Managing a mobile natal tooth in an infant: Preventing aspiration and alleviating breastfeeding discomfort

Introduction: Natal teeth are a rare condition in which a newborn presents with teeth at birth. The lower primary central incisors are the most commonly affected teeth. Natal teeth typically come in pairs and it is rare to see more than two erupt. 

Case History: A 2-month-old baby boy come with his mother for dental check-up. According to the heteroanamnesis, the lower tooth had erupted since birth and caused difficulty, discomfort, and soreness during breastfeeding. Two teeth had previously erupted, but one of them was extracted soon after birth. On intraoral examination, a natal tooth was observed in the lower anterior region, with severe mobility based on Miller’s classification (Grade 2).

Discussion: Diagnosis is made based on historical and physical examination. Several factors to consider before made the treatment plan whether to maintain the teeth in oral cavity or extract them are degree of tooth mobility, convenience during suckling, interference with breastfeeding, traumatic injury to the tongue, the tooth part of normal dentition or supernumerary, other systemic factors. If the erupted teeth are not mobile, do not interfere with breastfeeding, asymptomatic, and diagnosed as a tooth of the normal dentition, these teeth should remain in the arch. If the erupted teeth are mobile, interference with breastfeeding, and part of supernumerary teeth, these teeth should be extracted. 

Conclusion: Mobile natal teeth should be extracted to prevent the risk of aspiration and to make breastfeeding more comfortable.