Enamel Hypoplasia Causes Symptoms and Treatment

Enamel Hypoplasia

Enamel hypoplasia is defined as an incomplete or defective formation of the organic enamel matrix of the teeth in the embryonic stage of the tooth.

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There are 2 basic types of enamel hypoplasia and they are:

1. Hereditary type enamel hypoplasia. This is an ectodermal disturbance that occurred during the embryonic development of the enamel. The mesodermal components are normal. Both the deciduous and permanent teeth are involved and only the enamel is affected. The 3 types of hereditary type of enamel hypoplasia are a) Hypoplastic type, where there is defective formation of organic matrix. b) Hypocalcification type in which there is defective mineralization of the matrix. and c) Hypomaturation type where there is defective maturation of the matrix.

2. Environmental type enamel hypoplasia. This is caused by the environmental factors that causes damage to the enamel cells. Either deciduous or permanent teeth are involved and sometimes a single tooth is involved. Here both the enamel and the dentin are involved in varying degrees. The environmental factors which produce enamel hypoplasia are:

a. Nutritional deficiency, includes vitamins A, C, and D.

b. Exanthematous diseases (skin diseases) such as measles, chickenpox, scarlet fever etc.

c. Congenital syphilis.

d. Hypocalcemia.

e. During birth, such as birth injury, prematurity, Rh hemolytic disease etc.

f. Local infection or trauma.

g. Ingestion of chemicals such as fluoride etc.

h. Unknown causes.

Features Of Enamel Hypoplasia

There are many distinct features that are seen in cases of enamel hyperplasia. The signs of enamel hypoplasia are seen when they erupt in the mouth. The usual features of Enamel hypoplasia are:

1. Enamel that has not formed to a full thickness. The enamel is soft and thin that are chipped away more easily from the underlying dentin.

2. The crowns of the tooth may show discoloration such as white spots or cloudy opacities, that varies depending upon the type of the disorder ranging from white, yellowish white, to brown.

3. Hypoplasia due to congenital syphilis, the front teeth is characterized by a screw driver shaped, also known as Hutchinson's teeth and the posterior teeth is referred to as mulberry molars with a barrel shape.

4. The hypoplasia seen due to local infection or trauma during the tooth formation exhibits mild brownish discoloration of the enamel to severe pitting and irregularity of the tooth crown, it may involve single tooth referred to as Turner's Teeth.

5. When ingesting excessive fluoride containing drinking water during the time of tooth formation results in mottled enamel characterized by occasional white flecks or spotting of the enamel. It ranges between whitish flecks and white opaque areas to areas showing pitting and brownish staining on the enamel surface. These teeth have a tendency to wear or fracture.

Treatment for Enamel Hypoplasia

Sometimes enamel becomes stained with a brown color and so for cosmetic reasons, the affected tooth is bleached with an agent such as the hydrogen peroxide, the procedure is done periodically since it can recur. When an area is affected by caries, the enamel might crumble as the enamel is weaker in those areas. The decayed portion of the tooth may be filled with a tooth colored cement. If the cavity is advanced or extensive, it may need a bigger permanent restoration such as crowns, onlays etc.