Sunday, February 23

Natal teeth - Neonatal teeth

Neonatal teeth - Natal teeth
Natal teeth are present at the time of birth. Neonatal teeth grow after birth during the first month. Except for the time of appearance, there is not much difference between these teeth. Natal teeth are uncommon and one in every 2,000 to 3,000 infants may have them at birth. In some infants their presence may be associated with certain medical conditions.

Actually these teeth are primary deciduous dentitions, which have emerged very early. The most commonly affected are the lower central incisors. They usually occur in pairs. In very rare cases primary maxillary incisors or primary lower canines may be involved. In a few cases they may be supernumerary and get replaced by the true primary dentition. A dental roentgenogram can help in differentiating the supernumerary incisors.

Though the exact etiology is not clear, maternal health during pregnancy appear to predispose the fetus in developing this condition. Maternal exposure to infections, fever, trauma, hormones, chemicals and toxin can become causative factors.

The teeth may be smaller than the primary incisors and may appear conical and yellowish. The root may be absent or poorly developed. They have hypoplastic or hypomineralized enamel, irregular dentin and most of them are mobile. Some may have shell-like crown structure loosely attached to gingival tissue.

These teeth may interfere while feeding or breastfeeding. The nipples may get lacerated and become infected and painful. There is a great chance for the infant to hurt and damage the tongue leading to sublingual ulceration (Riga-Fede disease). If the incisors are wobbly and loose there is a risk of swallowing or aspirating them into lungs. In such situations their extraction may be considered by the dentist.

In some rare cases they may be associated with genetic disorders such as Ellis–van Creveld syndrome, Meckel-Gruber syndrome and Sotos syndrome. Natal teeth are also associated with congenital disorders like Hallermann–Streiff syndrome, jadassohn-lewandowsky syndrome (pachyonychia congenita), craniofacial dysostosis syndrome, steatocystoma multiplex, Wiedemann-Rautenstrauch syndrome and Pierre Robin syndrome.

1.Alexander K. C. Leung and William Lane M. Robson. Natal teeth: a review. J Natl Med Assoc. 2006 February; 98(2): 226–228. PMCID: PMC2595049.

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Neonatal teeth - Natal teeth.

Sunday, February 16

Baby teething age

Baby teething age
The average teething age of babies is six months. It is quite common for them to start teething as early as three months of age. Likewise in many of them the teething may start as late as twelve months of age.
The milk teeth start appearing sooner in girls than in boys.

The general pattern of emergence of deciduous teeth is as follows. The central incisors emerge first at the age of 6-12 months. The lower central incisors start emerging earlier than the upper central incisors. The emergence of the lateral incisors may occur at 9-16 months of age.

The emergence of the canine teeth may commence by the 16th month of age and by 24th month all the canines will have emerged. The first molars start emerging by 14 months and by 20th month all four first molars will have emerged.

The emergence of the second molars may commence by 20 months and get completed by 24 months. The emerging of teeth may go on till 3 years in some children which it is quite normal. Delayed teething beyond 18 months requires a visit to a dentist as there may be some underlying health problem.

There are many exceptions to the above pattern. Neonatal teeth are the teeth present at the time of birth. If the emergence of teeth occurs by the first month, the teeth are known as natal teeth. There are many teething problems to be faced by the baby. Teething symptoms in them include irritability, tender and swollen gums and pain. They may try to place fingers or objects into the mouth to find relief.
The primary lower central incisors
primary lower central incisors

At the time of emergence of teeth from the gums they may suffer from teething pain. In some cases there may be mild teething fever due to mild gum infections. The excessive drooling may cause teething rash on the face. There are many known home remedies for teething to bring relief to the baby.

Whatever may be the age of teeth emergence, dentists recommend brushing teeth as soon as they appear. It is not advisable to wait till 2-3 years for the teething to complete before starting to brush. Early childhood caries (ECC) in babies of over 6 months of age is becoming more common. Nursing caries occur in prolonged breast-fed children and in those continuing bedtime breast-feeding. Lack of oral hygiene by 18 months is also a risk factor for ECC.

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Baby teething age.