Natal and neonatal teeth: early diagnosis and management.

The eruption of teeth in newborns is a rare disorder of the oral cavity and are called 'natal teeth' when they are present at birth or 'neonatal teeth' when they erupt within the first month of life. In most of these cases, they are prematurely erupted deciduous teeth or supernumerary teeth. Supportive management should be given, to facilitate child's feeding and to prevent further complications, such as aspiration as the tooth could be mobile. This study describes a series of cases that were reported to our department, involving teeth located in the mandibular anterior region either at birth or within a few days after birth. The choice of treatment for each child was based on individual assessment of the case, considering options such as monitoring and extraction along with their associated complications.

Natal and neonatal teeth: a review and case series.

Natal and neonatal teeth are a relatively rare but well-documented phenomenon, with the majority being prematurely erupted teeth of the normal primary dentition. Related complications include feeding issues, traumatic lingual ulceration and risk of aspiration. We present three clinical cases referred to the Paediatric Dentistry Department at Guy's and St Thomas' NHS Foundation Trust and their management. Treatment choice is based on individual assessment of each patient and options include monitoring, smoothing of the teeth or extraction. General dental practitioners should be able to diagnose natal and neonatal teeth and provide initial management in primary care, with referral to secondary care services in more complex cases or those which are likely to require extraction.

Dental Management of Congenital Granular Cell Lesion and Neonatal Teeth: A Case Report.

Congenital granular cell lesion (CGCL) is a rare benign oral cavity tumor in infants. Neonatal teeth are also rare dental anomalies that appear during the first month of life. This report describes a case of eruption of neonatal teeth after surgical excision of CGCL. Surprisingly, residual neonatal teeth erupted after extraction of the neonatal teeth. If neonatal teeth are mobile, they should be carefully extracted with curettage of the underlying tissues of the dental papilla; failure to curette the socket might result in eruption of odontogenic remnants. If neonatal teeth were exfoliated, parents should be informed of the need for regular checkups with a dentist due to possibility of development of residual neonatal teeth.

Oral Reactive Lesions Associated to Incomplete Removal of Natal Teeth: Case Report.

Natal teeth are infrequent at birth. Dental extraction is the most recommended treatment to avoid complications. Reactive soft tissue lesions associated to natal tooth or its incomplete removal are rare. A five-month-old female presented natal teeth #71 and #81 which were removed the day after the birth. The baby evolved with two nodules in the region of #71 and #81, pedunculated, 10 and 9 mm, respectively, covered by a pink mucosa, firm in consistency. Periapical radiography showed two radiopaque areas, suggestive of root fragments. After 30 days the nodule located in the region of #81 became purple in color and ulcerated. Both lesions were removed with high intensity diode laser. Histopathological analysis was compatible with inflammatory fibrous hyperplasia (#71) and pyogenic granuloma (#81). Early diagnosis of oral lesions in newborns by means of histopathological examination and a minimum invasive treatment, such as laser surgery, should be of primary concern.

Riga-Fede disease: A systematic review and report of two cases.

AIM: The term Riga-Fede disease has been used historically to describe traumatic ulceration that occurs on the ventral surface of tongue, buccal mucosa, gum or floor of the tongue in newborns and infants. It is most often associated with natal and neonatal teeth in newborns. The painful symptoms may be absent or acute, up to the point of preventing the baby from feeding. The aim of this work is to offer a description of the therapeutic solutions for the treatment of this pathological condition, with a review of the literature and the report of two cases. MATERIALS: A systematic review of the literature of articles presenting Riga-Fede Disease associated with natal and neonatal teeth was performed following the PRISMA protocol (Prefered Reporting Items for Systematic Reviews and Meta-Analyses). This bibliographic search was performed through two databases, PubMed and Google Scholar. CONCLUSION: Extraction and ameloplasty are the most effective treatments in the resolution of the Riga-Fede disease associated with natal/neonatal teeth. In the case of high dental mobility, resulting in an increased risk of exfoliation and possible tooth ingestion/inhalation, extraction is the therapeutic treatment of choice. When nutrition is not compromised, ameloplasty is the treatment of choice, as it is less invasive and more conservative.

Neonatal teeth: Importance of histological findings in management update.

