HomeHealth articlesneonatal teethHow Is Oral Anatomy of an Infant Important for Breastfeeding?

Importance of Oral Anatomy During Breastfeeding

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The development of facial and oral structure is important for breastfeeding. Read further to learn about oral anatomy and breastfeeding techniques.

Medically reviewed by

Dr. Naveen Thomas

Published At February 7, 2023
Reviewed AtJuly 11, 2023

Introduction

In certain birth deformities, the infant already has prenatal teeth during birth. As the infant grows, it starts showing the clinical signs of tooth eruption. Infants born with major craniofacial anomalies, like cleft lip and palate, have greater difficulty during feeding. All these oral anatomic features, like prenatal teeth during birth, the process of eruption of teeth, and craniofacial anomalies, affect the child’s breastfeeding process.

What Are the Growth Features Seen in the Mouth of an Infant?

There are two stages in life where teeth are completely absent in the mouth: at birth and during old age. In some rare cases, teeth are present during birth and are known as natal teeth. The anatomical features of the oral cavity at the time of birth are.

  • At birth, the infant is completely devoid of teeth and has gum pads.

  • These gum pads are thick membranes with the firm outer skin.

  • The gum pads are like a raised wall, with the anterior part known as the labial buccal side and the posterior part known as the lingual surface. These gum pads are separated from the cheek surface with a groove.

  • The gum pads are in the upper and lower arches, respectively. The teeth start erupting on these gum pads.

  • A child has twenty milk teeth, ten on each upper and lower arches. Each arch is again divided into left and right quadrants, with five teeth erupting from each.

  • The upper and lower teeth relationship is very important for the occlusion or closure of teeth.

  • The upper or maxillary arch is wider and longer when compared to the lower arch.

  • The child has a forward upper arch and backward lower arch, leaving the mouth open. This is corrected during breastfeeding habits. This space is covered by teeth during the eruptive stage.

  • The disk seen in the temporomandibular joint is flattened and does not act like the hinge joint of adults. This helps in the further development of the muscles and joints of infants.

  • An infant's lip is triangular and has a well-developed groove in the midline of the upper lip. This promotes maximum engagement of the breast during the sucking process.

  • The midpoint of the upper lip bulges out and increases in volume due to the constant breastfeeding process.

  • On the palatal surface, curved groves known as rugae are present. These rugae are highly established in children and help hold the breast tissue when sucking.

What Is the Eruption Age of Each Milk Tooth?

Disturbances in the eruption age of teeth result in a disposition of teeth leading to malocclusion. This gives the dentition a crooked appearance. Eruption of teeth could be altered due to other reasons like diseases, poor nutrition, and genetic makeover. At birth, the infants already have partially calcified milk teeth under the gum pads, which begin to erupt at 7.5 months. Here is the chronological chart of teeth eruption sequelae:

chronological-chart-of-eruption-age-of-each-milk-tooth

What Are Some of the Signs Shown by Infants During Eruption of Teeth?

Certain symptoms follow the eruption of teeth. They are:

  • General irritation.

  • Swollen gums.

  • Disturbed sleep.

  • Loss of appetite.

  • Food passes out sideways of the mouth.

  • Ulcers of mouth.

  • Increased biting habit.

  • Fever.

  • Increased rubbing of gums.

  • Ear rubbing.

  • Red cheeks.

  • Diarrhea.

  • Facial rashes.

  • Pain in the gums.

How Can Teeth Eruption Symptoms Be Managed?

There are certain techniques beneficial to calm down the adverse symptoms of teething. They are:

  • Putting an ice pack to relieve the pain.

  • Encouraging the child to bite harder on objects like carrots, cucumbers, and rusks promotes the opening of gum pads and help the tooth to erupt.

  • Placing pacifiers.

  • Applying topical painkillers.

  • Giving medications for fever.

  • Rubbing the gums with wet gauze to ease the irritation.

What Are the Different Dental Deformities Seen During Pre-eruptive and Post-eruptive Stages of Teeth?

During the development of the oral cavity, many deformities are seen, which are auto-corrected as the development stages proceed. These deformities do not require any treatment. Some self-correcting oral anomalies at birth are.

