Babies typically arrive without teeth, with their first teeth usually emerging several months into infancy. However, in rare instances, a baby may be born with teeth already present, or develop them very soon after birth. This unusual occurrence prompts questions about infant dental development.
Natal and Neonatal Teeth: The Early Arrivals
Teeth present at birth are called natal teeth, while those emerging within the first 30 days are neonatal teeth. These early teeth are almost always primary teeth that have erupted sooner than typical. They are most commonly found in the lower front gum area, specifically the lower central primary incisors, accounting for about 85% of cases.
Natal and neonatal teeth are often smaller or more conical than fully developed baby teeth and may appear yellowish or brownish. They can also have underdeveloped roots or be loosely attached. Over 90% of these early teeth are part of the normal set of primary teeth, with less than 10% being extra (supernumerary) teeth.
Why Some Babies Have Teeth at Birth
Natal and neonatal teeth are uncommon, occurring in about 1 in 2,000 to 1 in 3,500 live births globally. Natal teeth are about three times more frequent than neonatal teeth. While the precise cause is often unknown, several factors contribute to their early eruption.
One contributing factor is the superficial position of the tooth germ, the developing tooth bud, within the gum tissue. Genetic predisposition also plays a role, as a family history of early tooth eruption is sometimes observed. Rarely, natal or neonatal teeth may be associated with certain medical conditions, such as specific syndromes or developmental abnormalities. However, in the majority of instances, they are isolated occurrences and do not indicate underlying health issues.
Addressing Early Teeth: What Parents Need to Know
Early teeth can present several considerations for the infant and caregiver. Concerns include feeding difficulties, as the tooth can irritate a breastfeeding mother’s nipple or cause discomfort for the baby. A loose tooth with underdeveloped roots poses an aspiration risk if it detaches. Sharp edges can also irritate the baby’s tongue, potentially leading to ulceration.
Management decisions depend on the tooth’s stability, its impact on feeding, and whether it’s causing irritation. If the tooth is stable and not causing problems, it might be monitored. If it has sharp edges, a dentist might smooth them to prevent injury. Extraction may be considered if the tooth is significantly mobile, interferes with feeding, or poses an aspiration risk. Consulting a pediatrician or pediatric dentist is important for assessment and guidance.
Normal Teething: What to Expect Later
In contrast to the rare occurrence of natal and neonatal teeth, most infants begin the normal teething process much later. Typically, the first primary tooth emerges between 6 and 12 months of age, with the lower central incisors often appearing first. By the time a child reaches approximately three years old, they generally have a full set of 20 primary teeth.
During normal teething, infants may exhibit several common signs:
- Increased drooling
- A tendency to chew on objects
- Irritability
- Slightly swollen or tender gums
- Changes in appetite or disrupted sleep patterns
Comfort measures, such as offering safe teething rings, gently massaging the gums with a clean finger, or providing chilled (not frozen) items like a wet washcloth, can help soothe discomfort during this developmental phase.