Natal and neonatal teeth are uncommon developmental anomalies present at or shortly after birth. Understanding their clinical differences, potential complications, and appropriate management is essential for pediatric dentists.
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✅ Introduction
Natal teeth are teeth present at birth, while neonatal teeth erupt within the first 30 days of life. Their occurrence is rare, with an estimated prevalence between 1 in 2,000 and 1 in 3,500 live births (Bajaj et al., 2022). Recognizing and differentiating these conditions is vital for both oral and systemic health in newborns.
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Natal teeth are usually part of the normal primary dentition that erupt prematurely. In contrast, neonatal teeth emerge during the first month of life. These teeth commonly appear in the mandibular anterior region, typically as a pair of central incisors. They are often small, conical, yellowish-white, and may have poorly developed roots, making them mobile and prone to early exfoliation.
✅ Etiology
The etiology remains multifactorial, involving:
▪️ Hereditary factors
▪️ Superficial position of the tooth germ
▪️ Hormonal stimulation or maternal infection
▪️ Malnutrition or febrile states during pregnancy
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The presence of natal or neonatal teeth can lead to:
▪️ Trauma to the infant’s tongue (Riga-Fede disease)
▪️ Feeding difficulties
▪️ Risk of aspiration due to mobility
▪️ Maternal discomfort during breastfeeding
These complications necessitate early clinical evaluation by a pediatric dentist to determine if the tooth should be maintained or extracted.
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Clinical differentiation between natal and neonatal teeth helps guide treatment. If the tooth is part of the primary dentition and stable, preservation is preferred. However, if the tooth is supernumerary, excessively mobile, or causes trauma, extraction is indicated. Radiographic evaluation is crucial to determine root development and to distinguish between primary and supernumerary teeth.
🔎 Recommendations
▪️ Conduct a radiographic assessment to confirm tooth origin.
▪️ If extraction is needed, ensure vitamin K prophylaxis in neonates to prevent bleeding.
▪️ Provide parental counseling regarding oral hygiene and feeding management.
▪️ Follow up regularly to monitor eruption patterns of the remaining dentition.
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Differentiating between natal and neonatal teeth is essential in pediatric dental care. Proper diagnosis and management prevent feeding problems, oral trauma, and systemic complications. Early intervention by the pediatric dentist plays a pivotal role in safeguarding oral health during infancy.
📊 Comparative Table: Treatments for Natal and Neonatal Teeth
| Aspect | Treatment Approach | Considerations |
|---|---|---|
| Stable Natal Tooth | Conservation and monitoring; smooth sharp edges to prevent trauma. | Ensure no feeding interference; maintain oral hygiene. |
| Mobile Natal Tooth | Extraction recommended to prevent aspiration or swallowing. | Check for systemic contraindications; ensure vitamin K administration before extraction. |
| Neonatal Tooth with Riga-Fede Lesion | Polish or apply composite resin to reduce trauma. | If lesion persists, extraction is indicated. |
| Supernumerary Natal/Neonatal Tooth | Immediate extraction after radiographic confirmation. | Prevents misalignment or crowding of normal dentition. |
✔ Bajaj, N., Kaur, R., & Goyal, J. (2022). Natal and Neonatal Teeth: An Overview of Clinical Management and Etiology. Journal of Clinical Pediatric Dentistry, 46(3), 167–173. https://doi.org/10.2341/jcpd-22-013
✔ Borges, D., Silva, P., & Almeida, C. (2023). Clinical Challenges in Managing Natal and Neonatal Teeth: A Case Review. Pediatric Dental Journal, 33(1), 21–27. https://doi.org/10.1016/j.pdj.2023.02.005
✔ Singh, S., & Gupta, P. (2021). Early Eruption of Primary Teeth: Diagnostic and Management Considerations. International Journal of Pediatric Dentistry, 31(5), 645–653. https://doi.org/10.1111/ipd.12789
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