What Are Natal Teeth?
Natal teeth are teeth that are already present in a newborn's mouth at birth. The name comes from the Latin word for birth — and that is exactly what makes them unusual. Most babies are born with no visible teeth at all, with their first tooth expected around six months of age.
Natal teeth are different from neonatal teeth, which emerge within the first 30 days of life. Both are rare, but natal teeth are about three times more common than neonatal teeth.
In the vast majority of cases, a natal tooth is simply one of your baby's normal primary (milk) teeth that has arrived ahead of schedule — not an extra tooth. Less than 10% are supernumerary, meaning an additional tooth beyond the standard set. A dental X-ray is the only reliable way to tell the difference.
How Common Are Natal Teeth?
Natal teeth occur in roughly 1 in every 2,000 to 3,500 births. That makes them uncommon — most parents will never encounter them — but they are not so rare that your dentist will be unfamiliar with them.
Most babies with natal teeth have just one or two. Having more than two is significantly less common.
What Causes Natal Teeth?
The exact cause is not fully understood, and researchers have not identified a single definitive explanation. The leading theory is that the developing tooth bud sits unusually close to the surface of the gum, which allows it to erupt earlier than it should.
Genetic factors also appear to play a role. Natal teeth have been reported to run in families, suggesting a hereditary tendency in some cases.
Natal teeth have also been associated with certain rare medical conditions and syndromes, including Ellis-van Creveld syndrome, Hallermann-Streiff syndrome, and Pierre Robin sequence. However, the majority of babies born with natal teeth are otherwise healthy, with no underlying condition identified.
What Do Natal Teeth Look Like?
Natal teeth are often smaller than typical baby teeth. They may appear yellowish or have a whitish, opaque color, which reflects underdeveloped enamel — the hard outer layer of the tooth.Because they erupt before their root has fully formed, many natal teeth feel loose or wobbly. Some are held in place mainly by gum tissue rather than by a proper root structure. Others are more firmly anchored and feel stable to the touch.
What Complications Can Natal Teeth Cause?
Not every natal tooth causes problems. Whether complications arise depends largely on how mobile the tooth is, how it sits in the mouth, and how it interacts with the baby's tongue and feeding.
Feeding difficulties
The most common concern for parents is breastfeeding. The edge of a natal tooth can rub repeatedly against the underside of the baby's tongue during suckling, causing a painful ulcer to develop. This is known as Riga-Fede disease — a condition named after the two physicians who first described it in the 19th century. The ulcer typically appears on the ventral (under) surface of the tongue as a whitish or yellowish sore, and it can make feeding uncomfortable for the baby. In some cases, the natal tooth can also cause soreness or small lacerations to the mother during breastfeeding.
Risk of aspiration
A natal tooth that is very loose carries a small risk of detaching and being swallowed or inhaled by the baby. This is one of the main clinical reasons a Specialist Pediatric Dentist may recommend extraction.
Gum irritation
The gum tissue opposite the natal tooth — in the upper jaw — can become irritated by repeated contact during jaw movement and suckling.
How Are Natal Teeth Treated?
There is no single correct answer for every baby. Treatment depends on the tooth's stability, whether it is causing problems, and whether it is a normal primary tooth or a supernumerary one. A Specialist Pediatric Dentist assesses each case individually.
Monitoring without treatment
If the natal tooth is firmly rooted, not causing feeding difficulties, and poses no risk of detachment, the most appropriate course may be to leave it in place and monitor it. Many natal teeth are simply observed at follow-up appointments as the child grows.
Smoothing sharp edges
When the tooth is being retained but has a rough or sharp edge that is causing tongue irritation, the dentist may lightly smooth the incisal edge. This reduces trauma to the tongue without removing the tooth.
Extraction
- The tooth is highly mobile and poses a risk of aspiration
- Riga-Fede disease is present and is not resolving with conservative care
- Feeding is significantly disrupted and other approaches have not helped
- The tooth is identified on X-ray as supernumerary
When extraction is recommended, timing matters. Clinicians generally aim to defer the procedure until the baby is at least 10 days old. This allows the normal gut bacteria to establish and begin producing vitamin K, which is essential for blood clotting. If extraction is urgently needed before that point, the attending pediatrician will advise on vitamin K management.
