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Enamel Hypoplasia: Causes & Treatment Options


A picture of what enamel hypoplasia is.
Enamel hypoplasia (EH) is a defect in tooth enamel that results in less quantity of enamel than normal. The defect can be a small pit or dent in the tooth or can be so widespread that the entire tooth is small and/or mis-shaped. This type of defect may cause tooth sensitivity, may be unsightly or may be more susceptible to dental cavities. Some genetic disorders cause all the teeth to have enamel hypoplasia.
A picture of what enamel hypoplasia looks like.
EH can occur on any tooth or on multiple teeth. It can appear white, yellow or brownish in color with a rough or pitted surface. In some cases, the quality of the enamel is affected as well as the quantity.

Enamel Hypoplasia: Causes


A picture of what the enamel hypoplasia causes are.
Environmental and genetic factors that interfere with tooth formation are thought to be responsible for EH. This includes trauma to the teeth and jaws, intubation of premature infants, infections during pregnancy or infancy, poor pre-natal and post-natal nutrition, hypoxia, exposure to toxic chemicals and a variety of hereditary disorders. Frequently, the cause of EH in a particular child is difficult to determine.

Treatment options depend on the severity of the EH on a particular tooth and the symptoms associated with it. The most conservative treatment consists of bonding a tooth colored material to the tooth to protect it from further wear or sensitivity. In some cases, the nature of the enamel prevents formation of an acceptable bond. Less conservative treatment options, but frequently necessary include the use of stainless steel crowns, permanent cast crowns or extraction of affected teeth and replacement with a bridge or implant.

Enamel Hypoplasia: Treatment Options


A picture of what the enamel hypoplasia treatment options are.
Treatment of teeth with enamel hypoplasia must be determined on an individual basis in consultation with the child’s pediatric or family dentist. The following treatment options are based on the available literature and the experiences of faculty members in our department and should be adapted to meet the needs of each patient.

References


•  Brook AH, Fearne JM, Smith J: Environmental causes of enamel defects. Ciba Foundation Symposium 205:212-221, 1997.
•  Koch MJ, Garcia-Godoy F: The clinical performance of laboratory-fabricated crowns placed on first permanent molars with developmental defects. JADA 131:1285-1290, 2000.
•  Li RW: Adhesive solutions: report of a case using multiple adhesive techniques in the management of enamel hypoplasia. Dent Update 26:277-287, 1999.
•  Murray JJ, Shaw L: Classification and prevalence of enamel opacities in the human deciduous and permanent dentitions. Arch Oral Biol 24:7-13, 1979.
•  Quinonez R., Hoover R, Wright JT: Transitional anterior esthetic restorations for patients with enamel defects. Pediatr Dent 22(1):65-67, 2000.
•  Rugg-Gunn AJ, Al Mohammadi SM, Butler TJ: Malnutrition and developmental defects of enamel in 2- to 6-year-old Saudi boys. Caries Res 32:181-192, 1998.
•  Seow WK: Enamel hypoplasia in the primary dentition: a review. ASDC J Dent Child 58:441-452, 1991.
•  Silberman SL, Trubman A, Duncan WK, Meydrech EF: A simplified hypoplasia index. J Public Health Dent 50:282-284, 1990.
•  Slayton, R.L., Warren, J.J., Kanellis, M.J., Levy, S.M. and Islam, M. Prevalence of enamel hypoplasia and isolated opacities in the primary dentition. Pediatric Dentistry 23:32-36, 2001.
•  Witkop CJ, Jr.: Amelogenesis imperfecta, dentinogenesis imperfecta and dentin dysplasia revisited: problems in classification. J Oral Pathol 17:547-553, 1988.

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