From the Guidelines
A 3-day-old infant with two central incisors, also known as natal teeth, requires prompt evaluation by a pediatric dentist or pediatrician to determine the best course of action. The presence of natal teeth is extremely rare, and according to a study on the prevention of choking among children 1, dentition initially develops at approximately 6 months with eruption of the incisors. However, in this case, the infant has developed teeth much earlier, which may pose a risk for aspiration or feeding problems.
Key Considerations
- The teeth should be evaluated for looseness and potential interference with feeding, such as difficulty with breastfeeding or risk of aspiration.
- If the teeth are loose or causing feeding problems, they may need to be extracted, as the infant's airway is more vulnerable to obstruction due to its smaller diameter 1.
- If the teeth are firmly attached and not interfering with feeding, they can often be left in place with careful monitoring, and parents should clean these teeth gently with a soft cloth after feedings.
- Regular dental follow-up is crucial, as natal teeth typically have underdeveloped roots and may be more prone to decay.
- The presence of natal teeth can occasionally be associated with certain syndromes or conditions, so a thorough evaluation is necessary to rule out any underlying issues.
From the Research
Definition and Prevalence of Natal Teeth
- Natal teeth are defined as teeth present at birth, while neonatal teeth erupt during the first 30 days 2.
- The prevalence of natal teeth ranges from 1:2000 to 1:3000, with a higher frequency in cases of lip and palate clefts and syndromes 2.
- The incidence of natal teeth is approximately 1:2,000 to 1:3,000 live births 3.
Characteristics of Natal Teeth
- In about 85% of cases, natal or neonatal teeth are lower central incisors, often in pairs 2.
- Natal teeth are usually smaller, conical, and yellowish, with hypoplastic enamel and dentin, and poor or absent root formation 2, 3.
- The appearance of these teeth is dependent on the degree of maturity, but most of the time, they are loose and discolored 2.
Complications and Management
- Complications of natal teeth include discomfort during suckling, sublingual ulceration, laceration of the mother's breasts, and aspiration of the teeth 2, 3.
- Tooth extraction is indicated if the tooth is supernumerary or excessively mobile 2, 3.
- If the tooth does not interfere with breastfeeding and is otherwise asymptomatic, no treatment is necessary 3.
- In the case of a 3-day-old infant with 2 central incisors, the decision to maintain or remove these teeth should be assessed independently, based on the degree of mobility and interference with breastfeeding 4.