Natal teeth

Natal teeth are teeth that are present above the gum line at birth. They are an uncommon occurrence, appearing in approximately 1 in 2,000 to 1 in 3,000 live births. Natal teeth are most often found in the lower central incisors region of the newborn's mouth. Their appearance can be surprising to parents and caregivers and may require special attention from pediatric dentists.

Etiology

The exact cause of natal teeth is not well understood, but it is believed to be associated with a combination of genetic and environmental factors. Some cases have been linked to certain syndromes and conditions, such as Pierre Robin syndrome and Hallermann-Streiff syndrome, suggesting a possible genetic component. However, in many instances, natal teeth occur in infants with no other medical conditions or familial history of the phenomenon.

Classification

Natal teeth can be classified into four categories based on their characteristics:

1. True natal teeth, which are fully developed teeth that have erupted early.
2. Predeciduous teeth, which are not part of the normal series of baby teeth and will eventually be replaced.
3. Ectopic teeth, which grow in an abnormal position or orientation.
4. Supernumerary teeth, which are extra teeth beyond the normal complement.

Clinical Presentation and Complications

Natal teeth often resemble normal primary teeth in appearance, though they may be smaller, discolored, or poorly formed. They can be mobile due to incomplete root development, which may pose a risk of aspiration or ingestion. Additionally, natal teeth can cause complications such as irritation or injury to the infant's tongue (Riga-Fede disease), difficulty feeding, and discomfort during breastfeeding for the mother.

Management

The management of natal teeth involves a thorough evaluation by a pediatric dentist to assess the tooth's mobility, root development, and potential impact on feeding and oral health. Treatment options may include:

• Observation and monitoring for stable, asymptomatic natal teeth.
• Smoothing rough edges to prevent injury to the infant's tongue or the mother's breast.
• Extraction, which is considered for teeth that are extremely loose, pose a risk of aspiration, or cause significant problems with feeding or maternal discomfort during breastfeeding.

Prognosis

The prognosis for infants with natal teeth varies depending on the condition of the teeth and any associated complications. With appropriate dental care and management, most infants experience no long-term adverse effects from natal teeth.

See Also

• Teething
• Pediatric dentistry
• Primary teeth