Baby Dental Issues

Baby Dental Issues are now identified at a baby's first dental check up.  The American Dental Association (ADA) recommends that all children should see a dentist by their first birthday.

If your grandbaby was a preemie or had medical issues and has not yet developed any teeth by their first birthday or you have noticed other teeth issues, encourage the parents to call a dentist and ask for his or her advice about when to schedule the first visit.

Baby Playing

Baby Dental Issues:

Take a close look at your grandbaby's smile

  • Do you see any issues with his teeth? 
  • Do you see a darkening of the enamel on his teeth? 
  • Do you see any teeth at all? 

Studies have shown that premature infants have an increased risk for developing dental problems such as: delayed tooth eruption, enamel hypoplasia, tooth discoloration, palatal groove, and a possible increased risk for needing braces or caps in the future. The following gives a brief overview of each of the dental concerns associated with prematurity.

As with many other medical problems associated with prematurity, the smaller and sicker your preemie was, the more likely he or she will develop baby dental issues.

If you are concerned about your preemie's teeth, be sure to see a pediatric dentist or a general dentist who has experience treating premature infants.


According to the pediatric dentist, Dr. Tom Wickersham, Flower Mound, Texas, he expressed that premature birth can affect dental health.

As he explained in a recent visit to his office, that premature birth in humans is defined as birth with less than 37 weeks of gestation. A normal pregnancy runs 40 weeks. Preemies often have health issues, ranging from lapses in breathing to gastrointestinal reflux disease to respiratory distress syndrome.


Then he questioned:  "Did you know that most babies born prematurely also tend to suffer with certain dental problems?"    He would determine today if either twin had an issue.

Due to the size of the babies, how do you sit them in the chair?  You don't!  My daughter was instructed to sit with her son in her lap with his head facing out.  Then the dentist brought his stool to match her knees and he supported each of my grandson's head in his lap.  The bright light allowed him to check for issues, but really blurred my picture above!  My daughter restrained his arms and legs as the dentist checked each tooth. 

My daughter, being a nurse, did know that there was an issue with one of her babies, that was why we were at his office.  

Yes, when you look at one of my grandson's teeth, you can see that the enamel hasn't developed properly and his two front and middle bottom teeth are discolored.  This is known as enamel hypoplasia.   Usually this discoloration is caused by the following:

  • intubation and mechanical ventilation 
  • a lack of certain nutrients in the NICU
  • generally occurs in those preemies who had high bilirubin levels in the NICU

I had never noticed this issue and it made me realize that my daughter and son-in-law are very aware of their children's health issues!   When he smiles, the teeth really aren't visible and you have to pull up his lips to see the issue.   They had noticed it while brushing their teeth.  His brother's teeth are not affected at this time.

 Baby Dental Issues:
Delayed Tooth Eruption

Moms discussing dental issues

Below is a description of the baby dental issues as listed by the ADA website and from the book by Dianne Maroney, Your Premature Baby and Child that all parents and grandparents should be concerned about:

  • Delayed tooth eruption is common among premature infants, especially those who were very small and/or very sick. Studies have shown these delays are caused from infection after birth, poor nutrition (or nutrition that is significantly different than that of the womb), and/or prolonged intubation.
  • Some believe that birth stimulates the process of tooth eruption; therefore, a premature birth will alter this process and, if your preemie was very sick or very small, anticipate his or her teeth may be 2-6 months late coming in.

Baby Dental Issues:
Enamel Hypoplasia

  • Enamel hypoplasia means there is a lack of enamel (white coating) on the outside of the teeth. Premature infants have enamel hypoplasia four times more often than term children and they are more vulnerable to cavities.
  • The left upper front primary teeth are twice as likely to have enamel hypoplasia than the right. It can be found on the permanent teeth, however the problems are generally less severe. Causes are intubation and mechanical ventilation, as well as a lack of certain nutrients in the NICU.
  • Children with enamel hypoplasia are more likely to develop cavities in these teeth and will need careful, routine brushing and close monitoring by the dentist.

Tooth discoloration generally occurs only in those preemies who had high bilirubin levels in the NICU. A yellow or brown color is seen only on the primary teeth and cannot be removed by brushing or having them cleaned by the dentist. 

Baby Dental Issues:
Palatal Groove

  • A palatal groove is a narrow groove in the roof of the mouth, also called the hard palate.
  • This groove is caused by intubation in the NICU. Some preemies have developed grooves after being intubated for as few as seven days, but generally speaking, the longer the intubation time, the more likely a palatal groove will develop.
  • Complications such as crowding or poor positioning of the teeth, sucking or speech problems, and/or hearing difficulties may result.

Future Baby Dental Issues to be Considered


The need for braces may or may not be caused by prematurity. Few studies have been done in this area, and dentists continue to debate this issue. Some orthodontists treat preemies' crowded teeth or a palatal groove with a spacer in the first few years of life.

Others believe that the need for braces cannot be determined until the six-year molars have arrived and will not treat any problems until the dimensions of the jaw can be measured.   Usually these teeth are smaller than full term babies.  Smaller teeth may create gaps, or spaces between teeth, that create a need for orthodontic braces.

Some parents wonder if missing teeth are a result of prematurity. There are no studies showing this association

Baby Dental Issues:
Oral Aversions or Sensory Issues


Preemies with oral aversions or sensory issues may not want the dentist to come near their mouths. An occupational or speech therapist may have some helpful advice for taking your child to see the dentist. It may be best to take your preemie with sensory issues to see a pediatric dentist who specializes in handling difficult situations with children.

How to Take Care of Baby Teeth

How to Take Care of Baby Teeth -- powered by ehow

What can I do to prevent tooth decay?

It is very important to do the following to prevent tooth decay:

  • Develop good tooth-brushing habits as soon as the teeth break through the gums. The teeth should be cleaned two times a day, morning and before bedtime.
  • Avoid the habit of letting your child sleep at night or nap with a bottle. It can cause decay so severe that it destroys the teeth. Dentists refer to this as Nursing Bottle Tooth Decay.

As I have been researching premature infant issues in regards to my twin grandsons, I found this site that may be very helpful to other grandparents.   You may want to share this with their parents. 

"Preemie Support Group"--Inspire connects patients, families, friends and caregivers for support and inspiration" for premature babies.

Baby Dental Issues:

Enamel hypoplasia:  Enamel issues on baby teeth.

Delayed tooth eruption in babies.

Palatal groove is a narrow groove in the roof of the mouth

Find more grandparenting ideas online at our Home Page Grandparenting Essentials 

From Baby Dental Issues to Baby Eye Issues

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