Natal and neonatal teeth: appearance, causes, diagnosis, management

Milk teeth start to appear in the mouth of a baby around six months after birth. But in some rare cases, the baby is born with one or two teeth which are medically called natal teeth.

Natal teeth are the teeth which are present in the mouth of a newborn. Natal teeth are uncommon and are mostly seen in the lower front tooth region in a pair.

They are yellowish-brown or opaque white in colour. They are pretty small in size and have a little or no root.

There are a few cases where small teeth start to appear in the mouth of a baby within the first month after birth. These teeth which appear within 30 days after birth are known as neonatal teeth. Just like the natal teeth, neonatal teeth are also seen in the front part of the lower gum.

These natal and neonatal teeth can be "mobile" - they are loose as they do not have a supporting root. These teeth irritate the gums and tongue of the newborn and make gums and tongue red and inflamed. These teeth can also hurt the roof of the mouth and the upper gums.

Babies with natal and neonatal teeth face difficulty in suckling milk from their mother’s breast. The child can be seen crying all day as the teeth irritate and hurt the gums.

Moreover, the sharp tooth can also cause trauma to the nipple of the mother while breastfeeding.

There are many superstitions regarding natal and neonatal teeth in our society. Some people think of them as a sign of good fortune while others see them as harbingers of grave misfortune. Of course, these are superstitious beliefs with no scientific truth to them. Natal and neonatal teeth, though rare, have a perfectly logical explanation in medicine. That said, some dentists and paediatricians find it useful to counsel the parents before planning any treatment for the child.

Treatment may involve removing the teeth if they are very loose, as they can be a choking hazard for the newborn.

Further, as these teeth are usually milk teeth that have come out early, removing them means that your baby will most likely be missing these teeth throughout their childhood. (Although your child's permanent teeth should grow out as per usual.) In very rare cases, natal and neonatal teeth may be supernumerary - or extra - in which case, the child may also get all their milk teeth despite this extraction.

Types of natal teeth
Causes of natal and neonatal teeth
Diagnosis of natal and neonatal teeth
Treatment of natal and neonatal teeth

Doctors for Natal and neonatal teeth

Types of natal teeth

Depending upon their attachment, natal teeth can be classified as:

Category 1: A shell-like tooth structure is attached loosely to the gums with the help of the mucosa (a mucous membrane that lines the gums, in this case) and no roots are present.
Category 2: A solid tooth is attached loosely to the gums with the help of mucosa. A tiny root or no roots are present.
Category 3: Only the sharp top portion of the tooth appears on the gum line.
Category 4: Only a bulge is seen on the mucosa of the gums. The tooth is not visible but can be felt on touching the bulge.

Read more: How to clean your baby's mouth

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Causes of natal and neonatal teeth

There are various reasons that can lead to the development of natal and neonatal teeth in a baby’s mouth. Some of those reasons are:

Genetic: In some cases, the presence of natal teeth can be due to familial pattern and could have been inherited from the family.
Position of tooth germs: The teeth emerge from the gums after they mature. Until then, they stay deep in the gums and are called tooth germs. If these tooth germs arrive at the surface of the gums before time, they form natal and neonatal teeth.
Sotos syndrome: This is a disorder in which the child has a distinctive facial appearance: narrow face, pointed chin, natal teeth, overgrowth in childhood, and learning disabilities or delayed development of mental and movement abilities.
Pierre Robin syndrome: This is a genetic condition in which the child is born with a small jaw, abnormally placed tongue (rolled back towards the throat) and natal teeth. The child also gets ear infections repeatedly.
Epidermolysis bullosa simplex: It is a group of genetic conditions marked with very fragile skin which blisters easily. Natal teeth are also seen in this condition.
Chondroectodermal dysplasia: Also known as Ellis Van Creveld syndrome, this is a genetic condition. As a child with this condition grows up, his or her cartilage converts into bones prematurely. A child with this condition is usually born with extra fingers and natal teeth.
Hallermann-Streiff syndrome: This is a rare genetic condition in which the child is born with abnormalities in the skull and facial bones. The child is born with eye abnormalities and dental defects including the presence of natal teeth.
Riga-Fede disease: This is a rare disease where ulceration is seen on the ventral side of the tongue (bottom part the tongue) and on the inner side of the lower lip. It is mostly associated with the continuous trauma caused by the natal or neonatal teeth.

Diagnosis of natal and neonatal teeth

The doctors may perform a physical exam by checking the mobility of the teeth (to check how loose it is). The doctor may also look for any trauma or injury caused by the teeth.

A small dental X-ray can be done to look for the extent of root development.

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Treatment of natal and neonatal teeth

These are the measures that can help treat natal and neonatal teeth:

If the natal and neonatal teeth are causing injury to the gums and tongue of the baby, they must be removed.
If the tooth is moving excessively, it should be removed by a dentist as there is a risk of the tooth falling into the baby’s throat, which might choke the baby.
If the tooth is firm and is not hurting either the baby or the mother, then it can stay in the baby’s mouth as it will develop its roots over time.

No special care is required after the natal or neonatal tooth is removed. The wound heals on its own within a week.

Natal and neonatal teeth can cause problems while breastfeeding. Doctors may also recommend removing the teeth to facilitate breastfeeding.

Read more: Benefits of breastfeeding