Monday, July 20, 2009

07/24/09 Oral Abnormalities in Taiwanese Newborns

Resident: Jason Hencler

Article title: Oral Abnormalities in Taiwanese Newborns

Author(s): Ming-Hui Liu, DDS; Wen-Hsi Huang, DDS

Journal: Journal of Dentistry for Children

Volume #71; Number 2; Pg: 118-120

Year: 2004

Major topic: Oral Abnormalities in Newborns

Type of Article: Observational

Main Purpose: Investigate the frequency of oral abnormalities in newborns in Taiwan

Overview of method of research: Study included 420 infants born between February and April 2000. Babies with craniofacial abnormalities and systemic conditions were excluded. One dentist examined all newborns within 3 days of birth. Authors segmented each arch into 12 separate areas to record oral abnormalities. They also recorded natal and neonatal teeth.

Findings: All 420 newborns were of East Asian ethnicity and consisted of 231 males and 189 females. 4 kinds of oral abnormalities were found: 1) natal teeth 2) neonatal teeth 3) palatal cyst of the newborn 4) gingival cyst of the newborn. Frequency of natal and neonatal teeth was 1%. All teeth were located in the mandibular anterior area. Among the subjects examined, 86% had palatal cysts, 79% had gingival cysts. Overall the frequency was 94%.

Key points in the article discussion: Oral abnormalities of newborns include: 1) inclusion cyst 2) alveolar lymphangioma 3) median alveolar notches 4) natal teeth 5) neonatal teeth 6) congenital epulis 7) commissural lip pits 8) ankyloglossia. The terms natal and neonatal refer only to the time of eruption but not the origin of tooth germ. Crowns are either well formed or discolored with irregular surface and are mostly mobile due to short or missing roots. Histologically they have hypoplastic enamel and some have irregular dentin and enlarged interlobular areas in the dentin tubules. Most have large vascular pulp and may fail to form cementum. Other studies reported a slightly lower frequency of natal and neonatal teeth. Larger sample sizes in the other studies may explain this difference. Most natal and neonatal teeth occur in the mandible incisor region except in the case of cleft lip and palate, where they occur in the maxillary cleft areas. Gingival cysts near the surface appear as white masses. They don’t increase in size with age and they are rarely seen after 3 months of age. Frequency of cysts (94%) in this study was higher than recorded in any other published reports. Palatal cysts (84%) and gingival cysts (79%) were not low. This variance with past data may be due to racial difference, examination methods, and different definitions of cysts. This study found no significant correlation between gender, body weight, and gestational age.

Summary of conclusions: Palatal cyst frequency was highest. Of the gingival cysts, buccal aspects of the maxillary arch and lingual aspects of the mandibular arch were more pronounced. Frequency of palatal and gingival cysts of the newborn was not significantly affected by gender, body weight, gestational age, or delivery pattern variables. One natal tooth in 1 newborn and 2 neonatal teeth in another were located in the mandibular anterior for an incidence less than 1%.

Assessment of article: Data from this study could be useful to a Pediatric dentist when treating a patient population that included patients of East Asian ethnicity. Compared with other races, East Asian newborns may have higher incidence of the oral abnormalities considered in this study. The high frequency of oral cysts found in this study may be due to small sample size when compared with other past studies.

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