An upper first permanent molar usually has how many roots and cusps?

• A. Two roots, five cusps
• B. Three roots, Five cusps
• C. One root, cusps n/a
• D. Four roots, Six cusps

Answer: (B)

Understanding the typical anatomy of the upper first permanent molar is key. This tooth normally has three roots—two buccal roots and one palatal root. On the chewing surface, it standardly presents five cusps: two on the buccal side and three on the palatal/lingual side. The large palatal cusp is a defining feature, with the other two cusps forming the rest of the occlusal outline. Occasionally an extra cusp called the Carabelli cusp may appear, which can raise the cusp count to six in some people, but five cusps is the usual scenario. That’s why three roots and five cusps best fits the typical anatomy for this tooth.