To help you understand this better, we spoke to Dr Gopal Aggarwal, Director – Department of Paediatrics and Neonatology at Cloudnine Group of Hospitals, Gurgaon.
What Are Natal and Neonatal Teeth?
Natal teeth are present at birth. Neonatal teeth erupt within the first 30 days. Natal teeth are about three times more common. They usually appear on the lower front gum, often in pairs.They tend to be small and yellowish, or have poorly developed enamel and roots; they may be loose.
Most natal and neonatal teeth are thought to belong to the baby's normal primary dentition, although a small proportion may be supernumerary (additional teeth).
Why Is a Baby Born With a Tooth?
The exact cause is unknown. Suspected factors include:- A tooth bud lying close to the gum surface
- Family history, reported in about 15% of cases
- Rarely, a genetic syndrome such as Ellis-van Creveld or Hallermann-Streiff syndrome
- Cleft lip and palate, where natal teeth are reported more often
Are Natal Teeth Dangerous? Possible Complications
Natal teeth are not an emergency, but three problems can occur:- Tongue ulcer (Riga-Fede disease): A sharp edge rubs the underside of the tongue and causes a sore.
- Feeding difficulty: The tooth can make latching uncomfortable and may injure the mother’s nipple.
- Aspiration risk: A loose tooth could dislodge and be inhaled. Reviews have found no reported cases of aspiration, yet the risk drives most removal decisions.
Although uncommon, natal and neonatal teeth are recognised dental findings. The healthcare professional will assess the tooth’s stability, appearance and position. Depending on the findings, it may simply need monitoring. In selected cases, smoothing a sharp edge or removing a very loose tooth may be considered.
Can a Natal Tooth Affect Breastfeeding?
Sometimes. A firm natal tooth may not interfere with feeding. However, a sharp or poorly positioned tooth can irritate the baby's tongue or make breastfeeding uncomfortable.In some cases, repeated rubbing against the tongue can cause a small ulcer. A sharp tooth may also cause soreness or injury to the mother's nipple during breastfeeding.
When Does a Baby Born With a Tooth Need Treatment?
Not every natal tooth needs removal. The dentist will consider how firmly the tooth is attached, whether it is part of the normal primary dentition, whether it interferes with feeding, and whether it is causing injury.A stable, symptom-free tooth can often be monitored. The American Academy of Pediatric Dentistry recommends considering factors such as feeding difficulties, the risk of the tooth falling out and being aspirated, and other medical factors when deciding how to manage a prematurely erupted primary tooth.
A paediatric dentist may take an X-ray before the procedure. Extraction is quick and uses local anaesthetic. Newborns routinely receive vitamin K at birth, which supports clotting before extraction. The dentist also clears the tissue left in the socket, because remnants can sometimes form a residual natal tooth.
Removal may be considered when the tooth is:
- Loose and at risk of coming out
- Causing repeated injury to the baby's tongue or to the mother’s nipple
- Interfering significantly with feeding
- Causing persistent discomfort
- Associated with other dental concerns
A baby born with a tooth is usually healthy, and an early dental check decides whether the tooth needs monitoring or treatment.
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FAQs on Baby Born With a Tooth: Is It Normal or a Cause for Concern?
- Can a baby with a natal tooth breastfeed?
Usually, yes. A sharp edge can hurt the nipple or the baby’s tongue. In that case, the doctor may smooth or remove the tooth. - Is a natal tooth a sign of a health problem?
Usually not. Most babies with a natal tooth are healthy and have no other findings. Rarely, natal teeth occur with conditions such as cleft lip and palate or genetic syndromes. - Will a natal tooth fall out on its own?
A retained natal tooth works as a baby tooth and sheds when the permanent teeth arrive. A loose one may fall out earlier, which is why doctors monitor it.