Palmer notation uses symbols ( ⏌,⎿ ,⎾ ,⏋) to designate which quadrant the tooth is located in rather than numbers. These symbols reference the relative position of the midline via vertical lines as well as differentiating between the arcus maxillaris et mandibularis via horizontal lines. Once again, the permanent dentition is numbered 1-8 (mesial to distal). As an example of this notation, the dens premolaris secundus dexter maxillaris ( 5⏌), receives the number 5, a horizontal line below it (representing a maxillary tooth) and a vertical line to the right of the number (representing that this tooth is located in a quadrant right of the midline (working mesial to distal). A variation of this notation, known as Haderup notation, replaces the Palmer symbols with ‘+’ for maxillary and ‘-’ for mandibular, placed before or after the tooth number to denote the quadrant (e.g. +1, 1+, -1, 1- etc.
