What is Enamel Hypoplasia?

Enamel Hypoplasia can be a lifelong condition that patients continue to treat or a major problem that requires fillings, crowns, and even tooth extractions. To understand the cause of enamel deficiencies and how to treat and prevent them, you need to know how your enamel works and why it doesn't always form correctly. Keep reading to learn more about Enamel Hypoplasia and how dentists treat it.

What Is Tooth Enamel?

Enamel is the hard, protective covering on the outside of your teeth. It is the hardest part of your body and works like a suit of armor protecting the soft and sensitive areas. It's because of enamel that you're able to eat a bowl of hot soup or enjoy ice cream in the middle of summer without your teeth experiencing pain. This protective coating also fights against physical attacks on the teeth, like biting down on hard candy and ice cubes.

Unfortunately, tooth enamel is almost 90% mineral, which dissolves in acidic environments like our mouths. When we eat highly acidic foods like fruit or candy -- not to mention soda -- the bacteria in our mouths turn it into lactic acid, which can wear away enamel. Once your protective layer of enamel is gone, if can't grow back, which is why so many dentists emphasize good oral hygiene from a young age to keep the suit of armor strong.

However, kids and adults don't always end up with the right amount of enamel on their teeth, and can suffer from Enamel Hypoplasia. This article will focus primarily on its causes, effects, and treatment.

What is Enamel Hypoplasia?

What is Enamel Hypoplasia?

Image via Flickr by ayes

Hypoplasia is an enamel deficiency that leaves the teeth vulnerable to damage and decay. It often takes the form of grooves, pits, or lines within teeth, either across the surface or in certain spots. Depending on the severity, Enamel Hypoplasia can look like a small dent in the tooth, or take up several teeth throughout the mouth. There can be localized discoloration, or the entire tooth can turn a dark brown color. This can make the mouth incredibly sensitive, especially for toddlers that are just learning to communicate how they feel.  

While Enamel Hypoplasia can occur in both baby and adult teeth, it's often developed before the age of three. As the baby teeth are growing, the enamel is still soft and weak, creating opportunities for damage early on. Two types of causes are attributed to Enamel Hypoplasia: hereditary and environmental.

Hereditary Enamel Hypoplasia

Often genetic Enamel Hypoplasia means that both the baby teeth and the adult teeth will be affected. The hereditary defects mean that the enamel is missing one of the three critical developmental phases: formation, mineralization, and maturation. When the creation process is unable to develop completely, the enamel is either brittle and susceptible to cracks, or soft and easy to wear down. In the case of a hereditary condition, the parents and the children have no way to prevent Enamel Hypoplasia, and will have to treat the tooth or teeth as they start coming in and showing signs of malformation.

Environmental Enamel Hypoplasia

In most cases, Enamel Hypoplasia is somewhat preventable if it's the result of environmental factors in the infant's development and youth. According to the European Council on Pediatric Dentistry, environmental factors during early childhood can affect baby teeth, permanent teeth, or both. These events occur in the womb, during delivery, and in the months following birth. A few causes of Enamel Hypoplasia include:

·   Malnutrition and vitamin deficiencies, particularly vitamins A, C, and D

·   Bacteria and viral Infections like syphilis, measles, chickenpox, and other illnesses that cause a high fever.

·   A prolonged delivery, prematuritγ, birth injury, or low birth weight

·   Infections that result in long-lasting diarrhea and vomiting

Some of these causes occur outside of the womb, but the problem can also develop before the baby is born. If the mother suffers from malnutrition or becomes ill with a high fever, she is at risk of causing enamel hypoplasia in the infant when they're born. Certain infections when carrying can also cause this deficiency.

However, even perfectly healthy infants can suffer from Enamel Hypoplasia as a result of trauma to the newly developed teeth or mouth. Intubated infants that require surgery could experience trauma to their developing teeth and experience soft or malformed enamel when their baby teeth start to come in.

Treatment for Enamel Hypoplasia

The treatment process for enamel hypoplasia varies depending on the severity of the condition and the age of the child. For light cases where there is only mild discoloration, dentists might suggest bleaching the affected tooth to make it appear white next to its healthy counterparts. Some patients may need to have their teeth regularly bleached  with hydrogen peroxide after the initial treatment fades.

For more serious problems, like visible pits or decay, the dentist might drill out the affected areas and fill in the cavities. This will reduce sensitivity and pain if the Enamel Hypoplasia is only located in a small part of the tooth, but won't completely solve the problem if the entire tooth is affected. In that case, the dentist might recommend a more permanent solution, as the addition of a crown or onlay.

In advanced cases, the tooth may need to be removed altogether and replaced with a bridge or dental implant. The purpose of the dental implant is to prevent other teeth from shifting to bridge the gap to aid chewing, resulting in a crooked smile.

Enamel Hypoplasia Prevention

One of the most important factors in treating Enamel Hypoplasia is catching it early. It's better for the dentist to spot a sensitive area or fill a small cavity early on than to remove the whole tooth due to extensive decay.

As many cases of Enamel Hypoplasia are caused by malnutrition, the addition of Vitamins A and D can assist in strengthening developing teeth. Patients can either take vitamin supplements or increase their consumption or milk, orange juice, and green leafy vegetables.

For many patients, Enamel Hypoplasia is a lifelong condition where they constantly have to maintain good oral hygiene to prevent further decay. Dentists may require patients to come in for additional cleanings throughout the year and require professional toothpaste and brushes. Like many other oral diseases, proper hygiene and a regular treatment plan are all it takes for patients to reduce discomfort and eat whatever they want.

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