Dental problems in children: natal teeth & delayed tooth eruption (DTE)

Dentition in children: essentials to know


Two types of teeth erupt while children grow up to adulthood. 

  • First, Temporary (also known as Primary or Deciduous) teeth &

  • Then Permanent (also known as Secondary) teeth.



Here are the differences between the two types of teeth.


Temporary or Primary or Deciduous teeth

Permanent or Secondary teeth

Starts erupting at 6-7 MONTHS of life.

Starts erupting at 6-7 YEARS of life.

First tooth to appear: Central incisor tooth

First tooth to appear: 1st Molar tooth

Eruption completed by: 2.5-3 year age

Eruption completed by: 2.5-3 year age

Total number of teeth: 20 

(premolar not present here)

Total number of teeth: 32 

Exfoliation of temporary teeth: begins at about 6 year age & continues till 12 years.

Exfoliation of Permanent teeth: doesn’t happen. 


SEQUENCE of Primary dentition


Age 

Eruption (Primary tooth)

At birth

No teeth (sometimes Natal teeth can be normal variant also)

6-7 months

Central incisors

9-10 months

Lateral incisors

12-18 months

1st Molar

15-21 months

Canines (or Cuspid)

2-3 years

2nd Molar


(Pic_1: total 20 primary teeth in a child)



SEQUENCE of Secondary dentition


Age 

Eruption (Secondary tooth)

6-7 years

1st Molar

7-8 years

Central incisors

8-9 years

Lateral incisors

10 years

1st Premolar

10-11 years

2nd Premolar

11-12 years

Canines

12-13 years

2nd Molars

17-25 years

3rd Molars

(Pic_2: total 32 permanent teeth of an adult person)


Natal teeth

(Pic_3: tooth present at birth of a newborn)



Natal teeth: when one or more teeth are already present at birth. Most commonly are central incisors. These are also called Pre-Deciduous teeth. 


These can be present due to:

  • Normal variant (in most cases) or

  • Congenital syphilis or

  • Part of syndromic manifestations like 

    • Sotos syndrome

    • Ellis-Van Creveld syndrome

    • Epidermolysis bullosa

    • Pierre Robin syndrome


Problems with natal teeth: 

  • Mostly doesn't cause any functional problems.

  • However, difficulty during suckling, ulceration in mouth, biting of the mother’s breasts and aspiration of the teeth may be there which warrant urgent intervention. 


Video link:    for ‘natal teeth’ in a newborn baby

https://youtube.com/shorts/j_7IqETgri4?feature=share


Delayed Tooth Eruption (DTE)


Absence of any teeth eruption till 13 months of age.


Likely causes of DTE(delayed tooth eruption):

  • PEM (Protein energy malnutrition)

  • Rickets

  • Achondroplasia

  • Osteogenesis imperfecta

  • Cleidocranial dysplasia

  • Hypothyroidism

  • Hypoparathyroidism

  • Hypopituitarism

  • Down syndrome

  • Progeria

  • Incontinentia pigmenti

  • Idiopathic or unknown (in majority of cases)


Advanced dentition

Usual causes are:

  • Precocious puberty

  • Hyperthyroidism


Disclaimer


These informations are based on:

  • Standard textbooks of Pediatrics like Nelson 21st edition, OP Ghai, Suraj Gupte

  • Review articles in pediatric dentistry


Medical science is an ever-evolving subject, some of the information might change from time to time. However, mostly the basic concepts remain the same. For any confusion or query, please feel free to contact me via 

  • Comment section of the blog

  • Youtube channel ( Ped talk_Dr Sabya)

  • Gmail: pedtalkdrsabya@gmail.com

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