定義:Natal teeth (出生牙)are teeth that are already present at the time of birth(一出生就已存在的牙齒). They are different than neonatal teeth(新生兒牙), which grow in during the first 30 days after birth(出生30天內長出的牙齒)
 

considerations(考量):

Natal teeth are relatively uncommon, appearing in about one in every 2,000 to 3,000 births. Although most natal teeth are isolated incidents, their presence may be associated with certain medical syndrome.

Natal teeth generally develop on the lower gum where the central incisor teeth will appear. They have little root structure and are attached to the end of the gum by soft tissue and are often wobbly.

Natal teeth are usually not well formed but they are firm enough that, because of their placement, they may cause irritation and injury to the infant's tongue when nursing. Natal teeth may also be uncomfortable for a nursing mother.

Frequently, natal teeth are removed shortly after birth while the newborn infant is still in the hospital, especially if the tooth is loose and the child runs a risk of aspiration, or "breathing in" the tooth.

neonatal tooth(字典的定義)

A tooth erupting up to 30 days after birth. (剛出生30天內所見的牙齒通稱之)~~看一下一周大的嬰兒的neonatal tooth

寶寶一出生即有牙齒,稱為胎生齒(natal teeth),若是出生沒有牙齒,在滿月前長牙,則稱為新生兒齒(neonatal teeth)。發生胎生齒的機率為:一千名新生嬰兒可能會有一位有胎生齒;胎生齒發生的位置大多為下排2顆正中門齒,在有胎生齒或是新生兒齒的幼兒中,大約有15%~20%可以發現家人也有同樣的情形,只有在少數的情況下,胎生齒的發生與某些症候群或疾病有關。

不論是胎生齒或是新生兒齒,一般他們都是由牙齦邊緣長出,較少有牙根,除非太鬆動,不然這些牙齒並不是那麼容易會脫落,進而造成嗆入,所以,多數並不需要拔除。如果寶寶的牙齒真的搖搖欲墜,可以請專業的兒童牙醫師仔細檢查評估並拔除,以避免造成組織的傷害和出血。

少數新生兒在一生下來就長牙,古代稱這種牙齒為「鬼牙」,傳說長「鬼牙」的嬰兒會剋母親、帶來厄運;台北醫學院附設醫院兒童牙科主任劉居平表示,之所以會有這種無稽之談,主要是過去時代母親是以哺乳為主,而鬼牙會咬痛媽媽,甚至於造成乳頭受傷等不適症狀,才有這類傳說。

其實「鬼牙」在牙科醫學上稱為「新生牙」(Neonatal tooth),形成原因不明,絕大多數新生牙是過早萌出的乳牙,而不是多出來的牙齒,因此,一般牙醫師並不做特別處理,以免影響日後恆齒的生長,

除非有以下三種困擾才考慮拔除:

1.新生牙會磨到嬰兒舌根,導致舌下黏膜潰爛;

2.新生牙動搖不穩,怕脫落嬰兒吞入,造成氣道阻塞;

3.媽媽餵母乳會被新生牙咬傷,造成乳頭疼痛或發炎。若沒有這些障礙的話,醫師通常不建議拔除,否則拔掉「鬼牙」後就沒有這顆乳牙,孩子可能要缺牙到四、五歲了

 
 
Q

Our daughter had a tooth when she was born(女兒一出生就長出牙齒). The doctor called it a milk tooth(乳牙), and eventually the tooth fell out(最後牙齒脫落). Now her baby teeth have come in with a gap where her milk tooth used to be(再次的長出新的乳牙). Will this gap remain when her adult teeth come in, or will a tooth replace it?


 

A

Occasionally a child is born with teeth. Teeth can also erupt early -- within the first 30 days of life. These are called natal teeth and neonatal teeth, respectively.

(偶爾小孩在出生的時候就會出現牙齒,在出生的生命開始的前30天內萌發出來,這種情形統稱為新生兒牙)

Most commonly, there are only one or two natal/neonatal teeth in the lower anterior area, although more can be present in other areas of the mouth. The presence of natal or neonatal teeth in the posterior region is not common and may be associated with systemic conditions or syndromes.

