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Green teeth are a late complication of prolonged conjugated jaundice in extremely low birth weight infants
  1. S Battineni,
  2. D Booth,
  3. P Clarke
  1. Norfolk and Norwich University Hospital, Norwich, Norfolk, UK


Background Eruption of green, discoloured teeth affecting the primary dentition has been described in association with congenital viral infection, neonatal bacterial and fungal sepsis, haemolytic jaundice, biliary atresia and cholestasis. Extreme prematurity and extreme low birth weight have not, to our knowledge, previously been described as being risk factors for green teeth. We present three preterm infants cared for on our neonatal unit who were found to have erupted green teeth.

Methods Case series.

Results Green teeth were noted in three ex-preterm infants during neonatal follow-up at corrected ages of 9–10 months. All were born at our centre in the period 2006–2009. Their gestations ranged from 23+1 to 26+2 weeks and birth weights from 400 g to 840 g. All had prolonged conjugated hyperbilirubinaemia of onset in their third postnatal weeks and peaking in their eighth postnatal weeks. Their maximum conjugated bilirubin levels ranged from 144 to 275 mmol/l, and their conjugated hyperbilirubinaemia lasted 3–4 months in duration.

Conclusion Our local case series suggests that, in infants with prolonged conjugated hyperbilirubinaemia, being born extremely preterm and of extremely low birth weight are predisposing risk factors for eruption of green teeth in later infancy.

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