Baby Born with Teeth: Is This Normal?

Teething is a normal part of a baby’s development during the first year of life. Most babies get their first tooth between 4 and 7 months of age. The first teeth that poke through the gums are the central incisors, which are located on the bottom front.

While most infants get their first teeth months after birth, some babies are born with one or more teeth. These are called natal teeth. Natal teeth are relatively rare, occurring in about 1 out of every 2,000 births.

It can be a shock if your baby is born with teeth. But you don’t need to worry or take action unless the teeth interfere with feeding, or are a choking hazard. Your pediatrician can help advise you about what to do.

Natal teeth can seem mysterious, but there are certain conditions that can increase the chances of babies being born with teeth. These teeth may be seen in babies with a cleft palate or lip. Babies who are born with irregularities in dentin (the calcified tissues that help form teeth) may also have natal teeth.

There are underlying medical issues that may cause natal teeth. These include the following syndromes:

• Sotos
• Hallerman-Streiff
• Pierre Robin
• Ellis-van Creveld

In addition to certain medical conditions, there are a few risk factors that may increase a baby’s chances of being born with teeth. About 15 percent of babies born with teeth have close family members that had natal teeth when they were born, too. These include siblings and parents.

While there are conflicting studies on the role of gender and natal teeth, females seem to be more likely to be born with teeth than males.

Malnutrition during pregnancy is another possible risk factor.

While some babies are born with teeth, the situation isn’t always so clear cut. There are four types of natal teeth. Your doctor can determine which case your baby has:

• fully developed, though loose, crowns affixed to a few root structures
• loose teeth that don’t have any roots at all
• small teeth just emerging from the gums
• evidence of teeth about to cut through the gums

Most cases of natal teeth involve just one tooth. Being born with multiple teeth is even more rare. Lower front teeth are the most common, followed by upper front teeth. Less than 1 percent of babies with natal teeth are born with molars.

The exact type of teeth your newborn has will determine the risk for complications. This will also help your doctor determine if treatment is necessary.

Some babies aren’t born with teeth, but get them shortly after birth. Generally seen within the first month of life, teeth that emerge soon after birth are called neonatal teeth.

According to the journal Pediatrics, neonatal teeth are even more rare than natal teeth. In other words, your baby has a higher chance (though rare) of being born with teeth than getting teeth a few weeks after birth.

Symptoms of teething can start as early as 3 months of age. But in these cases, your baby won’t get any actual teeth for a month or more after that. Neonatal teeth appear so quickly after birth that your baby may not exhibit the normal telltale signs of teething like drooling, fussiness, and biting their fingers.

Natal teeth that aren’t loose are usually left alone. But if your baby is born with loose teeth that have no roots, your doctor might recommend surgical removal. These types of natal teeth can put your baby at risk for:

• choking from accidental swallowing of the loose tooth
• feeding problems
• tongue injuries
• injuries to the mother during breast-feeding

A loose tooth will be looked at via X-ray to determine whether a solid root structure is present. If no such structure exists, removal may be necessary.

Being born with teeth is rare, but it’s possible. If your baby has teeth at birth, be sure to talk to your pediatrician. Any loose teeth may need surgical removal to prevent hazards and health complications.

A pediatric dentist can help guide you through the process. Even if your newborn’s teeth aren’t considered an immediate concern, it’s important to monitor them to prevent any complications.

Can Babies Be Born With Teeth?

Did you know that babies can be born with teeth? Natal teeth (i. e., teeth that are present at birth) are relatively rare, though less rare than you might think. Approximately one out of every 2,000 to 3,500 newborns comes into the world with at least one tooth.

But if you’re imagining a newborn smiling up at his mother with a full set of teeth, you should know that babies with natal teeth are usually born with no more than two teeth. A few babies have arrived with a much more substantial portion of their primary (“baby”) teeth present, but no cases of newborns with a full set of teeth have been reported.

