Natal teeth – Neonatal teeth

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Natal teeth are present at the time of birth. Neonatal teeth grow after birth during the first month. Except for the time of appearance, there is not much difference between these teeth.

Natal teeth are uncommon and one in every 2,000 to 3,000 infants may have them at birth. In some infants their presence may be associated with certain medical conditions.

Actually these natal teeth are primary deciduous dentitions, which have emerged very early. The most commonly affected are the lower central incisors. They usually occur in pairs. In very rare cases primary maxillary incisors or primary lower canines may be involved.

In a few cases they may be supernumerary and get replaced by the true primary dentition. A dental roentgenogram can help in differentiating the supernumerary incisors.

Though the exact etiology is not clear, maternal health during pregnancy appear to predispose the fetus in developing this condition. Maternal exposure to infections, fever, trauma, hormones, chemicals and toxin can become causative factors.

The natal teeth may be smaller than the primary incisors and may appear conical and yellowish. The root may be absent or poorly developed. They have hypoplastic or hypomineralized enamel, irregular dentin and most of them are mobile. Some may have shell-like crown structure loosely attached to gingival tissue.

These natal teeth may interfere while feeding or breastfeeding. The nipples may get lacerated and become infected and painful. There is a great chance for the infant to hurt and damage the tongue leading to sublingual ulceration (Riga-Fede disease).

If the natal incisors are wobbly and loose there is a risk of swallowing or aspirating them into lungs. In such situations their extraction may be considered by the dentist.

In some rare cases they may be associated with genetic disorders such as Ellis–van Creveld syndrome, Meckel-Gruber syndrome and Sotos syndrome. Natal teeth are also associated with congenital disorders like Hallermann–Streiff syndrome, jadassohn-lewandowsky syndrome (pachyonychia congenita), craniofacial dysostosis syndrome, steatocystoma multiplex, Wiedemann-Rautenstrauch syndrome and Pierre Robin syndrome.

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References:
1.Alexander K. C. Leung and William Lane M. Robson. Natal teeth: a review. J Natl Med Assoc. 2006 February; 98(2): 226–228. PMCID: PMC2595049.
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