Lesson 68

Patient: Good morning, Doctor.

Doctor: Hello, how can I help you Madam?

Patient: I am one of your patients, but I’m calling because of my son. He’s only three weeks, but the problem is that he was born with a tooth, and because of it there is something on my son’s tongue. He cries and does not want to eat too much. My gynecologist told me that I should take him to the dentist.

Doctor: Of course, please come with him. Is the baby generally healthy?

Patient: Yes. My son is healthy. When he was born he weighed 4 kg and now he’s developing very well.

Doctor: Good. So we can meet tomorrow at 4 p.m.

Patient: Thank you very much. We will come tomorrow at 4 o’clock.

Next day

Patient: Good afternoon, Sir. Sorry for being five minutes late, but before leaving, it turned out that I had to change my son.

Doctor: Good afternoon, do not bother about this. Come to my office, please. We’ll fill in a patient’s card and we’ll check what’s going on.

After a while

Doctor: Well, yes. It’s a typical natal tooth. You can see a very small sore on his tongue that has developed because the tooth irritates mucous membranes. And the tooth moves. Actually, it is only embedded in the gum. The case is clear. The tooth must be removed.

Patient: Oh, does it have to be extracted? Can’t you just leave it in the gum?

Doctor: No, I can’t just leave it. Firstly, because of ulcer. It will heal as soon as I remove the tooth, and secondly because this tooth may fall out at any moment. It is unlikely that your son will swallow the tooth or aspirate it to bronchitis, but it can not be excluded. You know, it might end in different way, but the decision is up to you. I strongly suggest extracting it, because leaving it threatens the life and health of your baby.

Patient: No, no. I’ve just asked. Of course, I decide on its removal.

Doctor: Well, so we can proceed. I’ll use anesthesia, but a very simple one, because the tooth is just embedded in the gum.

After a while

Doctor: Well, it’s done. I removed it the same lever. Like I said, it would fall out by itself in a few days.

Patient: Thank you very much.

Doctor: It is not bleeding, so there is nothing you must do. Please do not feed the baby for two hours.

Patient: It will not be a problem. I fed him an hour ago.

Doctor: Well that’s all for today. The ulcer on the tongue heals itself soon. It is small. But if it doesn’t heal, please contact me.

Patient: Once again, thank you and goodbye!

Doctor: See you!

VOCABULARY PRACTICE

Rearrange the letters in words in green and complete the text about Tooth Erruption Process

Oral structures begin to form during the third and fourth weeks of 1)__________ (NIERYOMBC) development. The teeth begin to develop around the sixth week of 2)________ (FEALT) life. Development continues throughout fetal life and 3)__________ (BYOEND). Primary teeth begin to 4)_________ (TPURE) around 6 months of age (range 5-10 months). Eruption is completed by 24 to 36 months. 5)_________ (DLAEYS) of more than 12 months should be 6___________ (LUEATVADE) by a dentist.
Eruption is usually 7)___________ (RICALSYMET) (lower teeth usually before upper) in the following 8)________ (PAERTNT) for the primary teeth: central incisors, lateral incisors, first molars, canines, second molars.

9)_____________(IONEXOLFIAT) often follows a similar pattern.

Permanent teeth emergence is similar in pattern to that of the primary teeth. Eruption of the permanent teeth begins between 5 and 7 years and usually 10)___________ (SHEFNIIS) by the age of 13 or 14. The typical pattern is: central incisors, lateral incisors, first molars, premolars, canines, second molars, and third molars (wisdom teeth).

Some 11)________ (FANTSIN) erupt teeth before birth (natal teeth) or shortly thereafter (neonatal teeth). Generally, no treatment is 12)_________ (CATEDINDI). Extraction of these incisors may be considered if they are mobile, interfere with breastfeeding, or lead to Riga-Fede 13)___________ (ULERCATION).

Delayed emergence of more than 12 months can be 14)________ (CAUEDS) by: oral space issues, endocrine disorders, genetic disorders or dense gingival 15)___________ (SSUETI).

Match patient’s questions with doctor’s answers

Question 1: Where do natal teeth occur?

Question 2: What causes natal teeth?

Question 3: What should be done if a baby is born with teeth?

Question 4: What are some downfalls of natal teeth?

Question 5: Do natal teeth cause choking hazard?

Question 6: What should be done with natal teeth?

Question 7: How to care about these teeth if they are not extracted?

Question 8: If we decide to remove natal teeth will the baby get another set of baby teeth there, or will there be just a big space until adult teeth grow in?

Answer 1: Many times, parents don’t need to do anything.They can simply enjoy the fact that they don’t have to go through the teething process for the natal teeth. It’s not all roses though, there are a few different problems that can occur as a result of natal teeth.

Answer 2: Unfortunately they do. While many natal teeth are fixed firmly into the jawbone, sometimes natal teeth are very loose. And with these ones we have to be particularly careful.

Answer 3: The exact cause is still unknown. It is believed that the tooth simply develops in an abnormal position that is much closer to the surface of the gums.

Answer 4: The most common are problems with breastfeeding and tongue ulceration.

Answer 5: Most of them about 85% are lower central incisors, then upper incisors, lower canines and only about 1% of them are upper canines and molars.

Answer 6: Sometimes these neonatal teeth are not true teeth and are called “enamel pearls” and the normal teeth will emerge at their regular time. On other occasions these neonatal teeth are the real baby teeth that have emerged before adequate development and if we need to remove them, they will not be replaced until the permanent teeth emerge when the child is older, around the age of five to seven.

Answer 7: In cases where natal teeth are very loose, some sources say that it is a good idea to have the natal teeth extracted. Other sources say that there are no documented cases of a child choking on a natal tooth and that extracting it can be an emotionally difficult procedure for the parents.

Answer 8: Keep them clean by gently wiping the gums and teeth with a clean, damp cloth. Examine the infant’s gums and tongue frequently to make sure the teeth are not causing injury.