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Natal and neonatal teeth are a relatively rare but well-documented phenomenon, with the majority being prematurely erupted teeth of the normal primary dentition. Related complications include feeding issues, traumatic lingual ulceration and risk of aspiration. We present three clinical cases referred to the Paediatric Dentistry Department at Guy's and St Thomas' NHS Foundation Trust and their management. Treatment choice is based on individual assessment of each patient and options include monitoring, smoothing of the teeth or extraction. General dental practitioners should be able to diagnose natal and neonatal teeth and provide initial management in primary care, with referral to secondary care services in more complex cases or those which are likely to require extraction.

Purpose Tooth enamel might provide past chronological metabolic, nutritional status and trace metal exposure during development. Thus, the trace elements distribution embedded in tooth tissues represents an archive of the environmental conditions. The choice of biomarker is estimated as critical to the measurement of metal exposure. Natal teeth are defined as teeth being present at birth. Methods LA-ICP-MS provides a quantitative assessment of spatial distribution of trace elements in a natal tooth. The objective of the current study was to compare concentrations of building and other elements in a rare but reliable and valid biomarker - natal tooth. Results It have been reported presence of potentially toxic elements: Pb, Cu, Mn, Cd, Ni distributed in prenatally and perinatally formed enamel and dentine. Conclusions Analyses of deciduous enamel can provide answers into individuals’ earliest development, including critical pre- and perinatal period.

Background Neonatal teeth erupt during the neonatal period and natal teeth are the presence of teeth since birth. While rare, natal teeth and neonatal teeth can have a significant impact on breastfeeding. Neonatal teeth are less common, and although its exact etiology is still unknown, it can cause difficulties in breastfeeding to the mother and may eventually lead to discontinuation of breastfeeding. Other associated possible complications include tooth aspiration and sublingual ulceration. This paper was aimed to discuss the clinical features, complications, and management of neonatal tooth, in addition to its impact on breastfeeding and role in sublingual ulcer formation. Case presentation We present a baby girl who had a neonatal tooth with sublingual ulceration (Riga-Fede disease), which resulted in a difficulty to breastfeed for the baby and nipple pain to the mother. Following the extraction of the baby’s tooth, she immediately continued breastfeeding, and her tongue ulcer healed well. Conclusion Extraction of the neonatal tooth promoted rapid healing of oral ulcers and the reestablishment of breastfeeding.

Dental pulp stem cells were primarily derived from the pulp tissues of exfoliated deciduous teeth, primary incisors and permanent third molar teeth. The aim of this study was to isolate and extensively characterise SCs derived from human natal dental pulp (hNDP). For characterisation, proliferation capacity, phenotypic properties, ultrastructural and differentiation characteristics and gene expression profiles were utilised. A comparison was done between the properties of NDP-SCs and the properties of mesenchymal stem cells (MSCs) from bone marrow (BM) of the human. Stem cells isolated from hNDP and hBM were analysed by flow cytometry, reverse transcriptase-PCR, Real Time-PCR, and immunocytochemistry. Both cell lines were directionally differentiated towards adipogenic, osteogenic chondrogenic, myogenic and neurogenic lineages. hNDP-SCs and hBM-MSCs expressed CD13, CD44, CD90, CD146 and CD166, but not CD3, CD8, CD11b, CD14, CD15, CD19, CD33, CD34, CD45, CD117, and HLA-DR. Ultrastructural characteristics of hNDP-SCs showed more developed and metabolically active cells. hNDP-SCs and hBM-MSCs expressed some adipogenic (leptin, adipophilin and PPARgamma), myogenic (desmin, myogenin, myosinIIa, and alpha-SMA), neurogenic (gamma-enolase, MAP2a,b, c-fos, nestin, NF-H, NF-L, GFAP and betaIII tubulin), osteogenic (osteonectin, osteocalcin, osteopontin, Runx-2, and type I collagen) and chondrogenic (type II collagen, SOX9) markers without any stimulation towards differentiation under basal conditions. Embryonic stem cell markers Oct4, Rex-1, FoxD-3, Sox2, and Nanog were also identified. The differentiation potential of hNDP-SCs and hBM-MSCs to adipogenic, osteogenic, chondrogenic, myogenic and neurogenic was shown. This report described the first successful isolation and characterisation of hNDP-SCs.

