Yes, babies can be born with teeth; these rare “natal teeth” occur in about 1 in 2,000–3,000 births and are usually lower central incisors.
Seeing a tiny tooth in a newborn’s smile can catch anyone off guard. Most first teeth erupt around six months, yet a small number of infants arrive with one or more teeth already visible at the gumline. Clinicians call these natal teeth when present at birth and neonatal teeth when they erupt during the first 30 days. The vast majority are part of the normal baby set rather than extra teeth, and many can be kept in place with simple care.
Babies Born With Teeth: How Rare Is It?
Reports across pediatric dentistry place the rate between roughly one in two thousand and one in three thousand births. Most cases involve a single tooth or a pair. The classic site is the lower front gum where the future central incisors sit. Upper incisors, canines, or molars at birth are much less common. Girls appear slightly over-represented in some series, though findings vary.
Quick Definitions That Help
- Natal teeth: present on day one.
- Neonatal teeth: arrive during days 1–30.
- Typical timing for others: around six months, with wide normal ranges.
At-A-Glance Differences
| Feature | Natal Teeth | Neonatal Teeth |
|---|---|---|
| When They Appear | Visible at birth | Erupt in the first 30 days |
| Usual Location | Lower central incisors | Lower central incisors |
| Root Formation | Often minimal, can be mobile | Often minimal, may firm up over time |
| Keep Or Remove? | Keep if stable and not causing issues | Same principle as above |
| Main Concerns | Feeding soreness, tongue ulcer, loosening | Similar concerns if loose or sharp |
What These Early Teeth Usually Look Like
Appearance varies. Many look smaller than a typical baby tooth. Some are conical. Enamel may be thin. Because roots can be short, a tooth can wiggle when touched. Others look almost like any primary incisor and feel fairly firm. A pediatric dentist can tell whether it is part of the normal set or an extra tooth by exam and, if needed, a small radiograph.
Why They Show Up So Early
A single cause is not clear. Family patterns suggest heredity in a portion of cases. Accelerated eruption along the normal path explains most. A small minority tie to genetic syndromes or cleft conditions, which the baby’s medical team would already be assessing. In routine cases with a healthy newborn, no special testing is needed beyond dental review.
When Early Teeth Cause Trouble
Most newborns with a tooth at the gumline nurse or bottle-feed just fine. A few run into friction issues. Sharp edges can rub the underside of the tongue and form an ulcer known as Riga-Fede disease. A loose tooth can bother the infant while feeding or rub the parent’s skin. True choking risk is rare yet taken seriously if the tooth has marked mobility.
Common Signs To Watch
- Repeated tongue rubbing or a small ulcer under the tip of the tongue
- Ongoing soreness during latching despite position adjustments
- Visible wobble of the tooth with very gentle pressure
- Discoloration from wear or a chipped edge that scrapes soft tissue
First Steps Parents Can Take At Home
Keep the area clean. Wipe gums and any erupted surface once or twice a day with a soft, damp cloth. If there is a sharp point, ask a dentist about smoothing. Nursing parents can try minor latch tweaks or a different hold. If bottle-feeding, ensure a calm flow and a relaxed jaw position.
Simple Comfort Measures
- Cool, clean washcloth for gentle gum contact
- Frequent burp breaks to pause rubbing
- Short, more frequent feeds while irritation settles
How Dentists Decide Whether To Keep Or Remove
The default approach is conservative. If the tooth is stable, not hurting the tongue, and feeding is going well, keeping it is the goal. Many early teeth firm up as the socket matures. Smoothing a rough edge with a quick polish often solves friction. Bonding with a tiny amount of resin can round a point as well.
When Removal Makes Sense
- Marked mobility: a high chance of detachment
- Persistent tongue ulcer: not resolving with smoothing
- Feeding failure: weight gain at risk due to pain or poor latch
- Supernumerary tooth: confirmed extra tooth crowding the normal site
Newborns receive vitamin K prophylaxis in the hospital; dental teams confirm status before any extraction. If removal is needed, it’s usually quick, with small local measures and minimal bleeding. Follow-up focuses on comfort and hygiene. The underlying normal tooth bud, if present, will later produce the usual incisor.
Safe Care, Backed By Guidance
Reliable sources point to simple cleaning, early dental review, and case-by-case decisions rather than automatic extraction. For a plain-language overview, see the MedlinePlus page on natal teeth. For professional best practices around infant oral health, the AAPD perinatal & infant oral care guidance is a solid reference for clinicians and families to discuss together.
What A Visit To A Pediatric Dentist Looks Like
Expect a gentle exam and a conversation about feeding, sleep, and any rubbing or sores. The dentist will check mobility, contour, and how the tooth meets the tongue. If the situation is straightforward, you’ll leave with cleaning tips and, if needed, a smoothed edge. In more complex cases, a tiny radiograph confirms whether the tooth is part of the regular set or extra, and whether there is enough root support to keep it.
Questions Worth Asking
- Is the tooth part of the normal baby set?
- Can we smooth the edge rather than remove it?
- How mobile is it, and what does that mean for safety?
- What signs would prompt a return visit sooner?
Feeding Tips That Often Help
Small tweaks go a long way. Try a deeper latch so the tongue covers the lower gumline. A position that supports the chin can reduce rubbing. If a sore forms under the tongue, ask about a soft dental resin to round sharp points. Many babies settle once the edge is smooth and the latch is set.
Latching Ideas To Test
- Laid-back hold to let gravity assist a deeper latch
- Cross-cradle hold for fine control of alignment
- Paced bottle-feeding to keep jaw relaxed
What These Teeth Mean For Later
If a natal tooth is part of the normal set and stays, it often functions like any other primary tooth. If removal is needed because it’s extra or unstable, spacing can look a bit different for a while. Later, the permanent set still follows its own schedule. Your dental home will track growth and advise on spacing or alignment only if needed.
Myth Check
- “It always means a disorder.” Most cases stand alone without any broader diagnosis.
- “It’s unsafe to breastfeed.” Feeding is usually fine, especially after smoothing.
- “Extraction is routine.” Removal is for select cases with clear reasons.
How Clinicians Classify The Situation
Classification helps predict stability and plan care. Dentists look at where the tooth sits, how much it moves, and whether it’s the expected incisor or an extra. Mobility grading uses a gentle wiggle test. A firm tooth without sharp edges is a good candidate for keeping. A very loose tooth with an ulcer that keeps returning points to removal.
Practical Decision Grid
| Situation | What A Dentist May Do | Why It’s Chosen |
|---|---|---|
| Firm tooth, smooth edge | Leave in place; routine cleaning | Low risk; normal function |
| Firm tooth, sharp edge | Smooth/polish; resin rounding | Stops tongue rubbing |
| Mobile tooth without soreness | Close monitoring; feeding checks | May stabilize over time |
| Mobile tooth with ulcer | Smoothing first; remove if not resolving | Prevents ongoing injury |
| Extra tooth crowding the site | Extraction | Protects spacing for normal incisor |
Safety Notes New Parents Appreciate
Any tooth at birth deserves a look from a dentist within the first weeks. That single visit sets a clean plan and eases worry. Call sooner if the tooth seems looser than before, if a tongue sore appears, or if feeding starts to stall. Keep a soft cloth by the changing area and wipe after the morning feed and before bed. If your baby received vitamin K at birth, routine dental care is straightforward when a procedure is needed.
Clear Takeaway
Yes—teeth at birth happen, and most cases are simple. Clean gently, book an early dental check, and use smoothing or removal only when there’s a solid reason. With that approach, newborns with an early tooth eat well, heal well, and move into the usual teething stage like everyone else.