Home | About Us | Editorial Board | Current Issue | Archives | Search | Instructions | Subscription | Feedback | e-Alerts | Login 
Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
 Users Online: 427  
  Print this page Email this page   Small font sizeDefault font sizeIncrease font size

Year : 2005  |  Volume : 23  |  Issue : 1  |  Page : 51-52

Sublingual traumatic ulceration due to neonatal teeth (Riga-Fede disease)

Department of Pediatric and Preventive Dentistry, Modern Dental College, Indore, India

Correspondence Address:
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-4388.16031

Rights and Permissions



The term Riga-Fede disease has been used historically to describe traumatic ulceration that occurs on the ventral surface of tongue in neonates and infants. It is most often associated with natal and neonatal teeth in newborns. A case of Riga-Fede disease is presented.

Keywords: Riga′s disease, Riga-Fede′s disease, traumatic sublingual ulceration

How to cite this article:
Hegde R J. Sublingual traumatic ulceration due to neonatal teeth (Riga-Fede disease). J Indian Soc Pedod Prev Dent 2005;23:51-2

How to cite this URL:
Hegde R J. Sublingual traumatic ulceration due to neonatal teeth (Riga-Fede disease). J Indian Soc Pedod Prev Dent [serial online] 2005 [cited 2022 Aug 16];23:51-2. Available from: http://www.jisppd.com/text.asp?2005/23/1/51/16031

Traumatic ulceration on the ventral surface of the tongue is most commonly associated with natal or neonatal teeth in newborns.[1],[2] It may also occur in older infants after the eruption of primary lower incisors with repetitive tongue thrusting habits[3] and in children with familial dysautonomia (in sensitivity to pain).[4]

Typically the lesion begins as an ulcerated area on the ventral surface of the tongue with repeated trauma, it may progress to an enlarged, fibrous mass with appearance of an ulcerative granuloma. It may interfere with proper suckling and feeding and put the neonate at risk for nutritional deficiencies. In such instances, dental intervention may be required.

   Case Report Top

A twenty eight day old female was referred for evaluation of an ulcerated area on the ventral surface of the tongue [Figure - 1]. The mother complained of child exhibiting pain during suckling and would not nurse.

Oral examination revealed two crowns in the mandibular anterior region, whitish in color and exhibiting grade II mobility in central incisor position. The ventral surface of tongue showed 5 mm x 10 mm ulceration that extended from anterior border of the tongue to lingual frenum [Figure - 2]. On palpation, area elicited a pain response from the patient.

Examination of the rest of intraoral mucosa revealed no other lesions. Radiographic examination revealed a neonatal tooth, probably, a primary incisor, with well-formed crown but minimal root development. Based on clinical findings diagnosis of "Riga-Fede" disease was made.

Extraction of the teeth was chosen as treatment of choice over more conservative treatment which slows healing. Extraction was carried out under topical local anesthesia, which patient tolerated well. Patient was reviewed after ten days and the lesion was fully resolved. Mother informed that infant was feeding normally.

   Discussion Top

For the past two hundred years, many reports of infants born with teeth or teeth erupting immediately after birth have appeared in the medical and dental literature.[5] These teeth have been referred as 'Natal teeth', 'congenital teeth' and precocious dentition (Mayhall and Badenhoff).[6],[7] In modern dental literature, most satisfactory terminology has been defined by Massler and Savara.[8] Natal teeth indicates teeth present in oral cavity at birth and 'neonatal teeth', those which erupt during the neonatal period i.e., from birth to thirtieth day of life. Neonatal teeth often present with hypoplastic enamel and underdeveloped roots, with resultant mobility.

Major complication from neonatal teeth is an ulceration on the ventral surface of the tongue caused by tooth's sharp incisal edge. Constant trauma may create ulceration sufficient to interfere with proper suckling and feeding and put the neonate at risk for nutritional deficiencies.

The lesion was first described by Antonio Riga, an Italian physician in 1881. Histologic studies and additional cases were subsequently published by F. Fede in 1890.[3] It has been subsequently been known as " Riga-Fede disease More Details".

Treatment of Riga-Fede disease has varied over the years. Early treatment consisted of excision of the lesion. Due to the erroneous diagnosis of the etiology, resolution of the lesion occurred only upon weaning of the child.

In case of mild to moderate irritation to the tongue, conservative treatment such as smoothing the incisal edge with an abrasive instrument is advocated.[9] Alternatively, a small increment of composite may be bonded to the incisal edges of the teeth.[10]

In this case, ulcerated area was large and denuded and even a reduced incisal edges may still contact and traumatize the tongue during suckling, enough to delay healing. The pediatrician's concern over the infants failure to gain weight due to ulceration's interference with suckling dictated the need for rapid resolution of the lesion. So extraction of the natal tooth was chosen over more conservative treatments.

