The close relationship among oral, systemic, and psychologic health requires that oral health be evaluated thoroughly as part of health maintenance supervision. An understanding of the normal sequence and patterns of tooth eruption is the foundation for identifying and treating children with abnormal dental development and optimizing their oral health. Distinguishing normal from pathological dental development requires careful evaluation of the patient, including medical, dental, and family history; clinical examination; radiographic evaluation; and possibly special laboratory tests.
Problems in dental development and syndromes associated with abnormal dental development are reviewed here. The normal anatomy and development of human dentition are discussed separately. (See "Anatomy and development of the teeth".)
Problems in tooth eruption include natal and neonatal teeth, premature eruption, and failed tooth eruption.
Natal and neonatal teeth — Teeth that are present in the oral cavity at the time of birth are natal teeth; those that erupt during the neonatal period are neonatal teeth. The majority of natal teeth are the primary mandibular incisors and are not extra or supernumerary teeth (image 1). Natal teeth may be associated with a variety of syndromes including chondroectodermal dysplasia (Ellis-van Creveld syndrome), pachyonychia congenita, Sotos syndrome, and Hallerman-Streiff syndrome .
Treatment of natal teeth may involve observation, smoothing of the incisal edge (to prevent potential discomfort during breastfeeding and ulceration in the floor of the mouth), or extraction . Extraction of natal teeth should be considered only if they cause feeding difficulties for the infant or mother. Excessive natal tooth mobility has been considered to be a risk for aspiration. However, aspiration rarely, if ever, occurs.