On 4 February 2013 experts confirmed that the remains of the last English king to die in battle were found under a council car park in Leicester, England. Richard III, the last Plantagenet king, wore the crown from 1483 until his untimely death in 1485. There have been many myths published about him, even one with a dental reference. This paper explores what dentistry was like at the time of Richard III, reveals the truth behind the myths and sees how the University of Leicester's findings about his dentition and skull has provided an insight into his identification, lifestyle and final moments.

Introduction Riga-Fede disease is a rare pediatric condition in which chronic lingual ulceration results from repetitive trauma. Neonatal teeth or underlying neuro-developmental disorders which include Down syndrome are described as causative factors, but to the best of our knowledge, this is the first case report of both Down syndrome and natal teeth coexisting. The need for early extraction in the presence of two risk factors is highlighted in this case report. Case presentation An 18-month-old Sinhalese male presented with an ulcerating lingual mass on the ventral surface of the tongue. The lesion had progressed over the past six months. He also had clinically diagnosed Down syndrome. The ulcer was non-tender, indurated, and had elevated margins. It was not bleeding and two natal teeth in lower central dentition were seen in apposition with the lesion. There was no regional lymphadenopathy but the ulcer was causing concerns as it mimicked a malignant lesion. A clinical diagnosis of Riga-Fede disease caused by raking movements of the tongue against anterior natal teeth by a child who was developmentally delayed and prone to suck on his tongue was made. The mother was reassured and the natal teeth were extracted. Conclusions Early extraction of natal teeth is recommended only if there is a risk of aspiration or interference with breast feeding. Although Down syndrome is among the neuro-developmental conditions that lead to this lesion, its occurrence is usually at an older age. The presence of natal teeth together with Down syndrome caused the lesion to occur in infancy. Awareness of the benign nature of this rare condition by pediatricians and dental practitioners is important as it will allay anxiety and avoid unnecessary biopsy. This case also highlights the impact of two risk factors and needs consideration as an added indication for the early extraction of natal teeth.

Natal teeth are defined as those present in the mouth at birth. They are uncommon and most frequently occur in the anterior mandible as a pair of primary incisors. They are usually small and poorly developed with little or no root formation. Only 10% of these teeth are supernumerary. Problems arising are difficulty suckling, severe ulceration of the child's tongue or the mother's breast and the risk of aspiration. These situations would warrant extraction. If the natal teeth are firm and asymptomatic, conservative management is indicated. Negative cultural attitudes towards natal teeth demand good parental counselling and vigilant management in relation to child protection.

Inclusion cysts of transient nature during the neonatal period are developmental lesions, which are seen in the oral cavity of the newborn infant. These lesions are classified into three subtypes according to their localizations. When noticed by the anxious parents on the gingival surfaces, they are often mistaken for natal teeth, which lead to seeking medical attention. Herein, we describe a newborn infant with Bohn's nodules to increase the awareness of the physicians to this benign, self-limiting lesion.

A neonatal tooth is defined as a tooth, which erupts within the first month of life. Herein, we report a premature infant with a neonatal tooth.

The oral and dental features of a case of the Saldino-Noonan lethal short rib-polydactyly syndrome (SNS) are described. Natal teeth were noted. The anterior maxillary and mandibular fornices and the central labial frenula were absent. The tongue appeared larger than normal and lacked the sulcus terminalis and the vallate and foliate papillae. The tooth anlagen were abnormal. Microscopic studies revealed small tooth buds, in which hard tissue formation was more advanced than gestational age; abnormalities were noted primarily in the most recently formed dental tissue, indicating that the biochemical defect responsible for this disorder had acted abnormally on dentinogenesis mainly shortly prior to birth. Studies of oral and tooth development should be important to better understanding the abnormal function of the chondrodystrophy genes.

Two male infants with a pseudo-hydrocephalic progeroid syndrome with natal teeth are compared with two very similar female cases reported in the literature and interpreted as congenital progeria. All these cases may represent a separate entity, a previously unrecognized genetic progeroid syndrome.