Symptoms
The most obvious symptom is the presence of one or more teeth in the newborn's mouth. These teeth are usually located in the lower central incisor region (lower front teeth). They may be:
Loose or firmly attached.
Normally shaped or conical/peg-shaped.
Fully erupted or only partially visible.
May cause discomfort to the infant during breastfeeding.
May cause ulceration on the infant's tongue (Riga-Fede disease) or the mother's nipple during breastfeeding.
Causes
The exact cause of natal teeth is often unknown, but several factors may be associated with their development:
Genetics: There may be a hereditary component, with a family history of natal teeth or other dental anomalies.
Superficial positioning of the tooth bud: The tooth bud may be located closer to the surface of the gum, causing it to erupt prematurely.
Certain medical conditions: Natal teeth are sometimes associated with conditions like Ellis-van Creveld syndrome, Hallermann-Streiff syndrome, Pierre Robin syndrome, cleft palate, and others but this is less common.
Hormonal influences: Hormonal imbalances or disturbances during pregnancy might play a role, though this is not fully understood.
Malnutrition: Inadequate nutrition during fetal development is suspected to cause natal teeth.
Medicine Used
There is no specific medication used to "treat" natal teeth. Management focuses on addressing any complications or discomfort.
Analgesics: If the tooth is causing pain or discomfort, a doctor might recommend infant-safe pain relievers like acetaminophen (Tylenol) or ibuprofen (Motrin) in appropriate doses.
Topical Anesthetics: In some cases, a topical anesthetic gel may be recommended to numb the area and relieve discomfort. However, this should only be used under the direction of a healthcare professional due to potential risks of over-application in infants.
Is Communicable
Natal teeth are not communicable. They are a developmental anomaly, not an infectious disease.
Precautions
Monitor for feeding difficulties: If the natal tooth is interfering with breastfeeding or bottle-feeding, consult a lactation consultant or pediatrician.
Prevent tongue ulceration: Observe the infant's tongue for signs of Riga-Fede disease (ulceration caused by the tooth rubbing against the tongue). A dentist may smooth the tooth or consider extraction if this is a problem.
Protect the mother's nipple: If the tooth is causing pain or damage to the mother's nipple during breastfeeding, use a nipple shield or consult a lactation consultant for alternative feeding positions.
Prevent aspiration: If the tooth is very loose, there's a risk of it falling out and being aspirated (inhaled) by the infant. In these cases, extraction may be recommended.
Careful oral hygiene: Gently clean the tooth with a soft cloth or infant toothbrush.
How long does an outbreak last?
There is no "outbreak" associated with natal teeth. The tooth is present at birth, and the primary concern is its management and potential complications, which can last until the tooth is addressed (either extracted or remains in place).
How is it diagnosed?
Diagnosis is typically made through a visual examination of the newborn's mouth. X-rays are sometimes taken to determine if the tooth is a primary tooth or a supernumerary tooth, and to assess the root development.
Timeline of Symptoms
At birth: The tooth is present.
First few days/weeks: Potential feeding difficulties, tongue ulceration, or nipple pain may become apparent.
Ongoing: If the tooth remains, monitor for any ongoing complications or issues with oral hygiene.
Important Considerations
Consultation with professionals: It's crucial to consult with both a pediatrician and a pediatric dentist for evaluation and management.
Extraction vs. retention: The decision to extract or retain the tooth depends on factors like its mobility, interference with feeding, risk of aspiration, and potential for tongue ulceration.
Long-term dental care: If the natal tooth is a primary tooth that is extracted, the dentist will monitor the development of the permanent teeth to ensure proper eruption.
Riga-Fede disease treatment: Treatment for Riga-Fede disease is typically smoothing the edges of the tooth so that it doesn't rub against the tongue. If smoothing doesn't fix it then extraction is considered.