Dental Issues of Prematurity

February 20, 2015

We all picture the day our baby’s gummy smile is suddenly changed by their first teeth erupting. I mean, what’s cuter than a little baby looking up at you with their tiny new pearly whites grinning back at you? But what if there were issues that your preemie could be facing once they began teething? Wouldn’t you want to know so you could be prepared? I’ll tell you who wasn’t prepared…. ME.

15 Months - tooth eruption

15 Months – tooth eruption

One of the first common issues we faced was DELAYED TOOTH ERUPTION. If your preemie was particularly small or sick, an approximate 2-6 months delay of tooth eruption is common. We took our 29weeker to the dentist at 12 months to make sure everything looked ok. We were told the delay was just a “preemie thing” and were told to bring him back when his first tooth erupted. At 15 months, I was grinning ear to ear when it finally happened. It was finally going to happen!!

And then came the shocker. His teeth were noticeably dark YELLOW.

No one had warned us that preemies are more prone to having TOOTH DISCOLORATION. Generally, this yellow


or brown discoloration is only seen in preemies that have high bilirubin levels while in the NICU. In our case, TPN (total parenteral nutrition) was used for a prolonged period of time resulting in cholestatic jaundice, which significantly raised our son’s bilirubin level causing his primary teeth to become discolored. The downside is brushing or having them cleaned by the dentist cannot remove the discoloration, but the good news is the discoloration is only seen on the primary teeth.

Enamel Hypoplasia

Enamel Hypoplasia

It seemed like just as we were coming to terms that our son’s teeth would be discolored for the first 6 or so years of his life, we were hit with the next wave of dental issues – ENAMEL HYPOPLASIA. Enamel hypoplasia means there is a lack of enamel on the outside of the teeth. This can lead to the thin enamel chipping away, developing discolored spots on the tooth crowns, pitting or irregularity of the tooth crowns, and the teeth are more prone to wear and fracture (which is why he’s missing half of his front tooth).

We were faced with the question of what to do to treat these issues. Our son visited the dentist every 3 months for treatment and at just under 4 years old, we made the decision to have his teeth restored. Most people ask why we waited so long and what the process was like. We knew because of his thin enamel that a cavity was inevitable at some point and his dentist recommended we should wait and have everything done at once because sedation would be necessary. There were no negative impacts caused by the enamel hypoplasia. There were constant stares, pointing and whispers, but our son was in no pain whatsoever. Besides, we had more serious health issues to tend to in regards to his special needs before scheduling a cosmetic procedure that would most likely have him running to the hills every time he saw the dentist afterwards.

Recovery Room

Recovery Room

On the day of surgery, we checked-in to the Children’s hospital where their special needs care team took great care to make our son comfortable. After 2 hours in the operating room, we were in the recovery room with our little man. They had filled his cavities, filed and restored all of the pitting caused by the hypoplasia and had sealed his teeth so they would remain strong until his permanent teeth come in.

I wish I had been educated when it came to my preemie’s teeth so I could have been prepared for the road we had ahead. I now know that all of this is completely normal and want you to know if you are going through it, that you are not alone.

preemie tooth resoration

After Restoration

Beauty is not flawless. It shines even through your flaws.