When a baby is born with a tooth, it’s called a natal tooth. Though natal teeth are rare, they do happen. “A parent may be alarmed to see these teeth, but there’s rarely a reason for concern,” says Greg Grillo, DDS, of Express Dentist. “A consultation with a pediatrician is always a good idea to explore any risks or underlying conditions.” Let’s take a look at what parents need to know about natal teeth, what causes them, and what you should do if your baby has them.
What Are Natal Teeth?
Most babies will get their first teeth at about six months of age, but in rare instances babies may start getting teeth even sooner. When babies get teeth within the first 30 days after birth, these are called neonatal teeth. But some babies get teeth even earlier than that! When a baby gets teeth while in utero and is born with them, they are called natal teeth. Parents who notice a tooth (or teeth) in their baby’s mouth at birth may feel shocked and concerned. “Most parents, especially new parents, have been preparing for their child’s birth,” says Carla Ann Tornatore, D.D.S., director of pediatric dentistry and assistant professor of dental medicine at Touro College of Dental Medicine. “They are prepared for tooth eruption to take place at about 6 months of age. So, spotting a tooth in their newborn’s smile can be a bit unsettling.” Natal teeth are uncommon, says Margaret Madonian, DDS, pediatric and special needs dentist. But they are not completely unheard of. “Being born with teeth seems rare, but it happens approximately one out of every 3,000 births,” she says. Most natal teeth erupt on a baby’s lower gum line, and the prevalence of natal teeth has been estimated to be anywhere between 1 in 716 births to 1 in 3500 births. Female babies may be more likely to have a natal tooth than a male baby, though some researchers are doubtful that natal teeth are dominant in one sex over the other.
How Natal Teeth Look
You can identify a natal tooth by the fact that it was present when your baby was born. But that’s not the only clue. Natal teeth usually have a particular look. “They’re usually identified by their altered appearance and because they’re immediately visible after birth,” says Dr. Grillo. “They tend to be underdeveloped with incomplete root formation, and they’re often discolored.” The fact that natal teeth are often loose may pose a health concern, and if that’s the case for your baby, you should visit a pediatric dentist. “They are at risk of falling out and although rare, are at risk of being inhaled into the lungs,” Dr. Madonian warns.
Causes of Natal Teeth
No one knows for sure what causes natal teeth, says Jonathan Blau, MD, director of neonatology at Staten Island University Hospital. Natal teeth are more common in babies who have certain medical conditions, including Sotos syndrome, Ellis-van Creveld syndrome, pachyonychia congenita, and Hallermann-Streiff syndrome, says Dr. Blau. “They can also be more common in premature infants,” Dr. Blau explains. “However, natal teeth can definitely occur in healthy term newborns without any underlying medical conditions.” Other underlying conditions that may be linked to natal teeth include cleft lips and palates, Pierre-Robin, ectodermal dysplasia, and craniofacial dysostosis. Some sources have suggested that natal teeth may be hereditary. Either way, experts agree that there is not enough research to suggest clear connections between any of these. “It’s not clear why these teeth form,” says Dr. Grillo. “Some research suggests they could be linked to certain syndromes, such as Sotos syndrome. But these associations are inconclusive.”
Possible Complications
There are a few possible complications when it comes to natal teeth, including a baby accidentally swallowing the tooth, feeding issues, and injuries to a baby’s tongue. Dr. Madonian says one of the most common concerns is related to feeding, especially breastfeeding. “Natal teeth can be painful to the nursing parent, as well as to the baby,” she explains. Teeth that erupt before birth and neonatally can make it difficult for babies to suck properly and cause nipple pain for breastfeeding parents. If a natal tooth is causing any of these issues, a pediatric dentist will need to get involved, says Dr. Madonian. “The treatments can range from smoothing or bonding the teeth if they are stable enough and causing feeding difficulties, to removing the natal teeth if at risk of aspiration,” she explains.
How Natal Teeth Are Treated
The treatment plan for your baby’s natal teeth will depend on several factors, including how much the tooth is interfering with feeding, whether or not the tooth is hurting your baby’s mouth or tongue, and how loose it is. Dr. Grillo says that in most instances, no intervention is needed for natal teeth. “However, if there is discomfort or a concern about dislodgement and inhalation, the pediatrician may recommend removing the tooth,” he explains. Dr. Madonian agrees. “If the teeth are stable and not causing feeding problems, they may be able to be retained until they are ready to fall out naturally,” she says. Still, she recommends you and your child’s dentist monitor the situation. Importantly, as Dr. Tornatore points out, the majority of natal teeth are actually your baby’s primary tooth, meaning that these teeth are not extra teeth, and will stick around throughout your child’s early childhood. “Therefore, keeping this tooth would be the first choice as long as it will not cause any harm to the infant,” she says. If your dentist has not elected to remove the natal tooth, you need to care for it as you would any tooth. “These teeth need to be monitored closely for caries prevention,” Dr. Tornatore explains. “Regular dental check-ups along with good oral hygiene instructions are essential.”
A Word From Verywell
It’s totally understandable if the appearance of a tooth in your newborn’s mouth is distressing! That’s a common and completely OK reaction. Still, it’s important to keep in mind that while natal teeth are uncommon, they usually don’t present many issues. That being said, if your baby does have a natal tooth, you should visit your pediatrician or a pediatric dentist for a consultation so that the situation can be monitored.
