Blog – AMARA MEDICARE | Dental, Eye & ENT Specialists


Fixed Palatal Crib
Fixed Palatal Crib

Early and regular dental visit is essential in helping to maintain a child’s oral hygiene and promoting a good occlusion into adulthood. Some bad tooth alignment that is seen in some adults could have been better managed during childhood. In Nigeria, most pediatric visit starts at the age of 7-9 years and even at that more than 50% of children within that age group may not visit the dental clinic. Most pediatric visit is due to pain and when there is a need to wear an appliance, some parents are reluctant for various reasons; financial, cultural, psychosocial etc.

It is important for parents to understand that wearing of appliance in children is safe and may be necessary for both preventive and treatment purposes. Many children with persistent tongue or thumb sucking habits can be treated with appliances if behavioral management seems unhelpful. Appliances can also be worn to prevent misalignment of tooth, proper tooth eruption as well as helping to replace early loss of tooth in children.

It can be extremely difficult to encourage young children to wear removable dental appliances regularly.  Pediatric dental appliances can prevent injury to the teeth and may also reduce (or even eliminate) the need for extensive treatment later.


There are many types of pediatric dental appliances that can be recommended for various purposes. The major categories of pediatric dental appliance are as follows:

  1. Space Maintainers – Sometimes, primary (baby) teeth are lost prematurely due to trauma or decay.  Adjacent teeth tend to shift to fill the space, causing spacing and alignment problems for permanent (adult) teeth.  Space maintainers are inserted as placeholders until the permanent teeth are ready to erupt.   Depending on the position of the missing tooth and the condition of the surrounding teeth, the dentist may prescribe a band and loop, a crown and loop, a distal shoe or a lower lingual arch type of space maintainer to fill the empty gap. All spacer maintainers have similar function; however, the nature of the attachment to the adjacent teeth differs.  Fixed space maintainers are usually made of metal and are highly durable, while removable ones are rarely used with young children.
  2. Mouth Guards – The Nigeria Dental Association (NDA) recommends that children wear mouth guards when engaging in any potentially injurious activity, including sporting and recreational endeavors. The pediatric dentist can fabricate a customized mouth guard for the child, or a thermoplastic “boil-and-bite” mouth guard can be purchased.  Similar mouth guards are used for children who grind their teeth at night, a condition known as bruxism.
  3. Sucking Appliances – Children tends to have various habits, namely; thumb sucking, finger sucking, tongue sucking, tongue thrusting, lip sucking etc. Naturally, majority of children tend to outgrow their habit. However, children who continue to have habit after the age of 5 or 6 years risk oral complications such as; narrowed arches, impacted teeth, and misaligned teeth. Appliances such as goal post, palatal crib or rake, tongue crib, modified quad helix etc., can be used to correct various habits in children.


Other appliances include Expansion appliances used to widen the jaw arch in order to accommodate erupting tooth especially in children who have cleft palate, Bionator used for children in which their upper or lower jaws is proportionately smaller, Retractors used to correct misalignment and Retainers used to maintain tooth alignment.


Pediatric dental appliances are safe and may be necessary to prevent teeth misalignment in children as well as reduce cost of treatments in the future


Image of a baby born with teeth
Baby born with teeth

Teething is a normal part of a baby’s development during the first year of life. Most babies get their first tooth between 4 and 7 months of age. However, some babies are born with teeth and these can seem mysterious or superstitious to some families especially those culturally inclined. Some of these children tend to be deprived of parental love and care based on cultural or spiritual beliefs. Some ethnic groups in Nigeria refer to these children as ‘ogbanje’, ‘abiku’ etc. because they believe that the children are monstrous and bearers of misfortune.

These sets of teeth are referred to as natal or neonatal teeth depending on how early they grow in the child’s mouth and one should not be scared or worried about them unless the teeth interfere with feeding, or are a choking hazard.


Natal Teeth – These are teeth present at birth.

Neonatal Teeth – These are teeth that erupt above the gum within the first month (30 days) of life of the baby.


Natal teeth are relatively rare and occur in at least 1 out of every 2,000 live births. The rarity of natal teeth explains in part why some traditional beliefs were attached to it. The exact cause of teeth at birth is unknown. However. some medical conditions and predisposing factors are said to be associated with natal teeth.


  • Cleft Lip & Palate
  • Sotos
  • Hallerman-Streiff
  • Pierre Robin
  • Ellis-van Creveld
  • Down Syndrome
  • Ectodermal Dysplasia
  • Craniofacial Dystosis


  • Close Family members with natal teeth
  • Malnutrition during pregnancy
  • Poor maternal health during pregnancy
  • Congenital Syphilis
  • Endocrine disturbances


  1. Fully developed crown held down by little root
  2. Fully developed crown with no root
  3. Small tooth crown just emerging through the gum
  4. Unerupted but with evidence of tooth about to cut through the gum


Natal teeth that aren’t loose are usually left alone. But if your baby is born with loose teeth that have no roots, your doctor might recommend surgical removal. Some common complications of a loose natal tooth include;

  • Choking from accidental swallowing of the loose tooth
  • Feeding problems
  • Tongue injuries such as ulcer, inflammation etc.
  • injuries to the mother during breast-feeding
  • Dental caries on the tooth


No intervention is usually recommended unless they are causing difficulty to the infant or mother. However some recommend that they be removed as the tooth can cut or amputate the tip of the tongue. They should be left in the mouth as long as possible to decrease the likelihood of removing permanent tooth buds with the natal tooth. They should also not be removed if the infant has hypoprothrombinemia (a condition in which the baby can have spontaneous bleeding if the tooth is removed).


Being born with teeth is rare, but it’s possible. If your baby has teeth at birth, be sure to talk to your dentist. A dentist can help guide you through the process. Even if your newborn’s teeth aren’t considered an immediate concern, it’s important to monitor them to prevent any complications.


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