BACKGROUND: Presence of teeth in a newborn represents a rare finding and a disturbance of biological chronology of teeth. The aim of this paper is to report two cases with neonatal teeth histologically examined. CASE REPORT: In this paper two cases of patients with neonatal teeth are reported and histological examinations of three extracted teeth are described. We report an exceptional finding in one of the neonatal teeth microscopically examined: a massive inflammatory infiltration in the pulp tissue similar to that in pulpitis. RESULTS: The management of natal and neonatal teeth usually includes the extraction in case of ulceration on the tongue or severe tooth mobility to prevent accidental inhalation or feeding disturbances. The presence of an inflammatory infiltration of pulp tissue in one of teeth histologically examined suggests to review the indications for extraction considered to date. CONCLUSION: The management of natal and neonatal teeth should consider the presence of an inflammatory infiltration of pulp tissue. An anamnestic interview is advisable in ordert to deeply investigate about possible behaviours of the child due to pain or discomfort.

Natal teeth: report of two cases.

Presence of teeth at birth or within a month post-delivery is a rare condition. We report here 2 cases to highlight their clinical features and discuss their possible treatment. A 7- days old female newborn with two mandibular central incisors, noticed by the parents at birth, with complaint of continuous crying, inability to suck milk and causing discomfort to the mother. The left incisor was highly mobile justifying its extraction. The second case was a female newborn referred 2 hours after delivery, for a brownish highly mobile mandibular incisor noticed by the pediatrician. Extraction was immediately made to avoid the danger of aspiration. This phenomenon can lead to complications either local such as pain on suckling or general such as undernutrition or asphyxia by aspiration. The decision to maintain or remove these teeth should be assessed in each case independently, based on degree of mobility and interference with breastfeeding.

Accidental displacement of primary anterior teeth following extraction of neonatal teeth.

Eruption of the first tooth at 6 months of age is a significant stage in a child's life. However, the presence of a tooth in the oral cavity of a newborn can lead to a lot of delusions. Natal and neonatal teeth are of utmost importance not only to a dentist but also for a pediatrician due to parental anxiety, folklore superstitions, and numerous complications associated with it. The present case report describes a 1.5 cm × 1.5 cm, slow-growing, soft-tissue gingival mass which developed following the extraction of a tooth-like structure in a 4-month-old male patient. Histological examination revealed that it contained a tooth-like hard tissue intermingled with bone and fibrous tissue. Based on clinical and histological findings, the present case was diagnosed as gingival hyperplasia with displaced tooth buds of 71 and 81, which might be due to chronic irritation or traumatic extraction of the neonatal teeth. No abnormal recurrence of the lesion was detected during the follow-up period. However, postoperative clinical and radiographic photographs further reconfirmed the absence of tooth in relation to 71 and 81.

A comprehensive survey of natal and neonatal teeth in newborns.

OBJECTIVE: To evaluate clinical and histological characteristics and determine the incidence of natal/neonatal teeth in a large Turkish population. SUBJECTS AND METHODS: Among 17,829 newborns, who were hospitalized at the Neonatal Clinic of a governmental Children's Hospital between 2005 and 2011, 27 neonates were diagnosed with erupted teeth, which were examined in terms of location, clinical appearance and mobility. Besides histological evaluation, a positive family history was also recorded. The variables were analyzed using Chi-square test. RESULTS: Thirty-two natal/neonatal teeth were observed in 27 infants. The incidence of both natal and neonatal teeth was found to be 1:660, while the incidences were separately recorded as 1:1,048 and 1:1,782, respectively. The histological examination revealed a thin hypoplastic enamel layer and a normal dentin layer. There was no difference between the two genders in terms of natal/neonatal tooth type, positive family history and tooth morphology (p > 0.05); or between normal and conical shapes with regard to natal/neonatal tooth type, positive family history and tooth color (p > 0.05). CONCLUSIONS: This study exhibited a higher incidence in natal teeth than neonatal teeth. Macroscopic features were not found to be positively related to gender and tooth type.

Diagnosis and Management of Natal and Neonatal Teeth: Case Report of Three Newborns.