Regardless of their number, natal teeth present special dental concerns and may require specialized care. In this article, we will discuss

• the difference between natal and neonatal teeth,
• characteristics of natal teeth,
• whether natal teeth are the same as baby teeth,
• causes of natal teeth,
• complications associated with natal teeth,
• when natal teeth should be removed, and
• considerations related to caring for natal teeth.

Differences Between Natal Teeth and Neonatal Teeth in Babies?

Whereas a natal tooth is present at birth, a neonatal tooth erupts during the first 30 days of an infant’s life. Natal and neonatal teeth present extremely similar issues and are generally studied and discussed together. The following information applies to both natal and neonatal teeth.

What Are Natal Teeth Like In Newborns?

In some cases, natal teeth look like normal primary teeth. Often, however, they are somewhat underdeveloped. For example, natal teeth may be smaller than normal primary teeth and/or cone-shaped. Their enamel (the tooth’s hard, protective outer coating) is often hypoplastic, meaning that it is thin or even absent; hypomineralized, meaning that the enamel is softer than normal; and/or hypomatured, resulting in tooth discoloration. Additionally, natal teeth typically have underdeveloped roots and are at least slightly mobile; sometimes their roots are so underdeveloped that the natal teeth fall out while the baby is still very young.

Just as with older babies, the lower central incisors (the bottom front teeth) are usually the first teeth to erupt in newborns. As described below, this can sometimes result in feeding issues.

Are Natal Teeth Primary Teeth?

Sometimes parents wonder whether natal teeth are a sort of temporary tooth that will fall out and then later be replaced by primary teeth. They are not.

The vast majority of natal teeth are simply ordinary primary teeth that erupt unusually early. The remainder are a type of tooth known as a supernumerary tooth. A full set of primary teeth consists of twenty teeth, but occasionally children grow more than twenty. These excess teeth are known as supernumerary teeth and can lead to overcrowding and bite issues.

Fewer than 10% of natal teeth are supernumerary teeth. A pediatric dentist can use dental X-rays to determine whether a natal tooth is supernumerary.

What Causes Natal Teeth?

The precise cause of natal teeth in newborns is unknown. Researchers have theorized that they may be a result of genetics, fever, infection or malnutrition, but so far no studies have been able to confirm the cause. Interestingly, various studies have reported that between 8% and 62% of infants with natal teeth had a positive family history.

Researchers have suggested that certain other medical conditions may be associated with natal teeth, including the following:

• Cleft lip and palate,
• Sotos syndrome,
• Ellis-van Creveld syndrome (chondroectodermal dysplasia),
• Hallermann-Streiff syndrome (oculomandibulofacial syndrome with hypotrichosis), and
• Jadassohn-Lewandowsky syndrome (congenital pachyonychia).

Cleft lip and palate may be the most common of the medical conditions associated with natal teeth, and the incidence of natal teeth among cleft lip and palate patients is significantly higher than among the general population. One study found that approximately 30% of the bilateral cleft lip and palate infants studied and 5% of the unilateral cleft lip and palate infants had natal or neonatal teeth. Another found that approximately 11% of the bilateral cleft lip and palate infants studied and 2% of the unilateral cleft lip and palate infants had natal or neonatal teeth.

Complications Associated with Natal Teeth

Aspiration Risk. Natal teeth that are highly mobile can fall out spontaneously and therefore may present an aspiration risk. The chances that a child will aspirate (i.e., inhale) a natal tooth is believed to be extremely low. However, because an aspirated tooth can cause potentially serious respiratory issues, including obstruction of the child’s airways, the possibility of aspiration should be considered.

Feeding Difficulties. Natal teeth can cause discomfort (for the baby and/or the mother) during nursing. In some cases, babies may develop an ulceration of the tongue known as traumatic lingual ulceration or Riga-Fede disease. This condition is often associated with lower incisor (bottom front) natal teeth. As natal teeth may be sharp and cone-shaped, movement of the tongue backward and forward during nursing can lead to an ulcer on the underside of the tongue. Riga-Fede disease typically presents as an open sore that can develop into a fibrous mass on the tongue, and it can make feeding painful or difficult for affected infants.

