Neonatal and supernumerary teeth in cleft lip and palate: clinical management of asynchronous tooth eruption in infancy — a report of two cases
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Abstract
Background: Natal and neonatal teeth occur in 1 per 1,000–30,000 live births, with a higher prevalence in infants with cleft lip and palate (CLP). Their occurrence in CLP presents unique clinical challenges. Asynchronous tooth eruption may cause mucosal trauma, feeding difficulty, aspiration risk, and interfere with presurgical orthopedic therapy such as nasoalveolar molding (NAM). This report describes two rare CLP cases with asynchronous eruption patterns and clinical management.
Case Presentation: Two CLP infants experienced sequential tooth eruptions. Case 1 presented at 19 days and 4 months with two teeth along the unilateral cleft margin. Case 2, a bilateral cleft case, demonstrated a rare triple eruption sequence between 12 days and 6 months, with teeth emerging in different cleft regions. These eruptions led to feeding difficulty, aspiration risk, and appliance instability.
Management: Extractions were performed to prevent aspiration and restore appliance stability, enabling uninterrupted NAM therapy. Long‑term follow‑up confirmed normal eruption of the primary dentition and stable appliance function throughout NAM therapy.
Conclusion: Asynchronous tooth eruption of neonatal and supernumerary teeth in CLP infants is rare but clinically significant. Early recognition and timely intervention are essential to prevent aspiration, maintain feeding safety, and preserve appliance stability during presurgical orthopedic therapy.
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