December 04, 2015
One of a child’s first milestones is tooth eruption, often at about the age of six months. Several factors contribute to the time and placement of a child’s first teeth. However, there are certain expectations held by healthcare professionals. It is a rare occurrence for teeth to appear too early in the oral cavity, say prior to birth (natal teeth) or within the child’s first 30 days of life (neo-natal teeth). This is why these anomalies stimulate curiosity and concern for both clinicians and parents alike.
A Distinction in Time
Really the only difference between neonatal and natal teeth is the time of eruption. Neo-natal teeth are early deciduous teeth that come in during the first month of life. The mandibular incisors are most frequently involved, followed by the maxillary incisors. Natal teeth are already present at the time of birth. Natal teeth occur more frequently than neonatal teeth, with an approximate ratio of 3:1. Natal teeth are morphologically similar to neonatal teeth and again appear most commonly as mandibular incisors followed by the maxillary. Other terms used to describe these anomalous teeth include, congenital teeth, aberrant nodules, fetal teeth, precocious dentition, dens cannatalis, and predeciduous teeth.
Morphology of Natal and Neonatal Teeth
Mostly these teeth resemble the primary deciduous teeth. However many anomalous teeth are usually small, conical, yellow, and poorly developed. They might have an absence of roots and minimal bone support, which often accounts for the migratory nature of the teeth.
Folklore, Superstitions, and Facts
For centuries various ethnic groups associated this anomaly with different superstitions. Malaysian cultures believed a natal tooth heralded in good fortune. Conversely the Chinese cultures often believed the presence of these teeth was a bad omen, and children were thought of as beavers of misfortune. Even the renowned Shakespeare had something to say about natal teeth. In King Henry VI it said of Richard III, “teeth hadst thou in thy head when thou wast born to riguity thou camest to bite the word.” Thus, in England they believed early childhood teeth would guarantee conquest of the world. None of the superstitions have any scientific weight. However, some natal and neonatal teeth do come with complications. These might include: pain on suckling, refusal to nurse or feed, traumatic ulceration for the mother caused by early teeth, abnormal mobility of teeth, and even irritation or deformity in the infant’s tongue.
What Should I Do About Natal or Neo-Natal Teeth?
Often these teeth anomalies do not require treatment. As long as they develop like normal infant teeth and stay intact, then you have nothing to worry about. But the dentist might consider extraction of natal teeth if they are mobile and have little root structure. They do the procedure as a precaution against the tooth breaking loose and the child accidentally inhaling it into the airway or lungs. The clinician might also recommend tooth removal if it causes ulceration to the ventral surface of the tongue. If the tooth interferes too much with feeding or causes ulceration to the mother’s nipple during breastfeeding then clinicians might also recommend extraction.
If an infant has natal or neonatal teeth you should consult with a pediatric dentist as soon as possible. The dentist will perform an evaluation of teeth you can work together to determine the best course of action.