Crowding and Displacement. If the natal tooth is a supernumerary tooth, it may cause issues when the child’s other teeth come in. For example, supernumerary teeth can cause crowding issues and they can cause permanent teeth to come in incorrectly or to not come in at all.

Cavities. If the natal tooth has enamel hypoplasia or hypomineralization, it is at higher risk of developing cavities than a tooth without enamel defects. 

Do Natal Teeth Need to Be Removed?

It depends. When natal teeth are supernumerary, they generally should be removed. Your child’s pediatric dentist can diagnose a supernumerary tooth and help determine the appropriate time for the extraction.

In contrast, when a natal tooth is part of the normal primary dentition (i.e., is one of a child’s twenty primary teeth), it is best to save the tooth when possible.

Primary teeth are extremely important – they help children to chew food and to speak clearly, and they help permanent teeth to come in correctly. And unlike missing permanent teeth, a missing primary tooth cannot be replaced with dental implants, as an implant can prevent the replacement permanent tooth from erupting properly. This means that, when a natal tooth that is part of the normal dentition is removed, the child will have to live without that tooth until the replacement permanent tooth comes in (typically six to twelve years, depending on the location of the tooth).

Natal teeth that are causing feeding difficulties can often be managed by grinding or polishing down any sharp edges on the tooth or by applying a small amount of composite resin (white filling material) over the tooth to smooth it. Smoothing out rough edges in this way may prevent trauma and allow ulcerations associated with Riga-Fede disease to heal.

That said, sometimes natal teeth removal is recommended. If smoothing down the tooth is not sufficient to eliminate feeding issues, extraction may be required. Additionally, natal teeth that are highly mobile are often extracted to prevent potential aspiration.

Extraction of natal teeth should be performed by a pediatric dentist who has familiarity with natal teeth. The extraction should be followed by removal of the soft tissue lining of the tooth socket in order to prevent continued root development.

Natal Teeth Management

Natal teeth that are not extracted may require special care and monitoring. Natal teeth with enamel defects are at increased risk for cavities. A pediatric dentist can teach you how to properly clean natal teeth and can closely monitor them for signs of decay.

Board-Certified Pediatric Dentist in DFW

If your child is born with natal teeth or grows teeth during the first month of life, visit a pediatric dentist right away. Hurst Pediatric Dentistry’s Dr. Lin is a board-certified pediatric dentist who has experience handling natal teeth. Call (817) 510-6400 today to book an appointment to learn how to care for your child’s natal teeth and to see whether any treatments are advisable.

Hurst Pediatric Dentistry is located in Hurst, Texas and serves pediatric patients from Hurst, Euless, Bedford, North Richland Hills, Keller, Colleyville, Southlake, Westlake, Fort Worth, Saginaw, The Colony and the surrounding area.

This article is intended to provide general information about oral health topics. It should not be used to diagnose or treat any medical condition or as a substitute for the advice of a healthcare professional who is fully aware of and familiar with the specifics of your case. Always seek the advice of your dentist or other qualified healthcare provider with regard to any questions you may have relating to a medical condition or treatment.

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When do baby’s first teeth erupt?

All babies teething according to their own individual program: for some, this process begins earlier, for others later. As practice shows, the first tooth in most children appears at the age of 6 to 8.5 months, and by the year every healthy child has at least one milk tooth in his mouth.

At the age of three or four months, teeth preparing for eruption begin to actively declare themselves: the baby becomes capricious, cries, tries to bite everything that gets into his hands.

The first to appear are usually the two lower, centrally located teeth (lower central incisors or “ones”). Then – the central upper incisors, after which, by about ten months, the upper “twos”, or lateral upper incisors, erupt. By eleven to twelve months, the lateral incisors can also be seen on the lower jaw. Thus, ideally, a one-year-old child is the proud owner of eight milk teeth.

