- Natal teeth These are teeth which are present at birth
Neonatal teethThese are teethwhich erupt within30 days of birth
E tiology –Superficial position of tooth germ increased rate oferuption due to –(iii) Febrile incidence(iv) Hormonal stimulation(v) HeredityEruption could be depends on osteoclasitc activity witharea of the tooth germ.
♦ Incidence –♦ Incidence of Natal & Neonatal teeth has been estimated to be 1:1000 & 1:30,000. It is seen that 85% of natal or neonatal Teeth are mandibular incisor.♦ (1) 11% Maxillary incisor♦ (2) 3% Mandibular cuspids♦ (3) 1% Maxillary cuspids/molar
S yndromes as s ociated with pres ence of natl &neonatal teethThese teeth are reportedly associated with syndromeslike –(iii) Chondroectodermal dysplasia(iv) Hallermann – Streiff syndrome(v) Ellis Van Crevald syndrome(vi) Riga - Fede syndrome
♦ Radiographs– A radiograph should be made to determine the amount of Root development and the relationship of prematurely erupted teeth to its adjacent teeth. One of the parents can hold the X- ray film on the infants mouth during the exposure.♦ Most prematurely erupted teeth are hyper mobile because of the limited root development.
Harmful E ffects –1- Laceration of the lingual surface of tongue.2- Retained Natal/Neonatal teeth may causedifficulties for a mother who wishes to breast-feed herinfant. If breast-feeding is too painful for the motherinitially the use of breast pump and storing the milkare recommended.Management–1- The most important point to consider is whether thenursing mother can adequately establish breastfeeding. If there is traumatization of the nipple or if theventral surface of the infant’s tongue is traumatized,then the tooth should be removed.
2- If the tooth is not too mobile then it should be retained as it can become firm with time as the root continues to develop.2. If tooth is excessively mobile, because of the theoretical risk of aspiration or ingestion it should be electively removed.3. If tooth removal is indicated, care should be taken to extract the entire tooth as the crown only may be removed leaving behind the pulpal tissue ; if this happens, dentin and root will form ; the root will then require removal at a later date.4. The permanent teeth should be unaffected by extraction of primary tooth.
C linical Hint–Extracting Natal & Neonatal Teeth1- When removing these teeth always protect theairways by placing a gauze on the back of the mouth ;they are easily dislodged or dropped. A pair of Spencerwells forceps or similar will provide a firm grip on thetooth to be removed.2. Check the medical history for significant jaundicewhich may predispose to post operative bleeding.