2. Natal teeth
Teeth that are present at
birth are known as Natal
teeth
Neonatal teeth
Teeth which errupt
during neonate period,
from birth to 30 days are
called Neonatal teeth
3. Natal teeth
They are also
referred to as
Congenital
teeth, Fetal
teeth or
Dentition
Praecox
5. Kates (1984) reporting a 66% proportion for females
against a 31%proportion for males.
Natal teeth > Neonatal teeth
According to Bodenhoff and Gorlin (1963), the teeth
most affected are
1. Mandibular Incisors 85%
8. The presence of natal and neonatal teeth is definitely a
disturbance of biological chronology whose etiology is
still unknown.
Hypovitaminosis
Hormonal stimulation
Trauma
Febrile states
Syphilis
The current concept suggest that natal and neonatal teeth
are attributed to the superficial position of the developing
tooth germ which predisposes the tooth to erupt early
9. Boyd and Meles used and anatomical section and a
radiograph of the fetal mandible to demonstrate that
the tooth was not localized in an alveolus but slightly
below the surface of the alveolar bone, very much
above the germ of its permanent successor
Hereditary transmission of a dominant autosomal
gene
Osteoblastic activity inside the germ area related
to the remodeling phenomenon
10. Leung (1986) in a 17-year retrospective study of 50,892
records for children born at the Foothills Provincial
Hospital,
Calgary, Canada, detected the occurrence of natal teeth
in 15
infants, 5 of whom presented one of the following
anomalies:
cleft palate, Pierre Robin syndrome. Ellis-van Creveld
syndrome,
hypocalcemia with fracture of the ribs and rickets, and
adrenogenital syndrome with 18-hydroxylase deficiency.
11. Fauconnier and Gerardy (1953)24 presented an excellent
discussion of the difference between “early eruption” and “premature
eruption” in which they also proposed an etiology of
natal and neonatal teeth. They considered “early eruption” to
be that occurring because of changes in the endocrine system,
whereas “premature eruption” would be a clearly pathological
phenomenon with the formation of an incomplete rootless
tooth that would exfoliate within a short period of time. This
structure, designated “expulsive Capdepont follicle,” may result
from trauma to the alveolar margin during delivery, with
the resulting ulcer acting as a route of infection up to the dental
follicle through the gubernacular canal, causing premature
loss of the tooth.
12. 1. Ellis Van Creveld Syndrome or Chondroectodermal
dysplasia
2. Hallermann-Streiff Syndrome
13. Riga Fede Syndrome or neonatal sublingual traumatic
ulceration
15. Natal and neonatal teeth may resemble normal
primary teeth but in many instances they are
1. Poorly develpoed
2. Small
3. Conical
4. Yellowish
5. With hypoplastic enamel and dentin
6. Poor or Total Failure of development of roots
17. Category 1
A shell like crown
structure loosely
attached to the
alveolus by a rim of
oral mucosa, no
roots
18. Category 2
A solid crown loosely
attached to the
alveolus by oral
mucosa, little or no
root
19. Category 3
The incisal edge of
the crown just
erupted through the
oral mucosa
20. Category 4
A mucosal swelling
with the tooth
unerrupted but
palpable
21. It has been recommended that natal teeth of category 1
2 are candidates for extraction if mobility is moretan 2
mm as the could become hypermobile and may be
danger of Aspiration
22. 1. Traumatic ulceration on the ventral surface of tongue
2. Ulceration on the Sublingual area (Riga Fede
disease)
23. The importance of a correct diagnosis of natal and neonatal
teeth has been pointed out by several investigators1,9,26,31,32,33
who used clinical and radiographic findings in order to determine
whether these teeth belonged to the normal dentition or
were supernumerary, so that no indiscriminate extractions
would be performed.
A radiographic verification of the relationship between a
natal and/or neonatal tooth and adjacent structures, nearby
teeth, and the presence or absence of a germ in the primary
tooth area would determine whether or not the latter belongs
to the normal dentition.33 It should be pointed out that most
natal and neonatal teeth are primary teeth of the normal dentition
and not supernumerary teeth.6 These teeth are usually
located in the region of the lower incisors,5, 34 are double in 61%
of cases 4, 14 and correspond to teeth of the normal primary
dentition in 95% of cases, while 5% are supernumerary.29
Ooshima et al (1986)35 emphasized that multiple natal teeth
are extremely rare
24. After clinical diagnosis Radiographs must be taken to
determine root development
King and Lee recommended that inflamed gingival
tissue around teeth should be controlled by applying
chlorhexidine gluconate gel 3 times a day
25. In some cases sharpe incisal edge of tooth may cause
laceration of the lingual surface of the toungue and
selective grinding of tooth is advised in such
conditions
26. Most prematurely erupted teeth are hypermoblie
because of the limited root formation and
development
Some teeth may be mobile to the extent that there is a
danger of aspiration in which case removal of the
tooth is indicated
If extraction is indicated, after the tooth is removed,
careful Curttage of Socket is indicated
In an attempt to remove all odontogenic cellular
remnants that may otherwise be left in the extraction
site
27. Such remnants may subsequently develop a typical
tooth like structure that requires additional treatment
28. Earlier it was recommended to delay surgical
procedures untill after 10th postpartum due to inability
of clotting in newborns
Now a prophylactic dose of Vit K is given as standard
procedure
29. Eruuption of neonatal teeth may cause difficulties for a
mother who wishes to breastfeed her infant
If breastfeeding is painfull initially, breast pump and
bottling the milk are indicated
30. The preferable approach is however to leave the tooth
in place and to explain to the parents the desireability
of maintaining this tooth in the mouth because of its
importance in the growth
Adjascent teeth would erupt within a short time and
the prematurely erupted teeth will become stabilized
as the others teeth in the arch will erupt