Natal and neonatal teeth are rare features that can lead to various issues, from traumatic injuries and feeding difficulties to more severe problems, such as risk of aspiration due to excessive mobility of teeth. The purpose of this paper is to discuss the diagnosis and management of natal and neonatal teeth, and describe three cases of newborns with natal teeth. Decision processes and management are detailed regarding the specificity of each case. Periodic follow-up is recommended to maintain oral health and prevent any issues related to premature loss or eruption of primary teeth. A close collaboration between pediatricians and dentists should be considered in order to allow early diagnosis and efficient treatment.

Management of prematurely erupted teeth in newborns.

The majority of natal and neonatal teeth are prematurely erupted primary teeth, whereas few are supernumerary in origin. They most commonly occur in mandibular central incisor region and often can lead to difficulty to the mother during breast feeding and tongue ulceration in newborn. Moreover, since majority of these have poorly developed roots and are mobile, there is always a fear of aspiration into respiratory passage. Extraction therefore is the most commonly rendered treatment for these teeth. This paper comprises cases of natal and neonatal teeth describing about their clinical characteristics and sequel. This paper has also highlighted the factor which needs to be considered during the management of natal/neonatal teeth and protocol followed at our centre.

Neonatal osteomyelitis: An unusual complication of natal tooth extraction.

Osteomyelitis of mandible, if it affects the neonate presents as a diagnostic and therapeutic challenge to the clinician. Symptoms and signs are often non-specific, and the consequences of a missed diagnosis could lead to long-lasting functional limitations. A rare case of a 52 days old infant with osteomyelitis of the mandible following natal tooth extraction is presented in this report. The diagnosis, pathogenesis and management have been explained. The accompanying review briefly summarizes the main clinical, pathophysiological and radiological aspects of the condition and gives an update on the treatment.

Dientes natales: informe de un caso y revisión de la literatura / Natal teeth: report of a case and review of the literature

Cuando se encuentran dientes presentes al nacimiento es frecuente que los médicos pediatras interconsulten con el odontólogo, dichos dientes reciben el nombre de natales y neonatales de acuerdo con el momento en el cual hacen su aparición, si los dientes se encuentran presentes al nacimiento se les denomina natales y si aparecen durante el primer mes de vida se les llama neonatales. No es raro que los dientes natales y neonatales carezcan de raíz, y debido a su débil unión con eltejido gingival es posible que estos dientes puedan desalojarse y serbroncoaspirados o deglutidos por el menor durante la alimentación al seno materno. Si bien los dientes natales y neonatales no constituyen una entidad patológica per se, existen algunos síndromes genéticos que entre sus características se encuentran los dientes natales o neonatales.

When teeth are present at birth, pediatricians frequently seek the opinionof a dentist. These teeth are known as natal or neonatal depending onwhether they are present at birth or appear during the fi rst month oflife. It is not uncommon for natal and neonatal teeth to have no root,and due to their weak bond to the gingival tissue they can come looseand be breathed in or swallowed by the child during breast feeding.While natal and neonatal teeth are not a pathological entity per se,there are certain genetic syndromes whose features include natal orneonatal teeth.

[Natal and neonatal teeth: Update on current knowledge and treatments]. / Dents natales et néonatales : connaissances actuelles et prise en charge.

Being born with a tooth is indeed possible! Teeth may be present at birth (natal tooth) or they may appear within the 1st month of life (neonatal tooth). In their shape and composition, they look like physiological primary teeth. Of still unknown etiology, natal and neonatal teeth remain an uncommon phenomenon. Hereditary, endocrine, or environmental factors may be involved: no conclusive relationship has been proven. The treatment must be adapted to each tooth and each child. Several treatments are available to dental surgeons: extraction or arch maintenance. The aim of this article is to help doctors and pediatricians understand this phenomenon and provide them with tools to support these children and their parents optimally.

Manejo de dientes natales y neonatales: reporte de dos casos / Management of natal and neonatal teeth: report of two cases

Los dientes natales son órganos dentarios que se presentan al nacimiento, y los neonatales son aquellos que erupcionan durante el primer mes de vida. La etiología exacta es desconocida. El manejo de estos dientes depende de múltiples factores. La extracción está indicada cuando eldiente es un supernumerario o presenta movilidad excesiva debido al riesgo de broncoaspiración. Cuando tienen ligera movilidad, generalmente se estabilizan conforme van erupcionando. El objetivo de este reporte es la presentación de dos casos clínicos de dientes natales yneonatales que se manejaron con abordajes diferentes, el primero demanera conservadora y el segundo con la extracción del órgano dental.

