Natal Teeth: A Rare Pediatric Presentation: International Journal of Advances in Pediatric Dentistry

Meenakshi Bodh et al. / International Journal of Advances in Pediatric Dentistry, 2015;1(1):14-16.
INTERNATIONAL JOURNAL OF ADVANCES IN

PEDIATRIC DENTISTRY
Journal homepage: www.mcmed.us/journal/ijapd

NATAL TEETH: A RARE PEDIATRIC PRESENTATION
Meenakshi Bodh, Arun Kumar*, Ritu Namdev, Samir Dutta
Department of Pedodontics & Preventive Dentistry, Post Graduate Institute of Dental Sciences Rohtak-124001, Haryana, India.
Corresponding Author:- Arun Kumar

E-mail: [email protected]
Article Info ABSTRACT

Received 15/10/2015 Natal teeth are teeth as present in the mouth at birth. They are rare in occurrence and most frequently
Revised 27/10/2015 occur in the anterior mandible as a pair of primary incisors. They are probably smaller in size and are
Accepted 02/11/2015 poorly developed with little or no root formation. The various complications faced by mother as well
as infants are difficulty in feeding, severe ulceration of the infant tongue or the mother breast and the
Key words: natal risk of aspiration. Under such conditions, the early extraction of the natal tooth is warranted. In case,
tooth, hypoplasia, the natal teeth are firm and asymptomatic, the conservative management is indicated. The article
birth, mandibular presented a case report wherein two natal teeth were preset in the mandibular incisor region. Because
anterior, feeding. the teeth caused problems in the nursing process and ran a risk of aspiration, they were extracted.
INTRODUCTION
Teeth that are present in newborn infants are hemorrhagic episodes during extraction. If the level of
called natal teeth. The incidence of natal teeth is Vitamin K is found to be low, then an intramuscular
approximately 1:2,000 to 1:3,000 live births. The most injection of Vitamin K (0.5=1.0 mg) is recommended
commonly affected teeth are the lower primary central preoperatively. If the tooth does not interfere with breast
incisors. The eruption of more than two natal teeth is rare. feeding and is otherwise asymptomatic, no treatment is
The majority of natal teeth represent the early eruption of necessary [4,5]. This article presented a case report and
normal primary deciduous dentition. Less than 10% of management of an infant born with bilateral natal teeth.
natal teeth are supernumerary [1].
Natal teeth might resemble normal primary CASE REPORT
dentition in size and shape. The teeth are often smaller, An 11 days old baby boy was presented by
conical and yellowish-brown in color and have hypoplastic parents to the Department of Pedodontics and Preventive
enamel and dentin with poor or absent root formation. Dentistry, Rohtak with the chief complaint of two teeth
Natal teeth may be uncomfortable for a nursing mother and like structures in the lower anterior region since birth.
poses a risk of aspiration and swallowing by the infant if Medical history revealed that the infant was non-
they are excessively mobile. Other complications include significant with normal term pregnancy. The birth weight
sublingual ulceration (Riga-Fede disease) and laceration of was 3.12 kilogram. A thorough general examination was
the mother's breasts. Under these circumstances, natal teeth carried out to rule out the presence of any syndrome. In the
need to be extracted. A dental roentgenogram is indicated intraoral examination, the tooth was diagnosed as natal
to differentiate the premature eruption of a primary tooth teeth since they were present in the infant mouth at the
from a supernumerary tooth [2,3] time of birth (Figure 1a & 1b). Furthermore, the teeth were
The management includes the tooth extraction if highly mobile and caused discomfort for mother during
the tooth is supernumerary or excessively mobile and feeding. This in turn compromises the feed for the infant,
causing discomfort to mother as well as to infant. Before therefore the extraction of the natal teeth were planned.
planning for extraction a pediatrician must be consulted to The removed natal teeth were whitish to light brown in
evaluate the levels of Vitamin K for prevention of color and measured 7mm X 5mm and 6mm X 5mm in
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dimension. They also had a hypoplastic appearance. The like structure covered with enamel with dentin sub-
examination of extracted natal teeth showed teeth crown adjacent to it (Figure 2).
Figure 1a & 1b.Pre-Operative view shows natal teeth
Figure 2. The appearance of the natal teeth after extraction.
DISCUSSION The most commonly affected teeth are the lower

