guide. For periodontal measurements, see the six-point pocket charting guide.

Using tooth notation in AI dental notes

Knowing the notation remains important even when you dictate. In Dentistry Dashboard, you can record a consultation or dictate a summary, choose your note template and review the resulting draft. Set your preferred tooth-numbering format in AI Notes settings and check the teeth and surfaces before copying the note into the patient record.

If you prefer not to speak, treatment templates provide clickable options for recording treatment details. These are a different route from voice periodontal charting, which captures the measurements you call out.

Try the interactive AI Notes demo or explore voice periodontal charting. The printable chart remains free whether or not you use the software.

Common questions

Is UR6 the same as Palmer notation?

UR6 identifies the upper-right permanent first molar using letters and a number. Palmer identifies the same tooth as 6┘. They convey the same tooth identity using different written formats.

Which side is right on a Palmer chart?

Right and left belong to the patient. When you face the patient, the upper-right quadrant appears at the top left of the chart. Check that orientation before interpreting any bracket.

Is the printable Palmer chart free?

Yes. Download the PDF reference without an account. It includes the adult and primary quadrant layouts and the tooth-position key.