- Email: [email protected]
Natal teeth
Section
of the
Federal dental services
Natal teeth Report
of a case
Ray Rhymes, Jr., Lieutenant (DC) lJ,VN” USITED
STATES
NAVAL
TRAINING
CENTER,
GREAT
LAKES,
ILL.
N
atal teeth are found in infants at birth. This does not occur often, but it creates quite a problem for those involved when it does. There are several excellent sources of information concerning this unusual entity.‘+ It seemsthat these teeth are either predeciduous anomalies (called predeciduous dentition) or actually represent the deciduous teeth proper (called prematurely erupted teeth). The cause is unknown. Most authorities agree that extraction is the treatment of choice when the tooth is predeciduous, as in the case recently reported by Wallace.4 However, when a true deciduous tooth (prematurely erupted) is involved, there are mixed opinions as to whether it should be left or extracted. In either case Thoma and Goldman3 warn of the possibility of profuse bleeding if the choice is extraction. This bleeding may occur in some casesas a result of the vascular developmental papilla accompanying the incompletely formed tooth and the hypoprothrombinemia which may be present during the first 10 days of life.* If surgical intervention. is contemplated, medical consultation is advisable. In the case that follows a patient had a prematurely erupted deciduous lateral incisor and congenital absence of its partner on the opposite side. CASE The
REPORT
A 3-day-old Negro boy was brought only problem was that of a single
to the Oral mandibular
Surgery Clinic from the Obstetric Service, tooth which had been present since birth
The opinions or assertions contained herein are the views of the author and are not to be construed as official or representing the Department of the Navy or the Naval Services at large. “Formerly senior resident, Oral Surgery Department, Confederate Memorial Medical Center, Shreveport, La. (Dr. Dudley Isom, Chief Oral Surgeon). Present address: Dental Department Bldg. 600, United States Naval Training Center, Great Lakes, Ill.
541
(Fig. 1). The conservative app~‘oaclr was t’ollo~~ctl and thci i00tll \~as allo\Vecl to remain, though it was extremely mobile. For 31/r, months all went well, The patient was followed via regular outpatient visits. but the tooth never became more stable. Awarding to the mother, nursing was not a problem. At the next appointment, when the patient was I months old, the tooth was gone and its whereabouts was unknown. A chest, x-ray was negative, and an int,raoral film showed absence of both deciduous lateral incisors (Fig. 2). Otherwise, the child was in excellwt health. There has been no evidence of an endocrine disturbance.
DISCUSSION
Each individual case will present different problems, and these problems must be dealt with as the need arises by those immediately concerned. In retrospect, the opinions formed in this case are as follows: Mobility of the tooth never improved, and the thought of aspiration was constantly present. Because of the degree of calcification and the size of the tooth, it probably would have been difficult to localize it roentgenographically. Complications from broncoscopy, lung abscess, and pneumonia following aspiration of teeth are ever present. It is now thought that the tooth should hare been extracted initially.
Volume 18 Number 4
Natal
teeth
543
That would have deprived the child of a deciduous tooth, but the possibibty of severe complications of aspiration would have been avoided. Had the tooth become more stable with time, conservative treatment might have been deemed successful. SUMMARY
The case of a patient with a nata tooth has been presented. The tooth was observed for 4 months, at which time it was exfoliated and lost. Aspiration was an ever-threatening problem. In retrospect, the tooth should have been extracted initially. REFERENCES
1. Shafer, W. G., Hine, M, K., and Levy, B. M.: Oral Pathology, ed. 1, Philadelphia, 1958, W. B. Saunders Company, pp. 37-38, 51-52. 2. Massler, M., and Savare, B. S.: Natal and Neonatal Teeth, J. Pediat. 36: 349, 1950. 3. Thoma, K. H., and Goldman, H. M.: Oral Pathology, ed. 5, St. Louis, 1960, The C. V. Mosby Company, pp. 43.44. 4. Wallace, J. R.: Erupted Mandibular Central Incisors in a Newborn Infant, ORAL SURG., ORAL MED. & ORAL PATH. 16: 501-502, 1963.
of the
Federal dental services
Natal teeth Report
of a case
Ray Rhymes, Jr., Lieutenant (DC) lJ,VN” USITED
STATES
NAVAL
TRAINING
CENTER,
GREAT
LAKES,
ILL.