By about sixteen months, many babies already have first molars on the bottom and top. Fangs (“threes”) appear at the top and bottom later, in the eighteenth – twenty-second month of a child’s life. The second upper and lower molars erupt at the age of 24-33 months. But again, it should be remembered that this process is individual and the order of teething may also be different.

Teeth often grow in pairs: two, and sometimes four at the same time. In girls, for the most part, teeth erupt earlier than in boys. By the age of 2.5-3 years, a complete set of twenty fully erupted teeth can be found in a baby.

Alertness must be shown if a child who is almost a year old does not have a single tooth. In principle, some children may have a congenital feature in the form of late teething, but you should not draw any conclusions on your own, you should definitely consult with a qualified specialist who, if necessary, will prescribe additional examinations.

Causes of late teething in children:

• hereditary predisposition, which is a variant of the norm and can be traced in other blood relatives;
• decreased thyroid function;
• rickets;
• diseases of the digestive system;
• violations of enzymatic (fermentation) metabolism;
• pituitary insufficiency;
• lack of calcium in the child’s body;
• genetically determined diseases.

For the baby himself, the process of teething can proceed in different ways. Some children practically do not experience discomfort, others suffer from pain, their sleep is disturbed, their appetite worsens, their temperature rises (up to 38-39 ° C), salivation increases, nasal congestion, wet cough (due to profuse salivation), constipation or, conversely, , increased stool.

Experts recommend starting caring for the child’s oral cavity even before the first teeth erupt: in the morning and evening, before going to bed, the child’s gums should be gently wiped with a swab previously moistened with warm water. After the first teeth appear, you need to clean them with a special fingertip brush, which can also be used to massage the gum tissue. The front teeth should be cleaned with vertical movements, the side teeth with circular movements.

The network of Healthy Smile dental clinics employs experienced pediatric dentists, to whom you can book your baby for a free consultation.

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Symptoms of teething in children under one year old and ways to alleviate them

In the first year of life, the child develops rapidly. He learns to sit, crawl, walk. And he also has something that indicates the general physiological development, the maturation of the digestive system. He is preparing to move from eating exclusively milk or formula to a new stage – to the use of semi-solid and solid foods and the appearance of first milk teeth .

The eruption of the first milk teeth is influenced by genetic characteristics, health, nutrition and other factors. Even the dependence of teething in infants on the region of residence has been established. So, in the northern regions of Russia, there is a frequent deviation from the average terms towards a later eruption of ^[1] .

On average, the first baby tooth appears at 6-7 months. Within three years, all 20 milk teeth will take their place in the dentition. In some babies, teething begins at 4-5 months, someone waits up to 10-12 months. All of this is within the normal range of ^[2] .

There are several theories explaining the process of teething ^[2] :

• Hunter’s theory – pushing the tooth out of the bone alveolus occurs due to the pressure of growing roots;

• Yasvoin’s theory – the appearance of a tooth above the gum provokes processes of differentiation in the tissue of the dental papilla;

• Katz’s theory – an increase in tissue pressure in the area of ​​the bottom of the alveoli directs the tooth to the surface.

But none of them can fully explain this complex mechanism.

By the time of tooth eruption, the area of ​​bone covering the crown of the tooth has been resorbed. The same processes are noted in the gum. During the growth of the tooth root, the bone is also rebuilt and the dental alveoli gradually deepen. At the same time, morphological changes in the tissues surrounding the tooth occur: increased blood flow, changes in vascular permeability, increased production of the main substance of the pulp and periodontium

“Can the physiological process of teething in infants be pathological?” Doctor of Medical Sciences, Professor, Chief Pediatrician of the Central Federal District of the Russian Federation, Honored Doctor of the Russian Federation Zakharova I. N. ^[2]

It is not surprising that the appearance of teeth causes discomfort in children at any age, but this process is especially difficult for babies.