At a follow up appointment, the lesion was fully resolved and infant was feeding normally.

   References Top

1.Goho C. Neonatal sublingual traumatic ulceration (Riga-Fede disease): Reports of cases. J Dent Child 1996;63:362-4.  Back to cited text no. 1  [PUBMED]  
2.Buchanan S, Jenkins CR. Riga-Fede's syndrome: Natal or neonatal teeth associated with tongue ulceration, case report. Aust Dent J 1997;42:225-7.  Back to cited text no. 2  [PUBMED]  
3.Slaryton R. Treatment alternatives for sublingual traumatic ulceration (Riga-Fede disease). Fed Dent 2000;22:413-4.  Back to cited text no. 3    
4.Rakocz M, Frand M, Brand N. Familial dysatonomia with Riga-Fede's disease: Report of case. ASDC J Dent Child 1987;54:57-9.  Back to cited text no. 4  [PUBMED]  
5.Ruth AA. Natal and neonatal teeth: Histologic investigation of two black females. ASDC J Dent Child 1982;49:300-3.  Back to cited text no. 5    
6.Mayhall JT. Natal and neonatal teeth among the thinget Indians. J Dent Res 1967;46:748-9.  Back to cited text no. 6  [PUBMED]  
7.Badenhoff J. Natal and neonatal teeth. Dent Abstr 1960;5:485-6.  Back to cited text no. 7    
8.Massler M, Savara BS. Natal and neonatal teeth. J Pediat 1950;36:349-59.  Back to cited text no. 8  [PUBMED]  
9.Allwright W. Natal and neonatal teeth. A study among Chinese in Hong Kong. Br Dent J 1958;105:163-72.  Back to cited text no. 9    
10.Baghdadi ZD. Riga-Fede disease: Report of a case and review. J Cl Fed Dent 2001;25:209-13.  Back to cited text no. 10    


[Figure - 1], [Figure - 2]