N
atal teeth are found in infants at birth. This does not occur often, but it creates quite a problem for those involved when it does. There are several excellent sources of information concerning this unusual entity.‘+ It seemsthat these teeth are either predeciduous anomalies (called predeciduous dentition) or actually represent the deciduous teeth proper (called prematurely erupted teeth). The cause is unknown. Most authorities agree that extraction is the treatment of choice when the tooth is predeciduous, as in the case recently reported by Wallace.4 However, when a true deciduous tooth (prematurely erupted) is involved, there are mixed opinions as to whether it should be left or extracted. In either case Thoma and Goldman3 warn of the possibility of profuse bleeding if the choice is extraction. This bleeding may occur in some casesas a result of the vascular developmental papilla accompanying the incompletely formed tooth and the hypoprothrombinemia which may be present during the first 10 days of life.* If surgical intervention. is contemplated, medical consultation is advisable. In the case that follows a patient had a prematurely erupted deciduous lateral incisor and congenital absence of its partner on the opposite side. CASE The
REPORT
A 3-day-old Negro boy was brought only problem was that of a single
to the Oral mandibular
Surgery Clinic from the Obstetric Service, tooth which had been present since birth
The opinions or assertions contained herein are the views of the author and are not to be construed as official or representing the Department of the Navy or the Naval Services at large. “Formerly senior resident, Oral Surgery Department, Confederate Memorial Medical Center, Shreveport, La. (Dr. Dudley Isom, Chief Oral Surgeon). Present address: Dental Department Bldg. 600, United States Naval Training Center, Great Lakes, Ill.
541
(Fig. 1). The conservative app~‘oaclr was t’ollo~~ctl and thci i00tll \~as allo\Vecl to remain, though it was extremely mobile. For 31/r, months all went well, The patient was followed via regular outpatient visits. but the tooth never became more stable. Awarding to the mother, nursing was not a problem. At the next appointment, when the patient was I months old, the tooth was gone and its whereabouts was unknown. A chest, x-ray was negative, and an int,raoral film showed absence of both deciduous lateral incisors (Fig. 2). Otherwise, the child was in excellwt health. There has been no evidence of an endocrine disturbance.
DISCUSSION
Each individual case will present different problems, and these problems must be dealt with as the need arises by those immediately concerned. In retrospect, the opinions formed in this case are as follows: Mobility of the tooth never improved, and the thought of aspiration was constantly present. Because of the degree of calcification and the size of the tooth, it probably would have been difficult to localize it roentgenographically. Complications from broncoscopy, lung abscess, and pneumonia following aspiration of teeth are ever present. It is now thought that the tooth should hare been extracted initially.
Volume 18 Number 4
Natal
teeth
543
That would have deprived the child of a deciduous tooth, but the possibibty of severe complications of aspiration would have been avoided. Had the tooth become more stable with time, conservative treatment might have been deemed successful. SUMMARY
The case of a patient with a nata tooth has been presented. The tooth was observed for 4 months, at which time it was exfoliated and lost. Aspiration was an ever-threatening problem. In retrospect, the tooth should have been extracted initially. REFERENCES
1. Shafer, W. G., Hine, M, K., and Levy, B. M.: Oral Pathology, ed. 1, Philadelphia, 1958, W. B. Saunders Company, pp. 37-38, 51-52. 2. Massler, M., and Savare, B. S.: Natal and Neonatal Teeth, J. Pediat. 36: 349, 1950. 3. Thoma, K. H., and Goldman, H. M.: Oral Pathology, ed. 5, St. Louis, 1960, The C. V. Mosby Company, pp. 43.44. 4. Wallace, J. R.: Erupted Mandibular Central Incisors in a Newborn Infant, ORAL SURG., ORAL MED. & ORAL PATH. 16: 501-502, 1963.