Last month, here in Fremont, the newborn son of a family friend surprised his parents by coming into the world with two perfectly normal front teeth in his lower jaw.

If the child had been born several hundred years ago, he might have had something to worry about, because there were old wives’ tales regarding natal teeth, such as that a baby born with teeth would be selfish, or that such a baby was a vampire. Fortunately, we are enlightened enough not to to worry about the baby’s emotional predilections or go about strewing the house with garlic, as people once did to ward off vampires. Instead, doctors simply advise the parents to monitor the teeth.

Such teeth are called “natal teeth,” and natal teeth are extremely rare, with an incident rate at about one in 2000–3000 births. Natal teeth differ from neonatal teeth, which grow after baby’s birth, usually within the first thirty days. Natal teeth are usually the lower-front two teeth, and they may or may not be fully formed. Babies can also have more than two teeth, and, in rare incidents, even molars.

What is the reason for natal teeth, and will the child then have three sets of teeth over his lifetime, instead of the normal two? Not usually. Most of the time, natal teeth have simply erupted earlier then the usual schedule, and are not extra teeth, but normal baby teeth.

Although there is no known cause for the condition, several studies suggest that there are hereditary links, while others suggest natal teeth might be associated with certain medical syndromes. For this reason, babies born with natal or neonatal teeth should be carefully evaluated to rule out such a possibility.

What is the recommendation regarding natal teeth? Current thinking indicates that, unless the teeth are not fully developed, are loose, or are causing some other problem, they should not be pulled. Some of the reasons for pulling them might be that:

• If they are loose, natal teeth can increase the chance of a baby’s choking;
• Since natal teeth are usually very sharp, they can cause a lot of discomfort, especially in the early stages, to the nursing mother;
• If they create ulcers on the baby’s tongue, that can cause pain to the baby;
• If their enamel has not yet fully formed, they might be yellowed or unsightly.

Most of the time, however, there are no associated problems with natal teeth, and it is a condition that should simply be monitored.