GUIDE
About 1 in 2,000 to 3,000 babies is born with one or more teeth already present. It is unusual but usually harmless.
Finding a tooth in your newborn's mouth is surprising. Natal teeth are rare but well-documented, and in most cases they are simply early-arriving normal teeth. Here is what you need to know about whether they stay, whether they need to go, and what to watch for.
Natal teeth are teeth that are present at birth. They are rare — occurring in roughly 1 in 2,000 to 3,000 newborns — and they surprise nearly every parent who encounters them. If you are reading this because your baby was born with a tooth (or you just noticed one in the first few weeks of life), here is the most important thing to know: in the vast majority of cases, natal teeth are simply normal baby teeth that arrived very early. They are not a sign of anything wrong.
About 85% of natal teeth appear in the lower front of the mouth — the same location where most babies get their first tooth during normal teething. And about 90 to 95% of natal teeth are premature primary teeth, meaning they are the actual baby teeth erupting months ahead of schedule, not extra teeth.
The remaining 5 to 10% are supernumerary teeth — extra teeth that would not have been part of the normal set of 20 baby teeth. This distinction matters because it affects whether the tooth should be kept or removed, and a pediatric dentist can help determine which type your baby has, sometimes with the aid of X-rays.
Natal teeth can run in families. About 15% of babies with natal teeth have a parent or close relative who was also born with teeth. Historical figures including Julius Caesar, Napoleon, and Louis XIV were reportedly born with teeth — so your baby is in interesting company.
| Fact | Detail |
|---|---|
| Incidence | Approximately 1 in 2,000 to 3,000 births |
| Most common location | Lower central incisors (the bottom front teeth) — about 85% of cases |
| Type | About 90–95% are premature primary teeth (early-arriving normal teeth), not extra teeth |
| Gender | Slightly more common in girls than boys in some studies |
| Family history | Can run in families — about 15% of babies with natal teeth have a family member who also had them |
| Neonatal teeth | Teeth that erupt in the first 30 days after birth — managed similarly to natal teeth |
This is the central question, and the answer depends on several factors that a pediatric dentist will evaluate:
How firmly is the tooth attached? If the tooth has a good root and is firmly seated in the gum, it is usually a premature primary tooth and should be kept. It will function normally as part of your baby's primary dentition. If it is very loose and wobbly, there is a risk that it could detach and be aspirated (inhaled), which is dangerous. Loose natal teeth are typically extracted as a precaution.
Is it causing feeding problems? Some natal teeth have sharp or rough edges that can injure the mother's nipple during breastfeeding or cause ulceration on the baby's own tongue (a condition called Riga-Fede disease). If the edge can be smoothed, that is preferred. If the tooth is causing significant and unresolvable feeding problems, extraction may be discussed.
Is it a primary tooth or a supernumerary? If X-rays or clinical evaluation determine that the tooth is an extra tooth (supernumerary), it is usually removed to prevent interference with the normal primary teeth that will erupt later.
In most cases, natal teeth are kept in place. Extraction is reserved for situations where the tooth poses a safety risk (aspiration) or is causing significant functional problems. If the tooth is removed, it will not be replaced until the permanent tooth erupts, usually around age 6 to 7.
| Scenario | Recommendation | Considerations |
|---|---|---|
| Tooth is firmly attached with adequate root | Keep — this is likely an early primary tooth that will serve normally | Monitor for any issues with feeding. Clean gently with damp gauze. |
| Tooth is very loose or mobile | Consider removal — loose teeth in newborns pose an aspiration risk | A pediatric dentist should evaluate. If the tooth is at risk of detaching and being inhaled, extraction is the safest option. |
| Tooth is causing breastfeeding problems | Evaluate options — smoothing the edge or extraction may be discussed | Try smoothing the edge first. If breastfeeding cannot be maintained due to the tooth, extraction may be appropriate. |
| Tooth is confirmed as supernumerary (extra) | Usually remove — extra teeth can interfere with normal tooth development | X-rays can help determine whether the tooth is a premature primary tooth or an extra tooth. |
| Tooth is causing Riga-Fede disease (ulceration of tongue) | Smooth the edge first; extract if ulceration does not resolve | Riga-Fede disease occurs when a sharp natal tooth causes a chronic ulcer on the underside of the baby's tongue. It can interfere with feeding. |
One of the most common concerns parents have about natal teeth is their impact on breastfeeding. The concern is understandable — the idea of a newborn with a sharp tooth latching onto a nipple sounds painful.
