woman reading about enamel pearls

What's An Enamel Pearl? Not Tooth Jewelry!

An enamel pearl is a developmental defect that results in a nodule of enamel developing on the root of a tooth — where it doesn't belong! This anomaly can affect the health of the affected tooth and contribute to gum disease. Learn more about this abnormality and how it can be treated.


According to the University of Pittsburgh School of Dental Medicine, enamel pearls occur when remnants of Hertwig's epithelial root sheath, the collection of cells that form the tissue in the root of the tooth called the dentin, fail to separate from the newly created dentin and continue to secrete enamel. This prevents the normal root covering from forming, leaving a nodule of enamel instead. Most often, enamel pearls are detected by an X-ray.

Enamel pearls most commonly appear on the upper molars, but can be found on other teeth, according to a report inBiomedical Research. Their size can vary from 0.3 to 4 millimeters and they may affect 1.1 to 9.7 percent of the population. Routine X-ray evaluation should be done to make sure enamel pearls are detected early and receive proper treatment.


It's critical to detect the enamel pearl early, however, sometimes it may be mistaken for dental calculus, also known as tartar. If left untreated, it may cause gum and bone tissue destruction, inflammation and the development of periodontal pockets, which jeopardize the health and longevity of the tooth involved. The nodule of enamel can harbor plaque and lead to loss of theperiodontal ligament, the critical tissue structure that holds the tooth in place. If a patient has severe bone and tissue damage, tooth extraction may be the only option.

Once detected, the enamel pearl needs to be surgically removed to allow the patient and their dentist access to the area for proper plaque control. The dentist will use dental burs and files to remove it and after treatment is completed, the enamel pearl will not reappear.

Keep your pearly whites healthy by visiting your dentist for regular X-rays and cleanings. If you notice chronic inflammation, bleeding or discomfort despite good oral hygiene habits, contact your dentist right away. Proper evaluation and treatment by your dentist and dental hygienist can prevent this tooth anomaly from affecting your smile!

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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