The emergence of teeth in infancy is typically an anticipated developmental milestone occurring several months after birth. However, a rare phenomenon exists where babies are born with teeth already present. This unusual occurrence sparks curiosity and questions among parents and caregivers. This article explores the characteristics, origins, and practical considerations associated with these early teeth.
Early Erupting Teeth
Teeth present at birth are referred to as “natal teeth,” while those appearing within the first 30 days of life are known as “neonatal teeth.” Natal teeth are more common than neonatal teeth, occurring at a ratio of about 3 to 1. This phenomenon is uncommon, with studies indicating a worldwide prevalence of natal teeth around 1 in 289 newborns and neonatal teeth around 1 in 2,212.
These early teeth are most frequently found in the lower front gum area, specifically the central incisors. While they can sometimes resemble normal primary teeth in size, shape, and color, they are often smaller, conical, and may appear yellowish or brown. These teeth frequently have underdeveloped or absent roots, making them prone to looseness and discoloration.
Factors Contributing to Their Presence
The precise reasons behind the premature eruption of teeth are not fully understood, but various factors play a role. Genetic predispositions are a significant consideration, with a family history of natal or neonatal teeth reported in a notable percentage of cases, suggesting an inherited trait. This could be due to inherited shallow tooth germ placement or specific genetic variations influencing tooth development.
Developmental factors, such as hyperactivity of tooth-forming cells in the womb, may also contribute to their early appearance. Natal teeth are sometimes associated with certain syndromes or conditions, including Ellis-van Creveld syndrome, Hallermann-Streiff syndrome, and Sotos syndrome. Conditions like cleft lip and palate also have a higher association with natal teeth. Environmental factors during pregnancy, such as maternal nutrition, infections, or exposure to certain chemicals like polychlorinated biphenyls (PCBs), are also potential influences.
Addressing Early Teeth
When a baby has natal or neonatal teeth, a healthcare provider or pediatric dentist assesses the situation to determine if intervention is needed. Removal of these teeth is considered when they pose specific risks or complications. A primary concern is significant mobility of the tooth, which could present an aspiration risk if the tooth detaches and is inhaled by the infant.
These teeth can also cause feeding issues, leading to difficulties for the baby to suckle effectively or pain for the breastfeeding mother. Another complication is irritation or ulceration of the baby’s tongue, known as Riga-Fede disease, caused by the tooth’s sharp edges rubbing against the tongue. If the tooth is supernumerary (an extra tooth) rather than part of the normal primary dentition, or if it causes significant discomfort or injury, extraction may be recommended. In cases where removal is not necessary, smoothing the edges of the tooth can prevent injury.