Neonatal teeth are those present at birth (natal teeth) or that emerge within the first 30 days of an infant’s life. This phenomenon is uncommon, occurring in approximately 1 in 2,000 to 1 in 3,500 newborns.
Identifying and Understanding Neonatal Teeth
These early teeth often differ in appearance from typical primary teeth. They are frequently smaller, conical in shape, and may appear yellowish or brownish. The enamel can be hypoplastic (thin or absent) or hypomineralized (softer than normal). These teeth often have underdeveloped root structures, leading to increased mobility.
Neonatal teeth are most frequently observed in the lower central incisor region of the mouth, often appearing in pairs. While the specific cause of their premature eruption is not definitively known, a shallow positioning of the tooth germ is considered a primary factor. In some cases, a family history suggests a hereditary link. Neonatal teeth can also be associated with certain medical conditions or syndromes, such as Sotos syndrome or Ellis-van Creveld syndrome, though most instances occur as isolated findings.
Potential Complications for Mother and Baby
The presence of neonatal teeth can lead to several complications for the infant. One concern is ulceration on the underside of the baby’s tongue, known as Riga-Fede disease, caused by friction against the tooth. This can result in discomfort and feeding difficulties. There is also a risk of the tooth becoming loose, posing an aspiration hazard if it dislodges.
For the breastfeeding mother, neonatal teeth can cause irritation or discomfort to the nipples during feeding. The sharp edges of these teeth may lacerate the mother’s breast, making breastfeeding challenging and potentially leading to a premature cessation of nursing. While the infant’s tongue typically interposes between the tooth and the nipple during breastfeeding, direct trauma to the nipple can still occur.
Management and Treatment Approaches
When neonatal teeth are present, consultation with a pediatric dentist or pediatrician is advised to assess the situation. A clinical examination will evaluate the tooth’s mobility and condition. Radiographic imaging, such as an X-ray, may be used to determine root development and confirm if the tooth is part of the primary dentition or an extra tooth.
Treatment approaches vary based on the tooth’s stability and complications. If the tooth is firm and not causing issues, observation with regular monitoring is common. If sharp edges irritate the baby’s tongue or mother’s nipple, a dentist might smooth them. Extraction is recommended if it is excessively mobile, poses an aspiration risk, or causes significant feeding problems or persistent injury.