Enamel Hypoplasia, Hypomineralization and Teeth Effects

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Enamel hypoplasia (EH) is a developmental defect that can affect the primary and permanent teeth in one of two ways. It is sometimes identified as a physically missing tooth structure, and can be seen as pits, grooves or just missing parts in the crown of the tooth. Hypomineralzation, on the other hand, is a mere decrease in the mineral content of the enamel. It can be severe enough to give the tooth a translucent appearance or mild enough to maintain its opacity. It is hypomineralization that leads to soft enamel.

How It Forms

Teeth are formed with three highly mineralized and complex tissues: Enamel forms the outer layer of the tooth's crown, with dentin covering the inner layer of both the crown and underlying root. Cementum, another mineralized tissue, covers the dentin to form the inside of this root. The enamel of your tooth is the only visible portion, so although EH can produce developmental defects involving dentin and cementum, they are not usually noticeable at first relative to the case shown below.

Enamel hypoplasia

The Root Cause

In both your primary and permanent set, individual teeth develop at a different times. So there can be a spectrum of severity in the mouth based on teeth that either have enamel hypoplasia or just some minor hypomineralization, both of which raise one's risk for decay.

Because the formation of teeth hinges on genetic coding for proper development, inherited health problems in a small minority of the population can affect the entire dentition with EH. Systemic health issues that alter the metabolic process of enamel development can effect the teeth, as well. These issues include prenatal problems like maternal smoking, vitamin D deficiency and even preterm birth. In the event of a birth infection, diseases like the measles can also cause EH – particularly in the molars, according to the American Academy of Pediatric Dentistry (AAPD). Traditionally helpful chemicals can do the same thing – these include fluoride and the antibiotic tetracycline.

The Problem

Children with EH or hypomineralization can suffer from the same cosmetic issues, tooth sensitivity and increased risk for decay you can. So an early dental evaluation by your dentist or dental hygienist is perfectly appropriate. He or she will recommend fluoride applications, as well as remineralizing paste such as Colgate® Sensitive Prevent & Repair to decrease tooth decay. Teeth may also require repair with bonding, filling materials or crowns, especially if you or your child grinds at night. In this case, a nighttime mouthguard will be necessary to prevent excessive tooth wear.

Ultimately, homecare is a must. Kids need great oral hygiene now to keep EH under control later. With great toothpaste, toothbrushes and rinses, however, this shouldn't be a problem.

Image source: Inside Dentistry

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