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CASE REPORT
Year : 2019  |  Volume : 12  |  Issue : 1  |  Page : 72-74  

Natal teeth: An overview and case reports


1 Department of Pedodontics and Preventive Dentistry, Government Dental College and Hospital, Nagpur, Maharashtra, India
2 Department of Dental, Sai Sneha Deep Hospital, Nagpur, Maharashtra, India
3 Department of Plastic Reconstructive and Maxillofacial Surgery (Prosthodontist), Government Medical College, Nagpur, Maharashtra, India

Date of Submission19-May-2018
Date of Acceptance24-Jul-2018
Date of Web Publication21-Jan-2019

Correspondence Address:
Arti Dolas
46, Khan Khoje Nagar, Manewada Road, Nagpur, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_80_18

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  Abstract 


Natal teeth and neonatal teeth are rare occurrences. In some parts of the world, they are considered as good omen while in some parts as devil's sign. The history of natal teeth dates way back to 23 BC. It causes difficulty in feeding the infant as well as the feeding mother and also possesses the danger of accidental aspiration. This article presents two case reports where the natal teeth were extracted due to the risk of aspiration.

Keywords: Feeding, mandibular incisor, natal tooth


How to cite this article:
Dolas A, Deshpande N, Bahetwar T, Kalaskar R. Natal teeth: An overview and case reports. Med J DY Patil Vidyapeeth 2019;12:72-4

How to cite this URL:
Dolas A, Deshpande N, Bahetwar T, Kalaskar R. Natal teeth: An overview and case reports. Med J DY Patil Vidyapeeth [serial online] 2019 [cited 2019 Apr 25];12:72-4. Available from: http://www.mjdrdypv.org/text.asp?2019/12/1/72/250449




  Introduction Top


Natal and neonatal teeth were first documented by Titus Livius in 59 BC. He considered natal teeth to be prediction of disastrous events. Caius Plinius Secundus (elder) in 23 BC said that the male infant born with natal or neonatal teeth had a splendid future waiting ahead.[1],[2],[3],[5],[9] In the Indian community, it was considered to be a bad omen. The baby was considered to be unlucky or devils incarnation. The incidence of natal teeth and neonatal teeth ranges from 1:1000 to 1:30,000.[3] There was no difference observed in the prevalence between males and females.[1],[4] The aim of this article is to report two cases of natal teeth as well as to present a comprehensive knowledge about the natal teeth and its management.


  Case Reports Top


Case report 1

A 12-day-old female infant was referred to the Department of Pedodontics and Preventive Dentistry with the chief complaint of loose teeth in the lower front region of the jaw since birth and the inability to suck mother's milk. Interviewing the mother revealed that it was her first-born child and she was worried due to the social stigma that the child born with teeth is unlucky. A detailed medical history was taken, which revealed that the delivery was normal vaginal delivery and the perinatal history was normal and the patient was nonsyndromic. On intraoral examination, there was presence of two natal teeth loosely attached to gingiva in the mandibular anterior region with severe mobility [Figure 1]a. There was a danger of aspiration of these teeth, due to which decision to extract them immediately was made. Parents were informed about the chances of the absence of permanent central incisor in the future, as it was difficult to take intraoral periapical radiograph to rule out whether the natal tooth belongs to permanent dentition or was supernumerary. As the patient was 12 days old and had already taken her Vitamin K supplement, no Vitamin K was administered that day. Extraction was carried out using 2% lignocaine with adrenaline local infiltration technique after application of topical anesthesia [Figure 1]b. A careful curettage of the sockets was done to remove any odontogenic remnants [Figure 1]c. Postoperative hemostasis was achieved and postoperative instructions were given. The patient was recalled after 1 week and the healing was found to be uneventful.
Figure 1: (a) Intraoral photograph of 12-day-old infant showing two natal teeth in the mandibular anterior region. (b) Natal teeth after extraction. (c) Postextraction photograph after achieving hemostasis

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Case report 2

A 10-day-old male infant was referred to the Department of Pedodontics and Preventive Dentistry with a chief complaint of a tooth in the lower front region of the jaw since birth which was interfering with feeding and causing discomfort to the mother. A detailed medical history was taken which revealed that the delivery was normal vaginal delivery and the perinatal history was normal and the patient was nonsyndromic. On intraoral examination, there was presence of one natal tooth loosely attached to gingiva in the mandibular anterior region with moderate mobility [Figure 2]a. As the tooth was mobile and caused discomfort to the mother, a decision to extract the tooth was made. Parents were informed about the chances of the absence of permanent central incisor in the future, as it was difficult to take intraoral periapical radiograph to rule out whether the natal tooth belongs to permanent dentition or was supernumerary. The patient was 10 days old and had already taken her Vitamin K supplement at birth, so no Vitamin K was administered on the day of extraction. Complete hemogram was advised before going for extraction which was reported to be normal. Extraction was carried out using 2% lignocaine with adrenaline local infiltration technique after the application of topical anesthesia [Figure 2]b. A careful curettage of the sockets was done to remove any odontogenic remnants [Figure 2]c. Postoperative hemostasis was achieved and postoperative instructions were given. The patient was recalled after 1 week and the healing was found to be uneventful.
Figure 2: (a) Intraoral photograph of 10-day-old infant showing one natal tooth in the mandibular anterior region. (b) Natal teeth after extraction. (c) Postextraction photograph after achieving hemostasis