(一般的情況是,會在下顎前牙區看到1或2顆的新生兒牙,雖然有的也會出現在口腔中的其它地方,但出現在後牙區的情況較罕見,可能的情況是與系統性疾病或徵候群一起出現Jadassohn-Lewandowsky-syndrome, Ellis-van Creveld syndrome, Hallermann-Streiff syndrome)

These teeth are usually the normal primary incisor teeth erupting early. Due to this early eruption, the tooth will not be fully developed. While the majority of the crown will be formed, the root structure is not normally present; therefore, a natal or neonatal tooth will be mobile.

(這些早期萌出的牙齒通常會像乳切牙一樣的萌出,由於這樣早期的萌出,牙齒的發育並不是很完好,因此,新生兒牙基本上是浮動的)

If the mobility is not too severe, the tooth may become firm on its own and can be left alone. Excessive mobility may lead to exfoliation of the tooth, as in your daughter's case. If the tooth is excessively mobile and has not exfoliated, parents should consider having the tooth extracted to avoid aspiration or ingestion of the tooth. If the tooth is extracted, care needs to be exercised to extract the entire tooth.

(假若搖動度不是挺嚴重的,這種牙齒會穩固的存在於原地,大的搖動度會導致牙齒的脫落,如同您女兒的那種情況,假使牙齒是大的搖動度,但沒有脫落,家長必須思考將牙齒拔掉,以避免牙齒被吸入或是吞入,假使牙齒被拔掉,必須小心注意要整顆都拔除)

If only the crown is extracted with pulpal tissue (nerve and blood vessels present in the tooth) left behind, dentin (the layer of tooth structure underneath the enamel) and root structure may subsequently form. If this occurs, root removal may be required in the future.

(一旦牙冠部被拔除並帶有牙髓(含有神經與血管在中),象牙質和牙根的結構順利的形成,如果這樣的情況發生,牙根的移除在未來是必要的)

Because natal and neonatal teeth are usually normal primary teeth, a new primary tooth will not replace them once they are lost. In the anterior region of the mouth, this premature loss of the primary tooth does not typically result in problems with the permanent teeth. In the posterior region, maintenance of space for the permanent teeth to erupt normally should be considered

(因為新生兒牙通常是屬於正常的乳牙,假若正常的乳牙不存在的話,是沒法來替代的,在口腔中的前牙區,這樣的先期掉乳牙並不見得會導致產生恆牙的問題,在後牙地段,恆牙萌出空間的保持必須妥善的考慮)

以下的paper(文獻)可以來說明新生兒牙的情況

natal &neonatal teeth (這裡面有圖)

發生率:1:700 - 1:30,000 ,以女生較多發,好發生在下顎前牙區

病因學:以遺傳的可能最高Environmental factors(環境因素以多氯聯苯最常見, especially polychlorinated biphenyls (PCB)

Extraction during the first days of life seems to be atraumatic(有學者指出在一出生就拔除是不具損傷性的)

Indications for extraction include hypermobility, difficulties during breast-feeding, traumatic ulcerations on tongue/frenulum/lip (Riga-Fede's disease), inflammation, etc..(拔牙的適應症包括搖動度大,哺乳困難,舌頭/繫帶/唇的損傷性潰瘍,發炎)Riga-fede's disease(natal tooth)圖片

Development of baby teeth (乳牙的發育)

Development of permanent teeth (恆牙的發育)

Tooth anatomy (牙齒解剖)

牙胚的組織學圖像

Natal and neonatal teeth : A report of four cases

Unusual neonatal tooth in maxillary 1 st molar region: A case report

Sublingual traumatic ulceration due to neonatal teeth (Riga-Fede disease)

Residual Neonatal Teeth: A Case Report

Developmental Alterations of Teeth(非常優質的power points教學片,內有大量圖片)

ABNORMALITIES OF TEETH(dr.王文岑)

Abnormalities of the Teeth(哥大Steven Chussid D.D.S)精典多圖

Interruption of Breast Feeding Caused by the Presence of Neonatal Teeth

94 年第一次專門職業及技術人員高等考試試題(牙醫師)第43 /44題

九十三年第一次專門職業及技術人員高等暨普通考試醫事人員考試(牙醫師)第39題

九十二年第二次專門職業及技術人員高等暨普通考試醫事人員考試(牙醫師)第9題

arrow
arrow
    全站熱搜
    創作者介紹
    創作者 崇愛牙醫 的頭像
    崇愛牙醫

    崇愛牙醫診所(資料重建中,歡迎新舊朋友)

    崇愛牙醫 發表在 痞客邦 留言(0) 人氣()