Baby Born with Teeth - Natal Teeth
The short answer
Natal teeth (teeth present at birth) occur in about 1 in 2,000-3,000 births. In most cases, these are actual primary (baby) teeth that erupted early, not extra teeth. Most natal teeth are the lower front incisors. While natal teeth can sometimes cause breastfeeding difficulties or have a risk of becoming loose and being a choking hazard, many can be left in place and monitored. The decision to keep or remove a natal tooth depends on how firmly it is attached and whether it is causing problems.
By Age
What to expect by age
If your baby was born with teeth or teeth erupted within the first 30 days (neonatal teeth), your pediatrician and a pediatric dentist should evaluate them. Most natal teeth are real primary teeth (about 90%). The evaluation determines: how firmly attached the tooth is (loose teeth may need removal to prevent choking), whether the tooth is interfering with breastfeeding, and whether it is causing a tongue ulcer (Riga-Fede disease) from the baby's tongue rubbing against the tooth during sucking.
If natal teeth were left in place, monitor them for: loosening (which creates an aspiration risk), tongue or gum ulceration, and breastfeeding difficulties. If breastfeeding is painful due to the teeth, a lactation consultant can help with positioning. In some cases, smoothing the sharp edge of the tooth resolves nipple pain. If the tooth becomes very loose, it should be removed by a dentist. Natal teeth that remain firmly attached typically stay in place until the normal age for that tooth to fall out (around age 6-7).
If your baby has natal teeth that were kept, they will look like regular baby teeth and can be cared for the same way - gentle wiping with a damp cloth after feeds. Normal teething for other teeth begins around 4-6 months. Having natal teeth does not mean your baby will teethe earlier or later for the remaining teeth. The presence of natal teeth does not indicate any other health problems in the vast majority of cases.
If a natal tooth was removed, the permanent tooth should still develop normally in the space. The gap from a removed natal tooth does not need treatment. Regular dental care should begin by age 1 as recommended by the AAP and American Academy of Pediatric Dentistry. If the natal tooth remained, it will eventually be lost like any other baby tooth. In rare cases, natal teeth can be associated with certain syndromes, but isolated natal teeth in an otherwise healthy baby are a benign variation.
What Should You Do?
When to take action
- Your baby was born with one or two lower front teeth that are firmly attached - this is the most common presentation
- The natal tooth is not causing breastfeeding problems or tongue ulceration
- The tooth has been evaluated by a dentist and was determined to be a real primary tooth
- Your baby is feeding, growing, and developing normally despite having early teeth
- Your baby has natal teeth and breastfeeding is painful or difficult
- The natal tooth appears loose and could be a choking risk
- Your baby has developed a sore on their tongue from rubbing against the tooth
- You notice your baby has more than two natal teeth
- A natal tooth has become very loose and could be swallowed or aspirated
- Your baby has an ulcerated, bleeding sore on their tongue from the tooth
- Your baby was born with multiple natal teeth along with other unusual features - could indicate a syndrome requiring evaluation
Sources
Related Resources
Related Physical Concerns
Toddler Grinding Teeth While Awake and Asleep
Teeth grinding (bruxism) is very common in babies and toddlers - studies suggest 15-33% of children grind their teeth. Babies often grind their teeth when new teeth come in because the sensation is novel and they are experimenting with their bite. Most children outgrow grinding by age 6 when their permanent teeth start coming in. Grinding is usually harmless and does not require treatment unless it is causing tooth damage, jaw pain, headaches, or significantly disrupting sleep.
Baby White Tongue - Milk Residue or Thrush?
A white tongue in babies is extremely common and is usually just milk residue from breastfeeding or formula feeding. Milk residue coats the tongue lightly and can be wiped away with a damp cloth. Thrush (oral candidiasis) is a yeast infection that creates white patches that look like cottage cheese and do NOT wipe away easily - if you try, the tissue underneath may appear raw or bleed. Thrush can also appear on the cheeks, gums, and roof of the mouth.
Transitioning from Breastfeeding to Formula
Transitioning from breastfeeding to formula is a common decision that many families make for a variety of valid reasons. A gradual transition over 1-2 weeks is best for both your body (to prevent engorgement and mastitis) and your baby (to adjust to a new taste and feeding method). Replace one breastfeeding session with a formula bottle every 2-3 days. Your baby is well nourished whether they receive breast milk, formula, or a combination - the best feeding choice is the one that works for your family.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
Baby or Toddler Body Odor - When Is It Normal?
Babies and toddlers can develop body odor from several benign causes: sour milk caught in skin folds, sweating, diaper area odor, strong-smelling foods in the diet, and certain medications or vitamins. True body odor (like adult BO from apocrine glands) should not occur before puberty. If your baby or young toddler has a persistent unusual body odor that is not explained by skin folds, diaper, or diet, it could indicate a metabolic condition, infection, or foreign body (especially in the nose or vaginal area). Unusual persistent odor warrants a doctor visit.
Baby Clenching Fists After 3 Months
Newborns naturally keep their fists clenched due to the palmar grasp reflex. Hands should begin opening more by 2 months and be mostly open by 3-4 months. By 4 months, your baby should be reaching for objects with open hands. If your baby's fists remain tightly clenched after 3-4 months, especially with thumbs tucked inside the fist (cortical thumbs), it could indicate increased muscle tone (hypertonia) and should be evaluated. However, some babies simply have a stronger grasp reflex that takes longer to fade.