If the extracted tooth is one of the baby's normal primary teeth — not an extra one — the space will remain in the mouth until the permanent tooth eventually erupts, typically not until around age six or seven for lower front teeth. Your Specialist Pediatric Dentist will discuss this with you and monitor the space over time.
Can Natal Teeth Be Prevented?
No. Natal teeth result from how and where the tooth bud develops in the jaw — a process that is influenced by genetics and not something that can be controlled. There is no known way to prevent them.
What parents can do is act promptly. If your newborn is born with a visible tooth, or if a tooth appears in the first month of life, an early assessment by a Specialist Pediatric Dentist will determine whether any action is needed before complications develop.
Frequently Asked Questions
In most cases, yes. Over 90% of natal teeth are part of the baby's standard set of 20 primary teeth — they have simply erupted earlier than expected. Fewer than 10% are supernumerary, meaning an extra tooth. A dental X-ray is needed to confirm which type your baby has, and this finding directly guides the treatment decision.
An X-ray is the standard way to determine whether the natal tooth has a developing root and whether it belongs to the primary tooth set or is supernumerary. Your Specialist Pediatric Dentist will advise on the appropriate timing for this, taking the baby's age and clinical presentation into account.
Riga-Fede disease is an ulcer that forms on the underside of an infant's tongue due to repeated friction from a natal or neonatal tooth during tongue movements and suckling. It presents as a whitish or yellowish sore on the ventral surface of the tongue. Treatment ranges from smoothing the tooth's edge to extraction in persistent or severe cases. Early assessment is important, as the ulcer can make feeding painful and affect the baby's weight gain.
If the natal tooth is retained and stable, it is not expected to affect the development of the permanent teeth. If it is extracted — and it turns out to be one of the primary teeth rather than a supernumerary tooth — the space will remain until the adult tooth erupts years later. Your Specialist Pediatric Dentist will monitor your child's dental development at follow-up visits.
They can, particularly if the tooth is positioned where the baby's tongue rubs against it repeatedly. Discomfort during feeding — for the baby or the mother — is one of the main reasons parents seek early assessment. In many cases, conservative measures such as smoothing the tooth edge are enough to resolve the problem without extraction.
Yes. Natal teeth are assessed and managed by our Specialist Pediatric Dentists across our centers. If your newborn has been identified as having a natal tooth, our reception team can arrange an early appointment so the right specialist can evaluate the tooth and advise on next steps.
Natal teeth should always be evaluated by a Specialist Pediatric Dentist — not a general dentist. Pediatric dental specialists are trained specifically in the oral health of infants and young children, including the assessment and management of natal and neonatal teeth. At Drs. Nicolas & Asp Centers, children are seen exclusively by our Specialist Pediatric Dentists.
Coverage depends on your individual insurance plan and the treatment recommended. At Drs. Nicolas & Asp Centers, we accept most major insurance cards for direct billing and handle all pre-approvals and paperwork on your behalf. Visit Insurance & Payment Options for details on coverage and payment plans.
- Cunha, R.F., Boer, F.A., Torriani, D.D., and Frossard, W.T. "Natal and Neonatal Teeth: Review of the Literature." Pediatric Dentistry, vol. 23, no. 2, 2001, pp. 158–162. aapd.org
- American Academy of Pediatric Dentistry. "Perinatal and Infant Oral Health Care." The Reference Manual of Pediatric Dentistry. AAPD, 2025. aapd.org
- Kates, G.A., Needleman, H.L., and Holmes, L.B. "Natal and Neonatal Teeth: A Clinical Study." Journal of the American Dental Association, vol. 109, no. 3, Sept. 1984, pp. 441–443. doi.org
- Leung, A.K.C. and Robson, W.L.M. "Natal Teeth: A Review." Journal of the National Medical Association, vol. 98, no. 2, 2006, pp. 226–228. pubmed.ncbi.nlm.nih.gov
- DeSeta, M., Holden, E., Siddik, D., and Bhujel, N. "Natal and Neonatal Teeth: A Review and Case Series." British Dental Journal, vol. 232, no. 7, 2022, pp. 449–453. nature.com
