Kernicterus, a severe complication of jaundice in newborns, can occur if there is a delay in treating jaundice, causing bilirubin levels in the blood to rise uncontrollably and cross the blood-brain barrier. If left untreated, kernicterus can lead to brain damage and even death.
Newborns affected by hemolytic disease of the fetus and newborn (HDFN) commonly experience jaundice and require urgent treatment to avoid kernicterus and other long-term consequences such as cerebral palsy, seizures, hearing and vision loss, developmental delays and dental abnormalities.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell disorder that occurs when a baby’s RBCs break down quickly, which is called hemolysis. HDFN is caused by a mismatch between a mother’s and her baby’s blood type (A, B, AB, or O) or Rhesus (Rh) factor (Rh-positive or Rh-negative) during pregnancy.
How does kernicterus affect tooth development?
Kernicterus can affect dental enamel and cause defects known as dental enamel hypoplasia or dysplasia. A baby’s teeth start to develop during pregnancy, before four months’ gestation, with enamel beginning to form just before birth and continues until after birth.
When high bilirubin levels in the newborn’s blood develop into kernicterus, this disrupts the formation of enamel by damaging ameloblasts–cells that exist only during the stage of tooth development in which enamel is created. The teeth are weakened as a result and may have a yellow-green tinge.
Learn more about HDFN symptoms and risks
As a result of kernicterus, the enamel found on the surface of teeth doesn’t develop properly, increasing a child’s susceptibility to early childhood caries (ECC). This refers to instances of tooth decay, missing teeth or filled cavities and can cause dental pain and discomfort, infection, invasive dental procedures and impaired quality of life. It can affect both baby teeth and adult teeth.
Managing dental defects
Babies start to get their first teeth between four and seven months. An HDFN-affected baby may experience delays, and the quality of the teeth may be reduced as enamel is not properly formed and teeth may be pitted or damaged.
If you notice any delays in tooth eruption or damage to emerging teeth, contact a pediatric dentist. A thorough clinical examination, complete medical and birth history and some x-rays are required to diagnose enamel hypoplasia.
Dental defects can vary in severity, but close monitoring, good dental hygiene and fluoride treatment are always beneficial and can help prevent further damage. Further treatment to fill cavities or protect the teeth with sealant may also be required. In some cases, only baby or primary teeth will be affected, while in others, adult teeth may also have abnormalities.
Your pediatric dentist will provide you with a personalized approach to managing your child’s teeth if they are affected by kernicterus.
Sign up here to get the latest news, perspectives, and information about HDFN sent directly to your inbox. Registration is free and only takes a minute.
