|Year : 2020 | Volume
| Issue : 2 | Page : 98-100
Neonatal tooth in maxillary molar region: A case report
Avik Narayan Chatterjee, Raju Biswas, Sauvik Galui, Subrata Saha, Subir Sarkar
Department of Pediatric and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, India
|Date of Submission||06-Dec-2019|
|Date of Decision||07-Jan-2020|
|Date of Acceptance||20-Jan-2020|
|Date of Web Publication||22-Jul-2020|
Department of Pediatric Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata - 700 014, West Bengal
Source of Support: None, Conflict of Interest: None
Those teeth that erupt within the first month of life are called neonatal teeth. It may occur in any region of the maxillary or mandibular arches but its incidence in the maxillary molar areas is extremely rare. A case of neonatal tooth in the maxillary molar region has been presented here.
Keywords: Left side, maxillary deciduous first molar region, neonatal tooth
|How to cite this article:|
Chatterjee AN, Biswas R, Galui S, Saha S, Sarkar S. Neonatal tooth in maxillary molar region: A case report. J Oral Res Rev 2020;12:98-100
|How to cite this URL:|
Chatterjee AN, Biswas R, Galui S, Saha S, Sarkar S. Neonatal tooth in maxillary molar region: A case report. J Oral Res Rev [serial online] 2020 [cited 2020 Aug 10];12:98-100. Available from: http://www.jorr.org/text.asp?2020/12/2/98/290509
| Introduction|| |
Prematurely erupted teeth those present at the time of birth are called natal teeth, and those erupting during the first 30 days after birth are called neonatal teeth. These teeth are also known by various terminologies such as “Dentitia praecox,” “dens connatalis,” “congenital teeth,” “fetal teeth,” “infancy teeth,” “predeciduous teeth,” and “precocious dentition.”
The incidence of natal and neonatal teeth ranges from 1:2000 to 1:3500, respectively. The prevalence of natal tooth as reported by various authors and found in different studies ranges between 1:716 and 1:3500 live births. Bohendoff reported that the incidence of natal and neonatal teeth is 0.3%–0.5%. Although various authors have suggested different numbers, it can be said that natal tooth is more common than neonatal tooth.
Spouge and Feasby classified these teeth on the basis of maturity as follows: (1) A mature natal or neonatal tooth – Nearly or almost developed and has relatively good prognosis for maintenance; (2) An immature natal or neonatal tooth – A tooth with incomplete structure and poor prognosis.
It has been seen in various literatures that natal and neonatal teeth have been found most commonly in the mandibular deciduous central incisor area (85%), followed by the maxillary incisors (11%) and mandibular canine and molar region (3%). The least incidence has been reported in the maxillary canine and molar region (1%). de Almeida et al. reported that the incidence of neonatal teeth is more in females than in males. This is also concurrent with the findings of Shori and Hajare.
The etiology of neonatal teeth is not known, and opinions vary among different authors. Neonatal tooth may be due to the excessive development during the initiation and proliferation stage of tooth formation, or it may be due to hyperactivity of the osteoblasts within the tooth germ, or superficial positioning of the tooth germ in the jaws may be the other reasons which contribute to the formation of neonatal tooth.
The morphology and mineralization of natal or neonatal teeth may differ from normal teeth as they are smaller in size and conical in shape. In general, the crown of natal or neonatal teeth is like a normal tooth, but most of the times, it is devoid of any root.
This article presents a case report and management of an infant with neonatal tooth in the maxillary molar region on the left side.
| Case Report|| |
A 55-day-old male child reported to the department of pedodontics and preventive dentistry with a chief complaint of a tooth-like structure in the left upper back teeth region of the oral cavity, and the parents confirmed that it was not present at birth, and only after 20–25 days after birth that the parents noticed this structure in the oral cavity. Parents also reported that the child would cry everytime, especially at the time of feeding.
The parents confirmed a history of full-term, normal vaginal delivery, and the birth reports confirmed that no congenital disease was present. Reports also confirmed that the child has been given Vitamin K supplementation within 1 month of birth.
On intraoral examination, it was found that an unusual neonatal tooth was present in the left maxillary deciduous first molar region [Figure 1]. On palpation, it was found that the tooth was highly mobile (Grade II according to the Miller's classification of mobility). Although the neonatal tooth did not cause any difficulty to the mother during breastfeeding, there were increased chances of aspiration with Grade II mobility. It was, therefore, decided to extract the neonatal tooth in the maxillary molar region.
Topical anesthetic agent was applied to the maxillary gum pad in the region of the neonatal tooth, and it was extracted with a piece of cotton, and care was taken so that the child does not aspirate the tooth. The extracted tooth was found to be rootless in this case [Figure 2]. After extraction, curettage of the socket was done to prevent continued development of the cells of the dental papilla. Hemostasis was achieved by applying pressure over the area of the tooth, and the mother was advised to breastfeed the child.
| Discussion|| |
The exact etiology of neonatal tooth is yet to be known although some suggest that it may be of hereditary origin. However, some are of the opinion that various endocrinal disturbances, nutritional deficiency, or environmental factors such as polychlorinated biphenyls and dibenzofurans may lead to its occurrence.
The treatment planning for neonatal tooth depends on various factors which include the degree of mobility, inconvenience during suckling or breastfeeding, and whether it is a supernumerary tooth or is a part of the normal dentition.
No treatment is required if the tooth is asymptomatic, and breastfeeding is not impaired. The extraction of the tooth should be done only if the tooth is supernumerary, or if the tooth is extremely mobile with a possible risk of aspiration. If extraction is the treatment of choice, it can be postponed till the child becomes 10 days old or more only after the appropriate blood levels of Vitamin K are attained. In general, extraction in newly born infants may cause bleeding problem because the bacterial flora present in the digestive tract of newborn infants may be ineffective in the production of Vitamin K during the first 10 days following delivery. Since parenteral Vitamin K prevents a life-threatening hemorrhagic disease of the newborn, the American Academy of Pediatrics recommends that all newborn infants should be given a single intramuscular dose of 0.5–1 mg of Vitamin K.
After extraction of the tooth, curettage of the socket should be performed to avoid continued development of the cells of dental papilla failure to which might result in further eruption of the odontogenic remnants.
If the tooth is not recommended for extraction, smoothening of the cuspal tips or incisal edges may be required to prevent any trauma to the feeding breasts or the opposing gum pad. Furthermore, for nonextraction cases, proper oral hygiene maintenance instructions and the importance of regular dental visit should be explained.
It was reported in an Scanning Electorrn Microscopic (SEM) study on neonatal teeth of two female babies with cleft lip and cleft palate that irregular hypoplastic superficial enamel layer, regular dentinal layer with arrangement of dentinal tubule-like normal teeth, was present with only 300 μ root formation. Anegundi et al. also observed similar findings.,
| Conclusion|| |
A thorough oral examination of the newborn should always be carried out, and if diagnosed with neonatal tooth, proper treatment is necessary for the betterment of the infant. Parental counseling and proper follow-up is necessary for supervising the development of the dentition.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient's parents have given their consent for images and other clinical information to be reported in the journal. The patient's parents understand that name and initials will not be published and due efforts will be made to conceal the identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]