Retrognathic Mandible: In this condition, the chin is drawn backward, and the upper arch moves forward. This gives an open mouth space that is covered by the tongue while resting and is covered by the erupting teeth in the future.

Anterior Open Bite: The upper and lower jaw does not close properly, and the space is maintained for the primary incisor to erupt.

Infantile Swallow Pattern: During the eruption stage, the child changes its diet from its mother’s milk to solid food. This creates an auto-reflex action for swallowing food.

Anterior Deep Bite: At the time of the mixed dentition period, when the child has both milk and permanent tooth, the lower arch grows forward and downward, and the upper arch covers more than two-thirds of the surface area.

Spacing: During the eruption process, spaces between the teeth are corrected independently as the permanent teeth develop.

Crowding: When milk and permanent teeth are present in the oral cavity, the tooth becomes too crowded, giving a zig-zag pattern.

What Are the Complications Seen During Teeth Eruption?

In some cases, during the course of the eruption, certain complications develop, such as:

Eruption Cyst: They are also known as eruption hematoma. It is seen as a bluish-purple tissue at the site of eruption. They occur weeks before the eruption. The most common site of occurrence is the permanent first molar region. It is caused due to any trauma to the soft tissue. The cystic lesion is filled with blood and is self-cured as the tooth breaks out.

Eruption Sequestrum: It occurs during the eruption of the permanent first molar. The cusp erupts with a hard bony structure, which is dead. So the teeth erupt with a dead bony structure surrounding the cementum area. This is caused due to calcification of tooth minerals.

Ectopic Eruption: It is the presence of teeth at the time of birth or otherwise known as natal teeth. If the teeth erupt within thirty days of delivery, it is known as neonatal teeth. These incidents are very rare. These teeth have weak enamel and underdeveloped roots and have a high chance of shedding away. It is more commonly encountered in a female child than in a male. In every 11.25 to 30,000 births, such anomalies are reported. The most common natal and neonatal teeth occurrence is seen in the lower primary central incisor. The main cause for such early eruption is due to hormonal stimulation, less vitamin content in the body, trauma, fever, and conditions like syphilis. This could also be associated with a genetic condition, developmental anomaly, and multisystem syndromes. Clinically these teeth appear yellowish-white, conical, and hypo mineralized. A rim-like structure surrounds it. It is mobile and has underdeveloped or no roots. These natal teeth cause great disturbances during breastfeeding time.

How Can Natal and Neonatal Teeth Be Managed During Breastfeeding Time?

Such prematurely developed teeth present at birth create great difficulty during breastfeeding. Some of the management procedures are:

  • Pre-delivery radiographic imaging of the child reveals any abnormalities if present. This helps in the management of such natal teeth.

  • Application of topical gels for inflamed gingiva. For example, Chlorhexidine gluconate gel.

  • The sharp tooth structure can be reduced by shaping the teeth during a dental procedure.

  • The natal tooth is highly mobile, and the chances of aspiration are high. Hence, it is advised to remove such natal and neonatal teeth.

  • Curettage of extracted tooth structure is done. This prevents the remnant structure from growing abnormally.

  • Eruption of natal teeth causes difficulty in breastfeeding. Hence, the use of breast pumps is advised.

What Are the Complications of Natal Teeth?

The presence of natal teeth causes certain complications in the mouth, such as:

Ulcers: The constant touch of the sharp edge of the natal tooth can cause ulceration in the mouth. Ulcers are formed in the lip, tongue, and frenum areas. This lesion is known as Riga-Fede disease.

Non-Eruption of Teeth: Sometimes, the teeth do not erupt even after their eruptive age.

Conclusion

The development of oral structures and the first appearance of teeth together marks a significant milestone in the growth and development of the child. The eruption of teeth determines the dental age of the infant. Breastfeeding habit sustains the child with nutritional supply and meets all the child's physiological needs. Hence, prenatal screening and following proper guidelines during malformations are of paramount importance.

Dr. Naveen Thomas
Dr. Naveen Thomas

Dentistry

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