It can be shocking for parents when a newborn is born with teeth already visible. If your baby was born with teeth already erupted, your pediatrician may have mentioned "natal teeth." You might wonder: Is this normal? Does it need treatment? Will my baby need them removed? This guide explains what natal teeth are, why they happen, and what you should know about caring for your baby.

What Are Natal Teeth?

Key Takeaway: It can be shocking for parents when a newborn is born with teeth already visible. If your baby was born with teeth already erupted, your pediatrician may have mentioned "natal teeth." You might wonder: Is this normal? Does it need treatment? Will my...

Natal your smile are teeth that are already visible in your baby's mouth at birth or present at the time of delivery. They're different from neonatal teeth, which erupt (come in) during the first month after birth. The distinction matters because natal and neonatal teeth may require different management.

Most natal teeth (about 85%) are actually your baby's primary teeth (baby teeth) that have erupted very early—sometimes 6-9 months earlier than normal. Primary them typically start appearing around 6-9 months of age, so a tooth visible at birth represents very early eruption.

The remaining 15% of natal teeth are either permanent teeth that have erupted too early or supernumerary teeth (extra teeth). These require closer evaluation by your dentist because they may need different management than normal primary teeth.

Why Do Babies Get Natal Teeth?

The exact cause of natal teeth isn't completely understood. Normally, hormones and developmental signals keep primary teeth from erupting until your baby is around 6-9 months old. With natal teeth, something is different about these developmental controls.

Possible explanations include:

  • Abnormalities in the proteins that normally hold teeth back and prevent early eruption
  • Faster-than-normal dissolution of the tissues surrounding the tooth roots, allowing teeth to push through earlier
  • Minor variations in the signals that control tooth eruption timing

In most cases, a single natal tooth or two natal your smile represent a random variation in development with no underlying medical condition. Your baby's developmental history, appearance, and growth pattern will likely be completely normal.

How Often Does This Happen?

Natal teeth are relatively rare but not unheard of. They occur in approximately 1 in 2,000 to 1 in 3,000 newborns. So while your baby is unusual, your pediatrician and dentist have experience managing this situation. For more on this topic, see our guide on Parent Education Teaching Proper Hygiene.

Is Your Baby's Natal Tooth Normal or Supernumerary?

Your pediatrician or dentist needs to determine whether your baby's natal tooth is a normally-developing primary tooth that erupted early, or something unusual like a supernumerary (extra) tooth. This distinction is important for your baby's long-term dental health.

Normal primary teeth erupt in a predictable pattern at predictable positions. They have normal size and appearance. If your baby's natal tooth appears to be a normal primary tooth—either a lower front tooth or upper front tooth in the expected position—it's almost certainly a normal tooth that just came in very early.

Supernumerary teeth, by contrast, appear in unusual locations, have unusual shapes, or are additional teeth beyond the normal 20 primary teeth. If your dentist suspects your baby has a supernumerary tooth, they may recommend an X-ray to assess the situation.

When Natal Teeth Might Indicate Underlying Conditions

While most natal them are harmless variations, multiple natal your smile (more than two) may warrant investigation for underlying systemic conditions. Certain genetic syndromes and developmental disorders are associated with natal teeth, including:

  • Trisomy 13 (Patau syndrome)
  • Trisomy 18 (Edwards syndrome)
  • Trisomy 21 (Down syndrome)
  • Cleidocranial dysostosis (an inherited skeletal condition)
  • Ellis-van Creveld syndrome (an inherited condition affecting multiple body systems)
However, keep in mind: the vast majority of babies with one or two natal teeth have no underlying condition. Your baby's pediatrician will assess whether any additional evaluation is needed based on your baby's overall development, appearance, and family history. If your baby is developing normally and has no other unusual features, extensive genetic testing is usually not necessary.

Potential Complications: Riga-Fede Syndrome

One important complication you should know about is Riga-Fede syndrome. This occurs when your baby's natal tooth rubs against the soft tissues of your baby's mouth or tongue, causing irritation and ulceration (sores). For more on this topic, see our guide on Fluoride Varnish Pediatric High Strength.

Signs of Riga-Fede syndrome include:

  • Visible ulcers (sores) on your baby's lower lip or tongue
  • Bleeding from the affected area
  • Your baby seeming uncomfortable while nursing or eating
  • Your baby appearing to have pain in the mouth

If your baby develops these symptoms, your pediatrician or dentist may recommend removing the natal tooth to prevent ongoing irritation and allow the ulcers to heal.

Should Your Baby's Natal Tooth Be Removed?

Whether your baby's natal tooth needs to be removed depends on several factors:

Keep the tooth if:
  • It's stable and not loose
  • Your baby has no irritation or ulceration
  • The tooth is a normally-developing primary tooth
  • Your baby is nursing or feeding without difficulty
  • Your pediatrician sees no complications
Consider removing the tooth if:
  • Your baby has Riga-Fede syndrome (irritation and ulcers)
  • The tooth is so loose it's a choking risk
  • The tooth interferes with nursing or feeding
  • The tooth is a supernumerary (extra) tooth in an abnormal location
Your dentist can evaluate your baby's specific situation and make recommendations. If removal is necessary, most natal teeth can be easily extracted under local anesthesia, though this is rare for otherwise healthy natal teeth.

Nursing and Feeding With Natal Teeth

Many babies nurse successfully with natal teeth without any problems. The tooth typically doesn't interfere with breastfeeding if it's stable and your baby has no irritation. If your baby has just a single small natal tooth and nursing is going well, there's usually no need to remove it.

However, some mothers find breastfeeding uncomfortable if the tooth causes irritation to their breast or if the baby bites down during feeding. If this occurs, discuss options with your pediatrician and dentist.

Your Baby's Future Dental Development

If your baby's natal tooth is a normal primary tooth that erupted early, it will shed at the normal time for that tooth—not earlier because it came in early. For example, primary lower front teeth normally shed around 6-7 years of age, and your baby's early-erupted tooth will shed at approximately that same age.

This is important to know because some parents worry their baby will be missing them when peers still have their baby teeth. That's unlikely—the eruption schedule adjusts so your baby will have teeth at approximately the same developmental stage as other children.

When to See Your Dentist

Your pediatrician will likely refer your baby to a pediatric dentist for evaluation. You should schedule this appointment soon after birth if you haven't already. The pediatric dentist will:

  • Confirm whether the tooth is normal or supernumerary
  • Check for any instability or risk of loosening
  • Assess whether ulceration or irritation is present
  • Take an X-ray if needed to understand what's happening with other developing teeth
  • Discuss management options and answer your questions

Conclusion

Talk to your dentist about your specific situation and what approach works best for you. Your pediatrician will likely refer your baby to a pediatric dentist for evaluation. You should schedule this appointment soon after birth if you haven't already. The pediatric dentist will:

  • Confirm whether the tooth is normal or supernumerary
  • Check for any instability or risk of loosening
  • Assess whether ulceration or irritation is present
  • Take an X-ray if needed to understand what's happening with other developing teeth
  • Discuss management options and answer your questions

> Key Takeaway: Natal teeth require differentiation from neonatal teeth and assessment for developmental normality versus supernumerary status to guide appropriate.