This article has been cited by
1 Riga-Fede disease: a mimicker of malignancy
Somu Lakshmanan, Srinivasan Venkataraman, Urvashi Singh
BMJ Case Reports. 2021; 14(3): e235976
[Pubmed] | [DOI]
Somu Lakshmanan, Urvashi Singh, Deepak Genedi
[Pubmed] | [DOI]
3 Treatment Considerations for Care of Natal and Neonatal Teeth – A Review of Literature
Kamla Kant Shukla, Ashish Saxena, Ajay Parihar, Neha Verma
Journal of Research and Advancement in Dentistry. 2021; 12(5): 124
[Pubmed] | [DOI]
4 Minimal Invasive Approach for Management of Lingual Swelling on Ventral Surface of Tongue
Sandeep Tandon, Meenakshi Sharma, Chahita M Lalchandani, Anupama Kajal
International Journal of Clinical Pediatric Dentistry. 2020; 13(S1): S102
[Pubmed] | [DOI]
5 Conséquences locales et générales de la présence d’une dent natale chez le nouveau-né. À propos d’un cas clinique
Manuel Messa Savi de Tove,Ramata Bakayoko-ly,Koffi Arthur N’guessan
Médecine Buccale Chirurgie Buccale. 2013;
[Pubmed] | [DOI]
6 Riga-Fede disease [Maladie de Riga-Fede]
Marie, J. and Fricain, J.-C. and Boralevi, F.
Annales de Dermatologie et de Venereologie. 2012; 139(8-9): 546-549
7 Maladie de Riga-Fede
J. Marie,J.-C. Fricain,F. Boralevi
Annales de Dermatologie et de Vénéréologie. 2012; 139(8-9): 546
[Pubmed] | [DOI]
8 Traumatic lingual ulceration in a newborn: Riga-Fede disease
Van Der Meij, E.H. and De Vries, T.W. and Eggink, H.F. and De Visscher, J.G.A.M.
Italian Journal of Pediatrics. 2012; 38(1)
9 Rigaæs papilloma in a 3 month old infant: A case report
Saha, S. and Samadi, F. and Saha, S. and Samadi, F.M.
Journal of International Dental and Medical Research. 2011; 4(1): 12-16
10 Prevalence of oral abnormalities in a Turkish newborn population
Çetinkaya, M. and Öz, F.T. and Orhan, A.I. and Orhan, K. and Karabulut, B. and Can-Karabulut, D.C. and Ilk, Ö.
International Dental Journal. 2011; 61(2): 90-100
11 Natal and neonatal teeth: A retrospective study of 15 cases
Basavanthappa, N.N. and Kagathur, U. and Basavanthappa, R.N. and Suryaprakash, S.T.
European Journal of Dentistry. 2011; 5(2): 168-172
12 Multiple natal teeth: A rare case report
Sogi, S. and Hugar, S.M. and Patil, S. and Kumar, S.
Indian Journal of Dental Research. 2011; 22(1): 169-171
13 Traumatic ulcerative granuloma with stromal eosinophilia: A lesion with alarming histopathologic presentation and benign clinical course
Eleni, G., Panagiotis, S., Andreas, K., Georgia, A.
American Journal of Dermatopathology. 2011; 33(2): 192-194
14 Sublingual traumatic ulcerative lesions caused by the eruption of first primary mandibular molars: A case report [Lesión ulcerativa traumática sublingual causada por la erupción del primer molar temporal: Reporte de un caso]
Dezan, C.C. and Walter, L.R.F. and Weber-Gasparoni, K. and Sangiorgio, J.P.M. and Nogari, B. and Fernandes, K.B.P.
International Journal of Morphology. 2011; 29(4): 1136-1138
15 Prevalence of oral abnormalities in a Turkish newborn population
Murat Çetinkaya,Firdevs Tulga Öz,Ayse Isil Orhan,Kaan Orhan,Baris Karabulut,Deniz C. Can-Karabulut,Özlem Ilk
International Dental Journal. 2011; 61(2): 90
[Pubmed] | [DOI]
16 Neonatal sublingual traumatic ulceration - case report & review of the literature
Makkada Yuvaraj Padmanabhan,Ramesh Kumar Pandey,Radharishnan Aparna,Valiyatharavath Radhakrishnan
Dental Traumatology. 2010; 26(6): 490
[Pubmed] | [DOI]
17 Natal and neonatal teeth | [Natálne a neonatálne zuby]
Kováč, J., Kováč, D.
Cesko-Slovenska Pediatrie. 2010; 65(3): 118-123
18 Neonatal sublingual traumatic ulceration - case report & review of the literature
Padmanabhan, M.Y. and Pandey, R.K. and Aparna, R. and Radhakrishnan, V.
Dental Traumatology. 2010; 26(6): 490-495
19 Deformity of the tongue in an infant: Riga-Fede disease
Eley, K.A. and Watt-Smith, P.A. and Watt-Smith, S.R.
Paediatrics and Child Health. 2010; 15(9): 581-582
20 Riga-Fede disease: A case report
Mathew, P., Austin, R.D., Ramya, K.
Journal of Neonatal-Perinatal Medicine. 2010; 3(1): 71-75
21 Child oral health - The role of paediatric dentists and paediatricians in early prevention of oral diseases | [Oralno zdravlje u djece - Uloga pedodonta i pedijatra u ranoj prevenciji bolesti
Škrinjarić, I., Čuković-Bagić, I., Goršeta, K., Verzak, Ž.
Paediatria Croatica, Supplement. 2010; 54(supp 1): 131-138
22 Deformity of the tongue in an infant: Riga-Fede disease
Eley, K.A., Watt-Smith, P.A., Watt-Smith, S.R.
Paediatrics and Child Health. 2010; 15(9): 581-582
23 Riga-Fede disease: A histological study and case report
Taghi, A., Motamedi, M.H.
Indian Journal of Dental Research. 2009; 20(2): 227-229
24 Sublingual traumatic ulceration (a Riga-Fede disease): report of two cases
Sung Chul Choi,Jae Hong Park,Young Chul Choi,Gyu-Tae Kim
Dental Traumatology. 2009; 25(3): e48
[Pubmed] | [DOI]
25 Sublingual traumatic ulceration (a Riga-Fede disease): Report of two cases
Choi, S.C., Park, J.H., Choi, Y.C., Kim, G.-T.
Dental Traumatology. 2009; 25(3): e48-e50
26 Riga-Fede disease
D. Jariwala,R. M. Graham,T. Lewis
BDJ. 2008; 204(4): 171
[Pubmed] | [DOI]
27 Riga-Fede disease
Jariwala, D., Graham, R.M., Lewis, T.
British Dental Journal. 2008; 204(4): 171


Print this article  Email this article
Previous article Next article


   Next article
   Previous article 
   Table of Contents
    Similar in PUBMED
 Related articles
    Article in PDF (504 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

    Case Report
    Article Figures

 Article Access Statistics
    PDF Downloaded1011    
    Comments [Add]    
    Cited by others 27    

Recommend this journal

Contact us | Sitemap | Advertise | What's New | Copyright and Disclaimer | Privacy Notice
 © 2005 - Journal of Indian Society of Pedodontics and Preventive Dentistry | Published by Wolters Kluwer - Medknow 
Online since 1st May '05