From the Guidelines
If your newborn has teeth, you should have them evaluated by a pediatrician or pediatric dentist as soon as possible to assess the need for removal or other interventions and to establish a dental home within 6 months of the eruption of the first tooth, as recommended by the American Board of Pediatric Dentistry 1. Newborn babies typically do not have visible teeth at birth, but in rare cases, some babies are born with one or two teeth already erupted, known as natal teeth. These occur in approximately 1 in 2,000 to 3,000 births. Most natal teeth are loose and may need to be removed to prevent aspiration risk if they're very mobile. However, if they're stable, they can often remain in place. Some key points to consider when a newborn has teeth include:
- The teeth are usually part of the normal primary dentition (baby teeth) rather than extra teeth
- No specific medication is needed, but careful oral hygiene is important - gently wipe the teeth with a soft, damp cloth after feedings
- Natal teeth can sometimes cause feeding difficulties or discomfort for the mother during breastfeeding
- They develop because the dental buds that normally erupt at around 6 months sometimes emerge early during fetal development, though the exact cause isn't fully understood
- A pediatric dentist has the specialized training to assess and manage the oral health of infants and children, including those with natal teeth, and can provide guidance on oral hygiene and preventive measures to reduce the risk of dental caries and other oral health problems 1. It's also important to note that the presence of natal teeth may be associated with other oral health issues, such as dental anomalies or structural defects, which may require further evaluation and treatment by a pediatric dentist or other specialist 1. In terms of preventive measures, limiting the intake frequency of foods and liquids that promote acid production can help reduce the incidence of dental caries, and parents and caregivers should be counseled on proper feeding practices during infancy and the preschool years 1.
From the Research
Definition and Prevalence of Natal and Neonatal Teeth
- Natal and neonatal teeth are rare features that can be present at birth or erupt within the first month of life, respectively 2, 3, 4.
- The incidence of natal teeth is approximately 1:2,000 to 1:3,000 live births, with the most commonly affected teeth being the lower primary central incisors 5.
- Natal teeth usually occur in pairs, and the eruption of more than two natal teeth is rare 5.
Clinical Characteristics and Complications
- Natal and neonatal teeth can lead to various issues, including traumatic injuries, feeding difficulties, and risk of aspiration due to excessive mobility of teeth 2, 3, 4.
- Complications also include discomfort during suckling, sublingual ulceration, laceration of the mother's breasts, and aspiration of the teeth 5.
- Riga-Fede disease is a possible local complication associated with natal and neonatal teeth 6.
Diagnosis and Management
- Diagnosis of natal and neonatal teeth involves clinical examination and dental roentgenogram to differentiate the premature eruption of a primary tooth from a supernumerary tooth 5.
- Management options include monitoring, smoothing of the teeth, or extraction, depending on individual assessment of each case 3, 4, 6.
- Tooth extraction is indicated if the tooth is supernumerary or excessively mobile, or if it interferes with feeding 5, 6.
- A close collaboration between pediatricians and dentists is recommended for early diagnosis and efficient treatment 2.