Natal teeth erupt in the intrauterine period and are primary central incisors (85%), followed by the maxillary
present in the infant mouth during birth. On the other hand, incisors ( 1%), mandibular canines and molars (3%), and
neonatal teeth start erupting following delivery. In our maxillary canines and molars (1%). The strong predilection
case, the teeth were present in the newborn infant's mouth for the lower central incisors is consistent with the normal
during birth; therefore they were diagnosed as natal teeth. order of eruption of primary deciduous teeth. Natal teeth
More than 90% of the natal and neonatal teeth were usually occur in pairs. The eruption of more than two natal
reported as prematurely erupted. On the other hand, 1-10% teeth is rare. Natal teeth are present in 2% of infants with
of these teeth erupt as supernumerary [6]. unilateral cleft lip and palate and 10% of infants with
The incidence of natal teeth ranges from 1:2,000 bilateral cleft lip and palate. Natal teeth have been reported
to 1:3,500 live births. Leung [7] studied 50,892 infants in association with syndromes such as Ellis-van Creveld,
delivered over 17 years and found the incidence of natal pachyonychia congenita, oculomandibulofacial syndrome
teeth to be 1:3,392 live births. The condition is slightly with hypotrichosis, craniofacial dysostosis, steacystoma
more common in females. Natal teeth are rare in extremely multiplex, Meckel-Gruber and Pierre Robin syndrome [9-
preterm infants. There is a racial variation in the incidence; 11].
the problem is more common among infants of some The management of natal tooth depends upon the
American Indian tribes [8] complications associated. If the tooth does not interfere
The exact etiology is unknown. The infection, with breastfeeding and is otherwise asymptomatic, no
febrile states, trauma, malnutrition, superficial positions of intervention is necessary. Tooth extraction is indicated if
the tooth germ, hormonal stimulation and maternal the tooth is supernumerary or if the tooth is poorly
exposure to environmental toxins have been implicated as implanted and excessively mobile and associated with a
causative factors. The condition might occur as a familial risk of aspiration. Consultation with a pediatric dentist is
trait since a positive family history has been reported in 8- strongly recommended, especially if tooth extraction is a
62% of cases. Hereditary transmission of an autosomal consideration. Extraction of the tooth should be followed
dominant gene has also been suggested [5,8]. by curettage of the socket to prevent continued
15
development of the cells of the dental papilla. Failure to ACKNOWLEDGEMENT: None

curette the socket might result in the eruption of
odontogenic remnants and necessitate future treatment CONFLICT OF INTEREST:
[12,13] The authors declare that they have no conflict of interest.
CONCLUSION STATEMENT OF HUMAN AND ANIMAL RIGHTS

The occurrence of natal teeth is a rare event but All procedures performed in human participants
still possible for pediatric dentist to encounter natal teeth in were in accordance with the ethical standards of the
daily practice. Therefore, the clinician has the institutional research committee and with the 1964
responsibility to take into consideration the adverse effects Helsinki declaration and its later amendments or
these teeth may have for both the infant and the mother and comparable ethical standards. This article does not contain
provide appropriate treatment. any studies with animals performed by any of the authors.
REFERENCES
1. Cunha RF, Boer FAC, Torriani DD. (2001). Natal and neonatal teeth: review of the literature. American Academy of
Pediatric Dentistry, 23, 158-62.
2. Costacurta M, Maturo P, Docimo R. (2012). Riga-Fede disease and neonatal teeth. Oral Implantology, 5(1), 26–30.
3. Campos-Munoz L, Quesada-Cortes A, Corral-De LaCalle M (2006). Tongue ulcer in a child: Riga-Fede disease. Journal of
the European Academy of Dermatology and Venereology, 20(10), 1357-59.
4. Sureshkumar R, McAulay AH. (2002). Natal and neonatal teeth. Arch Dis Child Neonatal Ed, 87, 227.
5. Mhaske MB, Yuwanati A, Mhaske R, Ragavendra K, Saawarn S. (2013). Natal and neonatal teeth: an overview of the
literature. ISRN Pediatrics, 11.
6. Rao RS, Mathad SV. (2009). Natal teeth: case report and review of literature. Journal of Oral and Maxillofacial
Pathology, 13(1), 41–46.
7. Leung AKC, Robson WLM. (2006). Natal teeth: a review. Journal of the National Medical Association, 98(2), 226-28.
8. Bhutta ZA, Darmstadt GL, Hasan BS, Haws RA (2005). Community-based interventions for improving perinatal and
neonatal health outcomes in developing countries: a review of the evidence. Pediatrics, 115(2), 519–617.
9. Portela MB, Damasceno L, Primo LG. (2004). Unusual case of multiple natal teeth. Journal of Clinical Pediatric
Dentistry, 29(1), 37–39.
10. Zhu J, King D. (1995). Natal and neonatal teeth. ASDC Journal of Dentistry for Children, 62(2), 123-28.
11. Ricci Volpato LE, Damo Simoes CA, Simoes F, Nespolo PA, Borges AH (2015). Riga-Fede Disease Associated with Natal
Teeth: Two Different Approaches in the Same Case. Case Reports in Dentistry Volume, 4.
http://dx.doi.org/10.1155/2015/234961.
12. Farsi JD, Ahmed MM. (2014). Natal and neonatal teeth. Saudi Medical Journal, 35, 499-503.
13. Ulson RCB, Correa MSNP, Lopes LD. (2008). Dente neonatal: relato de caso cl´ınico. Revista do Instituto de Ciencias da
Saude, 26(1), 130-34.
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Meenakshi Bodh et al. / International Journal of Advances in Pediatric Dentistry, 2015;1(1):14-16.

INTERNATIONAL JOURNAL OF ADVANCES IN

Journal homepage: www.mcmed.us/journal/ijapd

Corresponding Author:- Arun Kumar

Article Info ABSTRACT

Figure 1a & 1b.Pre-Operative view shows natal teeth

Figure 2. The appearance of the natal teeth after extraction.

DISCUSSION The most commonly affected teeth are the lower

development of the cells of the dental papilla. Failure to ACKNOWLEDGEMENT: None

CONCLUSION STATEMENT OF HUMAN AND ANIMAL RIGHTS

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