Enamel hypoplasia is an enamel defect that affects the amount of enamel in teeth, which causes the missing of enamel in severe cases. It is the teeth defect that has to do with both hereditary and environmental causes.

The process of teeth development in early ages of children with enamel hypoplasia is disturbed. Enamel is the hardest part of teeth that coats the teeth. Ameloblasts are cells responsible for the formation of enamel. Sometimes, problems happen during the activity of ameloblast cells. These problems can affect the enamel in its calcification, mineralization, and maturation of the structure of enamel.

Both primary and permanent teeth in children can be at risk of enamel hypoplasia. There are two types of enamel defects: enamel hypoplasia and hypomineralization.

If the problem is from the enamel of the tooth and the level of enamel, this is when hypoplasia has occurred. If the problem is from the mineral level in the tooth, we are faced with hypomineralization.

In mild cases, enamel hypoplasia can appear as chalky white spots.

What are the signs and symptoms?

The most common signs of enamel hypoplasia are white, yellow, and brown discoloration on teeth. Other symptoms can include pits and grooves on the surface of enamel in teeth. Usually, the crown of teeth has lines around it and stain of teeth can occur.

At what age children are at risk of enamel hypoplasia?

Infancy is a sensitive period. Enamel hypoplasia is the enamel defect that can have hereditary causes. Therefore, it can appear in infants from birth to 1 year of age. When babies are 2 years old, enamel hypoplasia continues to develop. Children may suffer from this condition as they age. This is why early examination of teeth is important. Parents should have their children’s teeth checked for any signs of tooth problems to target the defect with treatment options. 

Which teeth are mostly affected by enamel hypoplasia?

First molars and incisors are the most affected teeth by hypoplasia. If it is caused by environmental factors, premolars, upper and lower incisor teeth cannot be safe.  

What are the causes of enamel hypoplasia?

Children who are born prematurely and those children with lower birth weights are at higher risks of primary teeth enamel hypoplasia. The main causes are:

  • Vitamin and nutritional deficiencies. Vitamins A, C, and D are important vitamins in preventing enamel hypoplasia. Also, deficiencies in minerals like phosphorus and calcium can result in hypoplasia.
  • Tooth injuries. Injuries to teeth like primary teeth can cause problems in the development of permanent teeth. For example, dental injuries that have resulted in tooth dislocation can interrupt matrix development and the calcification stage of the teeth.
  •  Dental fluorosis. Dental fluorosis is a dental condition caused by a high amount of fluoride intake. If there is too much exposure to fluoride in infants, enamel hypoplasia can happen. Parents should be careful about fluoride consumption of their babies when they are 18 months to the time children reach 3 years of age.
  • Brain damage or neurologic causes. Children with mental disabilities and lower levels of intelligence are at higher risk of enamel hypoplasia. Also, children with brain disorders like cerebral palsy are more prone to this enamel defect.
  • Other causes. Syndromes, cleft lip and palate, and severe allergies are some more factors that cause enamel hypoplasia. Children who experience high frequencies of radiotherapy and chemotherapy during their teeth formation are also at risk. Due to exposure to radiation during their teeth maturation, hypoplasia can affect their teeth.

Treatment of enamel hypoplasia

If the problem is not very serious, teeth with enamel hypoplasia can be treated with composite resin bonding. Veneering is also another treatment choice for affected enamel defects. Polishing and contouring can improve the appearance of teeth significantly.

In severe cases, crowning especially full coverage crown is a treatment option for this enamel condition.      

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