Can babies be born with a full set of teeth? The answer is no. A full set of 20 primary teeth develops over many months following birth. However, in extremely rare cases, a baby may be born with one or two teeth already visible in the mouth. This is a form of premature eruption that has been documented throughout human history.
Understanding Teeth Present at Birth
Teeth that are present at the moment of birth are called natal teeth, while those that erupt within the first 30 days of life are known as neonatal teeth. These occurrences are uncommon, with an incidence generally reported to be between 1 in 2,000 and 1 in 3,500 live births. Natal teeth are about three times more common than their neonatal counterparts.
In the majority of cases, these early teeth are simply the child’s primary or “milk” teeth. Over 90% of these teeth are part of the normal set that would have eventually erupted later. They are most frequently found in the lower jaw, specifically where the two lower central incisors would appear. A small percentage, around 1% to 10%, are extra teeth, known as supernumerary teeth.
Why Do These Teeth Erupt Early
The exact cause for this early eruption remains unknown, but the most accepted theory involves the positioning of the tooth germ. The tooth germ, the structure that develops into a tooth, may be situated too superficially in the jawbone. This shallow position allows the tooth to break through the gum tissue prematurely.
In many instances, there appears to be a hereditary component, with a family history of natal or neonatal teeth reported in up to 60% of cases. This suggests a genetic predisposition may play a role in the timing of eruption. Early eruption is often an isolated finding, meaning the infant is otherwise completely healthy.
In rare instances, the presence of these early teeth can be associated with certain syndromes. Conditions such as Ellis-van Creveld Syndrome or Sotos Syndrome have been documented alongside natal teeth. A thorough medical evaluation can rule out systemic health issues when a baby is born with teeth.
The Structure and Risks of Early Teeth
The physical structure of natal and neonatal teeth often differs from teeth that erupt on time. Because they appear early, these teeth frequently lack proper root development, making them small, conical, and sometimes yellowish-brown in color. The absence of a fully formed root means the tooth is often mobile.
The enamel and dentin layers may also be poorly developed, resulting in a condition called hypoplasia. The hardness of the enamel in these teeth can be lower than that of normal primary teeth. This structural immaturity contributes to the primary risks associated with their presence.
The mobility of the tooth presents a risk of displacement, where the tooth could become dislodged and potentially inhaled by the infant. A sharp edge on the tooth can cause injury to the baby’s tongue, a condition known as Riga-Fede disease. The early teeth can also cause problems for the mother, leading to lacerations or trauma to the nipple during breastfeeding.
Medical Management and Next Steps
The decision to treat or retain a natal or neonatal tooth depends on an assessment of its structure and the complications it is causing. A pediatric dentist often uses X-rays to determine if the tooth is part of the normal primary dentition or if it is a supernumerary tooth. The X-ray also reveals the extent of root development and how stable the tooth is within the gum.
If the tooth is mobile, extraction is generally recommended to eliminate the risk of aspiration. Removal is also often necessary if the tooth is causing feeding problems or trauma to the baby’s tongue. If the tooth is stable and not causing any issues, it is typically retained and monitored.
If removal is necessary, the procedure is straightforward due to the minimal root structure, often requiring only local anesthetic. In newborns, it is standard practice to check for Vitamin K levels before extraction to ensure proper blood clotting. For teeth that are kept, smoothing any sharp edges is a measure to prevent irritation to the tongue and lips.