Author Name: Dr. Sandra Thompson
Natal teeth are teeth which emerge at birth in the oral cavity of the newborn child. Natal teeth are most likely to occur in the lower front region of the mouth where the first two lower baby teeth will normally emerge. Parents can also learn more about why some babies are born with teeth and how this unusual early eruption can occur.
Neonatal teeth differ from natal teeth in that the neonatal teeth emerge within the first month after birth while natal teeth are those which emerge before or at birth of the baby. The term is used to refer to the time of emergence and not the actual type of tooth.
The majority of natal teeth are actually primary teeth which emerge earlier than normal as part of the baby’s teeth. Sometimes, the emerging tooth can be a supernumerary tooth which does not form part of the baby’s normal teeth.
The natal tooth can look like a baby tooth or it can be small, pointy, discolored, or malformed. In some cases, the natal tooth is well anchored but in some cases, it may be loose due to underdevelopment of the root. Natal teeth are generally harmless if they are stable and do not affect feeding or cause any irritation to the mouth of the baby.
The main characteristic of a natal tooth is the presence of a tooth in the mouth of the baby at birth. In most cases, the teeth are located at the lower gum region and are of varying sizes, colors, shapes, and mobility.
In some cases, the appearance of the natal tooth is like any other baby tooth. However, in other cases, the natal tooth may appear smaller than a baby tooth, pointed, yellow, underdeveloped, or even loose. This is because the root of the tooth is sometimes underdeveloped, hence making it mobile.
Natal teeth do not always cause symptoms. When problems occur, parents may notice:
An irritated area or an ulcer can develop due to repeated irritation of the sharp tooth against the underside of the tongue. This condition is sometimes referred to as Riga-Fede disease and can cause discomfort while sucking and feeding issues in more severe cases.
Not all white spots found inside a newborn’s mouth indicate the presence of a tooth. Epstein pearls, Bohn’s nodules, and dental lamina cysts are harmless oral mucosa cysts that commonly affect newborns. These cysts can be described as small, smooth white or yellowish lesions that are normally not painful and go away spontaneously. Parents can read more about Epstein pearls in children and how they may differ from an erupted tooth.
The eruption of teeth at birth is defined as natal teeth. If teeth erupt during the first 30 days after birth, then the baby has neonatal teeth. In case parents are not sure whether they observe the eruption of a tooth or a benign mucosal lesion, then they should seek advice from healthcare professionals.
Natal teeth are not automatically dangerous. A stable tooth that does not interfere with feeding, injure the tongue, or cause discomfort may remain in place and be monitored by a pediatric dentist.
Possible concerns depend mainly on how loose, sharp, or poorly positioned the tooth is. A natal tooth may:
The term aspiration implies that the object ends up in the breathing passage rather than the digestive tract through swallowing. It applies only in situations where the tooth is quite mobile or in danger of coming out. It is important to understand that not all natal teeth pose choking hazards. The AAPD suggests retaining the natal teeth where there are no concerns of feeding, pain, functionality or aspiration.
Parents should under no circumstances try to pull, move, trim, file or remove a natal tooth from their baby's mouth. This could cause discomfort, bleeding, infections or even injuries. It would be better to consult a Kids dentist who will advise on the right course of action.
The treatment for natal teeth will depend on factors such as stability, shape, location, and impact on the infant's ability to feed. In addition, the pediatric dentist will also determine whether there is irritation from the tooth to the tongue or gums of the infant as well as whether the tooth is one of the regular baby teeth.
In cases where the tooth is stable and not causing irritation, monitoring may be the only step required. The dentist may advise that further follow up visits are made to monitor the tooth, the gums around the tooth, feeding, and mobility. Monitoring the development of primary and permanent teeth can also help identify unusual eruption patterns as a child grows.
In cases where there is a sharp edge on the tooth, the dentist may smooth out the tooth appropriately. Protective procedures may also be done if the tooth is irritated by rubbing against the undersurface of the tongue. Parents may be directed to visit their child's pediatrician or lactation specialist if adjustments in feeding techniques can increase the baby's comfort.
In some instances, a very small dental x-ray may be ordered to determine whether the natal tooth is a normal baby tooth or an additional tooth. Parents who want to understand how dental imaging is used for children can review this parent’s guide to pediatric dental X-rays.
The procedure may be advised if the tooth is very loose, interferes with feeding, causes recurrent injuries, and any other clinical problems. However, extraction should not be necessary solely because the tooth has erupted.
If the natal tooth happens to be one of the primary teeth that are supposed to erupt, extraction may result in absence of that tooth in that area until the permanent tooth erupts. This is the reason why the dentist will evaluate whether the advantages of the procedure outweigh its consequences. In addition, the medical history of the child should be evaluated.
Parents should arrange a pediatric dental evaluation soon after noticing a tooth present at birth. Even when the baby appears comfortable, an examination can confirm whether the area is a natal tooth, a neonatal tooth, or a harmless newborn gum cyst. Parents can also review information about a child’s first dental visit to understand what to expect from early pediatric dental care.
Promptly contact a pediatric dentist when:
Families can also learn more about pediatric dental care for infants available through Desert Kids Dental. If parents have concerns about a natal tooth, feeding discomfort, or unusual tooth development, they can contact Desert Kids Dental to arrange an evaluation.
In some cases, the symptoms necessitate emergency treatment by a doctor and not a regular visit to the dentist. These include having trouble breathing, choking, difficulty in swallowing, heavy and uncontrolled bleeding, or signs that the tooth might have come off.
Emergency medical examination should be considered when there are difficulties in feeding accompanied by dehydration or sickness, such as a lack of wet nappies, drowsiness, weakness, or inability to awaken. If breathing, swallowing, dehydration, or the baby's overall well-being is compromised, it is not advisable for parents to wait for a dental visit.
Natal teeth are uncommon, but they are a recognized variation in infant tooth development. Most are primary baby teeth that have erupted much earlier than expected. Although they are not automatically harmful, they should be evaluated to confirm that they are stable and not interfering with feeding.
No. Not every natal tooth needs to be removed. A stable tooth that causes no pain, feeding difficulty, or tissue injury may simply be monitored. Removal may be considered when the tooth is extremely loose, repeatedly injures the baby’s mouth, or significantly affects feeding.
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