Natal Tooth Management — ORE Part 1 MCQ

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ModeratePaediatric DentistryNatal Tooth ManagementORE Part 1

A child aged 9 months presents with a natal tooth (present at birth, now 9 months old) that is mobile and interfering with breastfeeding. What is the most appropriate management?

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Correct answer: D — Extract the natal tooth because it is mobile and causing feeding difficulties

Extraction is indicated because the natal tooth is both excessively mobile and interfering with breastfeeding—two independent indications. Consensus guidance states extraction is required when teeth are mobile (risk of exfoliation and aspiration) or cause feeding difficulty or maternal discomfort. While monitoring and smoothing are options for firm, asymptomatic teeth, this tooth meets extraction criteria. Option C is incorrect (treatment may be needed); Option E is insufficient (does not address mobility or feeding obstruction); Option B is inappropriate (natal teeth have poor root structure and are developmentally immature); Option A is irrelevant (does not address the mechanical problem). Individual assessment is standard practice, but the clinical presentation (mobility + feeding difficulty) is decisive for extraction.

Reference: Natal and neonatal teeth: a review and case series. Br Dent J. 2022; Guy's and St Thomas' NHS Foundation Trust Paediatric Dentistry. https://pubmed.ncbi.nlm.nih.gov/35396420/