The reality is more nuanced. Many mothers breastfeed successfully with babies who have natal teeth. A properly latched baby draws the nipple deep into the mouth, past the teeth, so the tooth does not necessarily make contact with the nipple during normal feeding. Latch issues, rather than the tooth itself, are usually the cause when problems occur.
That said, some natal teeth do have rough or sharp edges that can cause nipple injury, especially in the early days when both mother and baby are still learning to breastfeed. If this happens, a pediatric dentist can sometimes smooth the edge of the tooth to reduce irritation. A lactation consultant can also help optimize latch to minimize contact between the tooth and the nipple.
If the tooth is causing a chronic ulcer on the baby's tongue (Riga-Fede disease), this can also interfere with feeding by making it painful for the baby to nurse. Smoothing the tooth edge is the first-line treatment; if the ulceration does not resolve, extraction may be considered.
The bottom line: natal teeth do not automatically mean the end of breastfeeding. Get a dental evaluation, work with a lactation consultant, and most cases can be managed without removing the tooth.
In the vast majority of cases — the overwhelming majority — natal teeth are an isolated finding with no underlying cause. They are simply teeth that arrived early, often with a genetic component.
Very rarely, natal teeth can be associated with certain medical syndromes, including Ellis-van Creveld syndrome, Hallermann-Streiff syndrome, pachyonychia congenita, and Sotos syndrome. However, these conditions always have multiple other features that would be apparent. A baby with an isolated natal tooth and no other unusual findings is extremely unlikely to have a syndromic condition.
Your pediatrician will assess the full clinical picture. If the natal tooth is the only unusual finding and your baby is otherwise healthy, no further workup is typically needed.
Natal teeth are your baby's first dental milestone — just much earlier than expected. Log it in tinylog along with other milestones to build a complete developmental timeline for your pediatrician and dentist.
Natal teeth are rare but not alarming. Your medical team has seen this before, even if you have not. The evaluation process is straightforward, and the management is well-established.
Get a pediatric dental evaluation early. Even though the first dental visit is typically recommended by age 1, a baby with natal teeth should see a pediatric dentist sooner — ideally within the first few weeks of life — to assess the tooth's stability and plan for management.
Do not try to remove or wiggle the tooth yourself. Even if the tooth seems loose, extraction should only be performed by a dental professional under appropriate conditions. There is a risk of bleeding and, more importantly, of the tooth or tooth fragments being aspirated.
Most natal teeth turn out to be fine. The tooth stays, your baby teethes normally for the rest of the primary teeth (potentially on an earlier timeline), and the natal tooth takes its place in the normal row of baby teeth without incident. The story is usually more interesting than the medical reality.
Finding a tooth in your newborn's mouth is startling, especially if you did not know this was possible. Natal teeth are uncommon but well-documented in medical literature and are almost always a benign finding. Take a breath. Your baby is fine. The next step is simply to have the tooth evaluated by a pediatric dentist.
About 15% of babies with natal teeth have a close family member who also had natal teeth. Call your parents and your partner's parents and ask. If someone in the family was born with teeth, it is likely genetic and completely normal.
A natal tooth can occasionally cause nipple soreness or difficulty with latch. Work with a lactation consultant who can help you adjust positioning. If the tooth has a sharp edge, a pediatric dentist may be able to smooth it. In many cases, breastfeeding continues without significant issues despite the tooth.
If a natal tooth is extracted and it was the actual primary tooth (not an extra), there will be no replacement until the permanent tooth comes in, usually around age 6 or 7. This gap is cosmetic only and does not affect your child's development, speech, or ability to eat.
This guide is for informational purposes only and is not a substitute for professional medical advice. If your baby has a fever of 100.4°F (38°C) or higher, is refusing to eat, or seems unusually unwell, contact your pediatrician — these symptoms are not typical of teething alone.