Symptoms of teething in a child

The appearance of milk teeth is a natural physiological process, however, a number of children develop a symptom complex, which, according to the International Classification of Diseases, is classified as teething syndrome (ICD code – K00.7). Numerous surveys of young children say that the most common symptoms accompanying the appearance of teeth are:

• increased salivation — processes in the oral cavity are activated;

• irritability – the child experiences severe discomfort and cannot communicate it otherwise than by changing behavior;

• sleep disturbance – the pain is so severe that the baby cannot sleep or wakes up frequently during the night;

• itching of the gums – children try to compensate for it by trying to bite the breast or nipple, by trying to keep their hands, toys, clothes in their mouths.

Such harbingers of the appearance of a tooth occur in 35-60% of children. But some babies may have non-specific symptoms ^[2] :

On average, symptoms appear 5-8 days before the appearance of a tooth. When teething several teeth at the same time, this, as a rule, increases the discomfort.

Even if the child’s symptoms are very similar to those of teething, a specialist consultation is necessary. Be sure to consult a doctor if diarrhea or fever persists for a long time.

Ways to alleviate discomfort

To ease teething in a baby, it is necessary to:

• provide additional attention and care from parents;

• if the child is breastfed, breastfeed more frequently as this has a mild sedative effect;

• purchase several silicone teethers that can be cooled and offered to the baby during the day;

• massage the gums with a finger wrapped in a clean gauze pad or with a special silicone nozzle;

• blot drool in time with a clean tissue to avoid irritation of the skin around the mouth;

• if necessary and in agreement with the doctor, use medicines.

Today, there are pharmacological and non-pharmacological methods of therapy for the eruption of temporary teeth.

Topical preparations

Pediatricians prescribe gels and ointments as symptomatic relief for severe discomfort associated with teething.

These teething gels and ointments with proven effectiveness are divided into 3 groups ^[1] :

• Anesthetic-based analgesics (lidocaine, choline, benzocaine). Sometimes lidocaine-based preparations include anti-inflammatory or antiseptic components, providing a combined effect of the gel.

• Medicines based on anti-inflammatory or antiseptic agents.

• Preparations based on extracts of medicinal plants. They use extracts of Roman chamomile, boswellia, aloe, marshmallow, Indian ivy, medicinal rhubarb, calendula and other components of plant origin.

Homeopathic teething products are also produced, but their effectiveness has not been scientifically proven ^[1] .

Systemic drugs

In severe pain syndrome, hyperthermia, non-steroidal anti-inflammatory drugs are used, which reduce body temperature and have a systemic analgesic effect. The pediatrician should select the dosage and the drug suitable for the child.

Distractions

These include: the gum massage described above and baby teethers that help your baby temporarily relieve itchy gums.

Inspection of erupted teeth

Swelling and redness of the gums gradually subside as the infant’s teeth erupt and grow, but should be monitored. Normally, the teeth should be evenly located in the dentition, not have whitish or colored spots, irregularities on the enamel.

Violation of the timing, pairing and sequence of eruption of milk teeth can serve as a marker of various diseases and disorders. For example, rickets or hypothyroidism ^[2] . It is important to record the date of appearance of each tooth and its location in the mouth. It is convenient to do this with photos saved in a separate folder on your smartphone.

Erupted Tooth Care Instructions

To brush babies’ teeth, use special silicone fingertips with soft bristles. Toothpaste should be labeled as suitable for young children and free of substances that are harmful if swallowed: high concentrations of fluoride, parabens, sodium lauryl sulfate.

As soon as the first tooth shows above the gum line, it needs special care . Enamel has not yet fully formed, it is very thin, so children’s caries develops rapidly. Only 10% of children manage to avoid caries and adults practically fail ^[5] . Therefore, do not postpone the preventive fight against it.

To maintain the health of milk teeth, some of which will remain with the child until the age of 10-12, it is important to visit the dentist regularly once every 3-4 months. After a year, you need to visit an orthodontist to make sure that the bite develops correctly.

List of sources

1. Zaplatnikov A. L., Kasyanova A.