Enamel Hypoplasia

Enamel (outer layer of tooth) is formed at various developmental periods depending on which tooth.  For baby teeth, enamel is formed in utero and can be affected by anything that occurs to the mother’s physiology during pregnancy.  For permanent teeth, enamel starts forming at birth.  The development of enamel can sometimes be disturbed by infection, health problems, medication, or trauma.  When this occurs, the tooth can erupt with either discolorations or defects (little chips or uneven edges).  These imperfections are called enamel hypoplasia and can vary in severity.

Hypoplastic front teeth often pose cosmetic problems while hypoplastic back teeth usually present with exaggerated sensitivity.  In addition, because enamel is more porous on these teeth, decay tend to develop easily and spread rapidly.  Countless times I have seen back molars that already have huge holes in them even though they have only erupted six months ago.  There was even one time when I had to extract a permanent molar on a 8 year old because the tooth was soft as chalk and so broken down that there wasn’t enough structure to place a crown on it.

Very mild hypoplasia can be corrected by microabrasion, a technique where a polisher is used to remove the discoloration.  For teeth that are moderately hypoplastic, composite fillings can be used to replace the defected area.  Teeth that are severely hypoplastic often need to be restored with crowns so that all the surfaces can be protected against decay and fracture.




Mild hypoplasia on front teeth, notice the chalky white/yellow color



Moderate hypoplasia.  In this case there is a clear defect that already has decay in it.  Unfortunately if not treated this cavity will get larger very fast.




Severe hypoplasia on a back molar.  This tooth is likely to be very sensitive to cold and chewing.  Defects this large and severe should be restored with a crown.



If you have any questions regarding enamel hypoplasia, please contact me at my Las Vegas pediatric dental office .