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  Discussion Top


Bodenhoff and Gorlin reported that 85% of teeth are found in the mandibular incisor region, followed by 11% in the maxillary incisor region, 3% in the mandibular canine and molar region, and 1% in the maxillary canine and molar region.[3],[6],[8],[9] In 61% of cases, the teeth are double or in pairs and mostly correspond to normal primary dentition in 95% cases, while 5% are supernumerary.[1] The etiology of natal and neonatal teeth is still unknown. There are various hypothetical factors reported in literature by investigators which include the superficial position of tooth germ associated with hereditary factor, poor maternal health, maternal exposure to environmental toxins, endocrine disturbances, infections, and febrile episodes during pregnancy causing accelerated eruption.[1],[2],[3],[6] Different terminologies such as predeciduous teeth, dentitia praecox, and dens connatalis have been described in the literature. The currently adopted terms are “natal” and “neonatal” teeth given by Massler and Savara.[1],[2],[3],[5],[6],[7] Clinically natal or neonatal teeth are conical or normal in shape and yellowish brown/whitish opaque in color depending on the degree of maturity.[1],[2],[3],[6] They are usually attached to soft-tissue pad above the alveolar ridge, occasionally covered by the mucosa which results in exaggerated mobility.[2],[3],[6] Supernumerary tooth may be differentiated from the primary tooth using occlusal or periapical radiographs. However, there is difficulty in proper positioning of film in the mouth of newborn and during growth and development phase primary teeth undergo initiation of crown calcification which makes radiographic interpretation difficult.[3] Different factors are considered for management of natal or neonatal teeth which include implantation, degree of mobility, inconvenience to the infant during suckling, interference with breastfeeding, possibility of traumatic injury to mother's breast, or to the ventral surface of tongue of the infant.[1],[2] If the tooth is well implanted, it is better to leave the tooth as it is, unless it causes any trauma to mother or the infant. If the tooth is not well implanted or is mobile, it is advisable to perform extraction to avoid the risk of aspiration. Other options include smoothening of incisal edges, covering of incisal edges with composite resin, and feeding plate all of which prevents wounding of the maternal breast as well as the tongue of the infant.[1],[2],[3] If the treatment option is extraction, it is better to avoid extraction up to 10th day of life to prevent hemorrhage because the commensal flora of the intestine is not established to produce Vitamin K which in turn is required for production of prothrombin in the liver. If it is not possible to wait for 10 days, then it is advisable to assess the need to administer Vitamin K before extraction and assess the general health of the patient and then vitamin K (0.5–1.0 mg) should be administered intramuscularly as a part of immediate medical care to prevent hemorrhage.[1],[2],[3],[6],[7],[8],[9]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Cunha RF, Boer FA, Torriani DD, Frossard WT. Natal and neonatal teeth: Review of the literature. Pediatr Dent 2001;23:158-62.  Back to cited text no. 1
    
2.
Ardeshana A, Bargale S, Karri A, Dave B. Dentitia praecox-Natal teeth: A case report and review. J Appl Dental Med Sci 2016;2:44-51.  Back to cited text no. 2
    
3.
Anegundi RT, Sudha R, Kaveri H, Sadanand K. Natal and neonatal teeth: A report of four cases. J Indian Soc Pedod Prev Dent 2002;20:86-92.  Back to cited text no. 3
[PUBMED]    
4.
Kana A, Markou L, Arhakis A, Kotsanos N. Natal and neonatal teeth: A systematic review of prevalence and management. Eur J Paediatr Dent 2013;14:27-32.  Back to cited text no. 4
    
5.
Bodenhoff J, Gorlin RJ. Natal and neonatal Teeth: Folklore and Fact. Pediatrics 1963;32:1087-93.  Back to cited text no. 5
    
6.
Rao RS, Mathad SV. Natal teeth: Case report and review of literature. J Oral Maxillofac Pathol 2009;13:41-6.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Nirmala SV, Prabhu RV, Veluru S, Tharay N, Kolli NK. Natal teeth-A case report with decision support system. J Pediatr Neonatal Care 2015;2:00073.  Back to cited text no. 7
    
8.
Sothinathan R, Shakib K. Natal teeth: A sign of fortuity or grave misfortune. Br Dent J 2011;210:265-6.  Back to cited text no. 8
    
9.
Khandelwal V, Nayak UA, Nayak PA, Bafna Y. Management of an infant having natal teeth. BMJ Case Rep 2013;2013. pii: bcr2013010049.  Back to cited text no. 9
    


    Figures

  [Figure 1], [Figure 2]



 

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