What causes pitted and defective enamel?
The tooth’s enamel is the hard, protective outermost layer which is externally visible. Enamel hypoplasia is a condition where there is a defect of the enamel. The condition only occurs to teeth which are still developing. Both baby and permanent teeth can be effected. Enamel hypoplasia causes thin enamel and can make the teeth more prone to decay and visible defects. The condition often causes white spots, pits, and visible grooves on the enamel.
While the enamel is the hardest substance found in the body, it does not contain living cells. As a result, it cannot repair itself or regrow. Children with enamel hypoplasia should follow up with their dentist. The dentist will evaluate the teeth and monitor the issues to determine if intervention or treatment is needed.
Symptoms
While some signs of enamel hypoplasia are quite apparent, others are less obvious and may not be noticeable until there are serious dental issues. Thin enamel can result in the following issues:
* pits, groves, and fissures
* white spots
* stains or discoloration
* hot and cold sensitivity
* misalignment or abnormal wearing of the teeth
* susceptibility to acids from food and beverages
* accumulation of plaque and bacteria
* higher risk for tooth decay and cavities
Causes
Defective enamel development can be caused by an inherited condition called amelogenesis imperfecta, or congenital enamel hypoplasia. In the United States, this condition affects about 1 in 14,000 patients. The condition can cause abnormally small teeth and other types of dental issues. It is possible for congenital enamel hypoplasia to occur independently or in addition to another syndrome.
Enamel hypoplasia can be caused by the following prenatal issues: maternal vitamin D deficiency, maternal weight gain, smoking, drug use, inadequate prenatal care, and a premature birth or low birth weight.
Some of the environmental factors and issues in infancy which can cause enamel hypoplasia include the following:
* tooth trauma
* infection
* calcium or vitamin deficiency
* jaundice
* celiac disease
* cerebral palsy
Treatment
Early screening and a diagnosis are vital in treating the condition. This is one reason that a child’s first dentist appointment should occur within their first year of life. The treatment plan will vary based on the severity of the issue. Treatment is performed in order to prevent tooth decay, maintain good alignment, and to preserve the teeth.
Smaller defects which do not cause decay or sensitivity may not require immediate treatment. In some cases, the defects may just be superficial. The teeth will still need to be monitored to ensure the teeth at not at risk for decay or other issues. In most cases, the dentist will apply a topical fluoride to protect the teeth.
Common treatment solutions used to resolve pits or damaged enamel include the following:
1. Resin-bonded sealant
2. Resin-based composite fillings which can closely match the color of the teeth. This is often used on the front teeth
3. Dental amalgam fillings. This treatment is made from a combination of durable metals, but because of the silver color is not used on the front teeth.
4. Gold fillings. A gold filling is quite durable, but is not natural in its appearance and is quite expensive.
5. Crowns which cover the natural tooth
6. Enamel microabrasion is a minimally invasive procedure used to improve the teeth’s appearance
7. Professional whitening