Enamel hypoplasia and hypomineralization are two complications that affect the way a tooth’s enamel forms. Both occur as a result of an incident during the enamel’s formation period. Over a hundred different causes have been found to result in either hypoplasia or hypomineralization, although some are much more common than others. Second primary molars are the teeth most commonly affected by both of these conditions. They usually first appear after two years of age.
Enamel hypoplasia means that a tooth or teeth have less enamel than is normal. The enamel that the teeth do have is hard and healthy, but there is not enough of it to fully protect the teeth. This deficit usually occurs in certain portions of certain teeth (not all the teeth) and can result in denting or “cupping” on the surface of the teeth. Most people are first made aware of their issues with enamel hypoplasia when they notice a pit on the surface of their tooth. Enamel is also what helps to make teeth smooth. For this reason someone with hypoplastic teeth might notice the surface of their teeth feeling rough. In the very severest of cases, the tooth will have absolutely no enamel at all, and instead the surface layer will consist of dentin.
Hypomineralization of a tooth occurs when the enamel of a tooth hasn’t mineralized as much as a healthy tooth. This means the enamel is more porous and accordingly more susceptible to breaking, wearing down or decay. This is because the texture of hypomineralized enamel is often rough and can catch food, bacteria or plaque more easily. Hypomineralized teeth look mottled, with opaque whiteness or yellow or brown spots. Many cases of hypomineralization occur as a result of overexposure to fluoride in the crucial developmental years between ages 1 and 4. If the overexposure has come from fluoride supplements, foods or bottled water than the hypomineralization can have some serious effects and require restorative treatment. However, the majority of hypomineralization cases that are caused by public water fluoridation only have aesthetic side effects (e.g. white spots on teeth).
Some common causes of hypomineralization and hypoplasia are infections contracted in early childhood and direct trauma. The reason being that the enamel of toddlers and young children’s teeth has not yet calcified and is more vulnerable to developing these conditions. Depending on the severity of the condition hypomineralization and hypoplasia can either be treated with a surface sealant or a crown to protect the tooth’s dentin. In very severe cases the tooth is extracted because it cannot be saved. Too many restorative procedures on an already weak tooth can cause it to become useless, and instead removing and completely replacing the tooth is a better option.
Checking for signs of an enamel condition can be done at home. Does your child have spots of white, yellow or brown on their teeth? Do they complain of sensitivity and pain? Taking them to the dentist to have this looked at could save their smile! Call Dr. Bosse of Greenspoint Dental and schedule an appointment today.