Natal teeth are those present at birth. Those erupting during the fi rst month of life are neonatal teeth. The etiology is not known. Natal teeth management is dependent on multiple factors. If the natal tooth is su-pernumerary, the treatment of choice is extraction; likewise, when the teeth are excessively mobile, extraction is indicated due to the risk of aspiration. When natal teeth are only slightly mobile, they often stabilize soon after eruption. The aim of this report is to present two cases of natal and neonatal teeth that were managed with different approaches; the fi rst with a more conservative treatment and the second one with the extraction of the teeth.

Complication After Extraction of Natal Teeth with Continued Growth of a Dental Papilla.

The purposes of this case report were to describe a growing two-cm gingival mass that developed after natal teeth were extracted in a four-month-old female patient, present a review of the literature on the growth of a gingival mass after the extraction of natal teeth, and illustrate the clinical and histological features that differentiate this condition from other types of gingival masses in infants. Histological examination of the excised mass revealed that it contained tooth-like hard tissue (regular and irregular dentin) that intermingled with bone, dental pulp, and fibrous tissue. We found eight cases from 1962 to 2009 in which a soft-tissue mass with dentin-like hard tissue or a tooth-like structure had developed after the extraction of natal teeth. Based on clinical and histological findings, we deduced that the mass was the result of abnormal growth of a residual dental papilla, including mesenchymal stem cells. Consequently, dentists, obstetricians, gynecologists, and pediatricians should be aware of this potential complication and observe caution before they extract natal teeth.

Diente natal / Natal teeth

Introducción: se denominan dientes natales a aquellos dientes que se encuentran presentes en la cavidad bucal en el momento del nacimiento. Estos constituyen una alteración de erupción precoz y se presenta con más frecuencia en la región de los incisivos centrales inferiores. Dichos dientes pueden ocasionar trastornos en la alimentación, ulceraciones traumáticas sublinguales llamada entonces enfermedad de Riga-Fede y preocupaciones en cuanto a la posible aspiración de los mismos. Objetivo: describir las características de una niña con diente natal y los aspectos más relevantes del diagnóstico y tratamiento. Presentación del caso: a la consulta de odontopediatría se presentó una madre con una niña de un mes de nacida, remitida del Servicio de Pediatría debido a la sospecha de presencia de un diente en el momento de su nacimiento. Dada la dificultad para la lactancia, la gran movilidad del diente y el alto riesgo de desprendimiento, el tratamiento aplicado fue la exodoncia. Conclusiones: el caso presentó un diente natal pequeño y con ningún desarrollo radicular. El tratamiento aplicado fue exodoncia por el grado de movilidad del diente y forma cónica y puntiforme que tenía riesgo de desprendimiento. Por tener un mes de nacida no existía peligro de deficiencia de la coagulación resultante de la síntesis insuficiente de vitamina K que ocurre en los primeros días de vida. Aunque la presencia de diente natal es infrecuente es de gran importancia el conocimiento del diagnóstico y tratamiento del diente natal para el estomatólogo(AU)

Introduction: natal teeth are defined as those teeth that are present in the mouth at the time of birth. Natal teeth form an alteration of early eruption; generally the lower temporary central incisors are the most common tooth affected. These teeth are rare anomalies in newborns that can cause feed disturbances, tongue ulceration (Riga-Fede disease) and risk of aspiration of them.Objective: the aim of this paper is to present a case report of a newborn girl with neonatal tooth and the most relevant aspects concerning the diagnosis and treatment.Clinic Case: a30 -day-old female baby was brought to our department, because she had one tooth at birth. Due to the great mobility it was decided to extract the mobile natal teeth.Comment: natal teeth, in most cases are small and with poor root development. The treatment of these teeth will depend on the degree of tooth mobility and presence of sharp incisal edge.The extraction must do after of the first weeks, because the vitamin K levels are low in the first days after birth and this is very important for the clot formation(AU)

