A natal tooth is one that is already present when a baby is born, while a neonatal tooth is one that comes through in the first month of life, and most are part of the normal baby set rather than an extra tooth. They are uncommon, occurring in roughly one in two to three and a half thousand births, and natal teeth are about three times more common than neonatal ones. Most are managed simply, and the main questions are whether the tooth is loose and whether it is causing feeding trouble.
Key takeaways
- Natal teeth are present at birth; neonatal teeth appear within the first 30 days.
- They are uncommon and usually appear in the lower front position, and most are part of the normal baby set.
- The main concerns are a loose tooth, feeding difficulty, and a sore patch under the tongue called Riga-Fede disease.
- Management ranges from simply monitoring to smoothing the edge or, if the tooth is very loose, removing it.
What natal and neonatal teeth are
Occasionally a tooth erupts far earlier than the usual six-months-and-onwards timetable. When it is already there at birth it is called a natal tooth, and when it appears in the first month it is a neonatal tooth. The great majority sit in the lower front of the mouth, and in most cases the tooth is one of the baby’s normal primary teeth that has simply come through early, rather than an additional tooth. This distinction matters, because removing a normal early tooth leaves a gap until the adult tooth arrives, so a dentist usually takes an X-ray to check before deciding anything.
Why they happen
The exact cause is not fully understood. A superficial position of the developing tooth is thought to play a part, and the tendency can run in families. Suggested contributors include an extended pregnancy and other developmental and environmental factors, and early teeth are occasionally associated with certain syndromes, which is one more reason for a proper assessment. For most babies, though, a natal tooth is an isolated finding in an otherwise healthy child. Our guide on lip tie and feeding covers another infant mouth issue that can affect early feeding.
When they can be a concern
The table sets out the main issues that guide what to do.
| Concern | What it means |
|---|---|
| Loose tooth | Poorly rooted teeth can be very mobile, raising a small risk of the tooth coming free |
| Feeding difficulty | The tooth can make latching uncomfortable for the baby and the mother during breastfeeding |
| Riga-Fede disease | A sore ulcer under the tongue from the tooth rubbing during feeding |
| Sharp edge | A thin, sharp incisal edge can irritate the tongue or the mother |
How they are managed
Management depends on the tooth. A firm, well-formed tooth that is not causing problems is often simply left in place and monitored, and feeding support can settle early discomfort. A sharp edge can be gently smoothed, and sometimes a small amount of tooth-coloured material is added to round the edge so the tongue glides over it, which helps Riga-Fede disease heal. If a tooth is very loose, removal may be recommended because of the small risk of it detaching. When a tooth is removed in the first few days of life, vitamin K status is checked or a dose given beforehand, because newborns are naturally low in the vitamin needed for clotting. Our note on a baby tooth pushed into the gum covers another early-childhood tooth situation.
What parents can do
If your baby has a tooth at or soon after birth, the most useful step is an assessment with a dentist, who can check whether it is a normal early tooth and whether it is loose. In the meantime, watch for a sore patch under the tongue, any feeding difficulty, and how firm the tooth feels. Feeding support often makes a real difference, and many babies manage well with a tooth that is simply monitored. Keep the mouth clean by gently wiping the gums and tooth with a soft, damp cloth. This is general information and not a substitute for an in-person assessment of your baby.
Frequently asked questions
Is a tooth at birth normal?
It is uncommon but not rare, occurring in roughly one in two to three and a half thousand births. Most are a normal baby tooth that came through early rather than an extra tooth.
Does the tooth need to be removed?
Not always. A firm, well-formed tooth is often kept and monitored. Removal is considered mainly when the tooth is very loose or is causing feeding problems that cannot be managed.
What is Riga-Fede disease?
A sore ulcer that forms under the baby’s tongue when the early tooth rubs during feeding. Smoothing or building up the tooth edge usually allows it to heal.
Can my baby still breastfeed?
Usually yes, often with some feeding support. If latching is uncomfortable, a dentist and a feeding adviser can help with practical adjustments.
Why is vitamin K mentioned before removal?
Newborns are naturally low in vitamin K, which is needed for blood to clot. If a tooth is removed in the first days of life, vitamin K is checked or given first as a precaution.
If your newborn has a tooth, the team at Lumi Dental in Melrose Park can assess it and guide you on feeding and next steps. Learn about our general dental care or see our current deals. We do not publish prices in our articles and are happy to provide a written estimate after an examination.
This article is general information only and is not a substitute for personalised dental or medical advice. Please see a dentist about your baby’s situation.
