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Enamel Hypocalcification: Definition, Causes, and Treatment

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Medically Reviewed By Colgate Global Scientific Communications

Calcium plays an important role in your oral health. This mineral strengthens your tooth enamel — the outer shell that defends against cavities and decay. But what happens when your enamel does not have enough calcium? Find out more about hypocalcification and its causes and treatments.

What Is Hypocalcification?

Hypocalcification occurs when your tooth enamel contains an insufficient amount of calcium. This insufficiency causes your enamel to be thin and weak. Hypocalcification also gives your teeth an opaque or chalky appearance and can lead to white, yellow, or brown discoloration.

The weakened enamel puts your teeth at greater risk for decay, making your teeth more prone to cavities and erosion. You also might experience more sensitivity to hot and cold foods and beverages.

Hypocalcification vs. Hypoplasia

Hypocalcification and hypoplasia both impact your teeth's enamel. However, hypoplasia describes enamel that is hard but thin and deficient in quantity, usually caused by genetics or exposure to certain substances while the teeth are developing. Hypocalcification describes enamel that is soft and undercalcified but normal in quantity.

What Causes Hypocalcification?

Enamel hypocalcification usually results from two factors — excessive acidic conditions in the mouth or a genetic defect.

  • Acidic conditions. Plaque is a sticky, colorless biofilm that's always forming on your teeth. It feeds on the sugars and starches in your food and releases acid that attacks your enamel. With poor oral care, acid from plaque combined with acid from your diet can break down the calcium in your enamel, causing hypocalcification.
  • Genetic conditions. An inherited dental condition called Amelogenesis imperfecta can also lead to hypocalcification. The National Organization for Rare Disorders estimates that about one in 14,000 to 16,000 American children has amelogenesis imperfecta. With this rare disorder, tooth enamel does not develop normally in primary or adult teeth due to the malfunction of certain proteins. This results in enamel that is soft and easily worn away.

How Do You Treat Hypocalcification?

If you notice chalky or creamy spots on your teeth, see your dentist as soon as possible. Hypocalcification requires immediate attention to prevent tooth decay. When acid attacks are the cause of calcium loss, the treatment depends on your case's severity.

Treatment for mild cases starts with establishing a proper oral care routine. This includes brushing with fluoride toothpaste for two minutes twice a day, cleaning between teeth with floss or an interdental device, and scheduling regular oral exams with a dental professional. It also means adjusting your diet to avoid sugary and acidic foods. Additionally, your dental professional might recommend pastes, creams, and fluoride treatments to encourage remineralization. For more severe cases where hypocalcification has led to decay, restoration work might be required.

For amelogenesis imperfecta patients, hypocalcification cannot be cured, but dentists can provide artificial replacements for the unhealthy enamel. Full crown restorations or specialized dentures for defective teeth can cover and protect the inner tooth, preventing decay and relieving the tooth sensitivity patients with this condition often experience.

Tooth enamel provides the best protection for teeth, and losing calcium sends a warning signal that the enamel is becoming weaker. If a dentist can catch the problem in time, they can stop it from developing into something more serious. If you notice chalky spots or patches on your teeth, book an appointment with your dentist to have them checked out and treated and ask for advice on preventing them from reoccurring.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider. 

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