Diente natal / Natal teeth

INTRODUCCIÓN: se denominan dientes natales a aquellos dientes que se encuentran presentes en la cavidad bucal en el momento del nacimiento. Estos constituyen una alteración de erupción precoz y se presenta con más frecuencia en la región de los incisivos centrales inferiores. Dichos dientes pueden ocasionar trastornos en la alimentación, ulceraciones traumáticas sublinguales llamada entonces enfermedad de Riga-Fede y preocupaciones en cuanto a la posible aspiración de los mismos. OBJETIVO: describir las características de una niña con diente natal y los aspectos más relevantes del diagnóstico y tratamiento. PRESENTACIÓN DEL CASO: a la consulta de odontopediatría se presentó una madre con una niña de un mes de nacida, remitida del Servicio de Pediatría debido a la sospecha de presencia de un diente en el momento de su nacimiento. Dada la dificultad para la lactancia, la gran movilidad del diente y el alto riesgo de desprendimiento, el tratamiento aplicado fue la EXODONCIA. CONCLUSIONES: el caso presentó un diente natal pequeño y con ningún desarrollo radicular. El tratamiento aplicado fue exodoncia por el grado de movilidad del diente y forma cónica y puntiforme que tenía riesgo de desprendimiento. Por tener un mes de nacida no existía peligro de deficiencia de la coagulación resultante de la síntesis insuficiente de vitamina K que ocurre en los primeros días de vida. Aunque la presencia de diente natal es infrecuente es de gran importancia el conocimiento del diagnóstico y tratamiento del diente natal para el estomatólogo(AU)

INTRODUCTION: natal teeth are defined as those teeth that are present in the mouth at the time of birth. Natal teeth form an alteration of early eruption; generally the lower temporary central incisors are the most common tooth affected. These teeth are rare anomalies in newborns that can cause feed disturbances, tongue ulceration (Riga-Fede disease) and risk of aspiration of them. OBJECTIVE: the aim of this paper is to present a case report of a newborn girl with neonatal tooth and the most relevant aspects concerning the diagnosis and treatment. CLINIC CASE: a30 -day-old female baby was brought to our department, because she had one tooth at birth. Due to the great mobility it was decided to extract the mobile natal teeth. COMMENT: natal teeth, in most cases are small and with poor root development. The treatment of these teeth will depend on the degree of tooth mobility and presence of sharp incisal edge.The extraction must do after of the first weeks, because the vitamin K levels are low in the first days after birth and this is very important for the clot formation(AU)

Persistent lingual ulceration (Riga-Fede disease) in an infant with Down syndrome and natal teeth: a case report.

INTRODUCTION: Riga-Fede disease is a rare pediatric condition in which chronic lingual ulceration results from repetitive trauma. Neonatal teeth or underlying neuro-developmental disorders which include Down syndrome are described as causative factors, but to the best of our knowledge, this is the first case report of both Down syndrome and natal teeth coexisting. The need for early extraction in the presence of two risk factors is highlighted in this case report. CASE PRESENTATION: An 18-month-old Sinhalese male presented with an ulcerating lingual mass on the ventral surface of the tongue. The lesion had progressed over the past six months. He also had clinically diagnosed Down syndrome.The ulcer was non-tender, indurated, and had elevated margins. It was not bleeding and two natal teeth in lower central dentition were seen in apposition with the lesion. There was no regional lymphadenopathy but the ulcer was causing concerns as it mimicked a malignant lesion. A clinical diagnosis of Riga-Fede disease caused by raking movements of the tongue against anterior natal teeth by a child who was developmentally delayed and prone to suck on his tongue was made. The mother was reassured and the natal teeth were extracted. CONCLUSIONS: Early extraction of natal teeth is recommended only if there is a risk of aspiration or interference with breast feeding. Although Down syndrome is among the neuro-developmental conditions that lead to this lesion, its occurrence is usually at an older age. The presence of natal teeth together with Down syndrome caused the lesion to occur in infancy. Awareness of the benign nature of this rare condition by pediatricians and dental practitioners is important as it will allay anxiety and avoid unnecessary biopsy. This case also highlights the impact of two risk factors and needs consideration as an added indication for the early extraction of natal teeth.

[(Con)natal teeth: a role for maternity care and dental care]. / (Con)natale gebitselementen: een rol voor kraamzorg en tandheelkundige zorg.

A baby was referred to a dentist by an obstetrician 18 days after birth in connection with the presence of 2 teeth in the mandibula which resembled incisors. It appeared to be a case of 2 (con)natal teeth with a high degree of mobility. Dental treatment in the form of 2 extractions was necessary.